‎‎Fever +/- neutropenia is a medical emergency

Clinical pathway:

Practice Guidelines for Fever +/- Neutropenia patients (PDF)

Fever and neutropenia

Definition:

Fever: oral or temporal temperature ≥38.5°C or axillary temperature ≥ 38.0°C

Neutropenia: ANC <0.5 x 10⁹/L

Triage:

We recommend that the BC Children's Clinical Pathway be followed and the recommendations for empiric antibiotic use be implemented. (Caveat: individual hospital infection control policy may dictate other treatment based on their own antibiotic sensitivity profile).

The treating pediatric oncologist (after hours, the oncologist on call) should be notified when a child on active anticancer therapy develops a fever and neutropenia.

Please notify BC Children's Hospital

Weekdays (8am-4pm):

Oncology Clinic: 604-875-2345 ext 7079

After hours, weekends, and stat holidays:

Oncologist on call: 604-875-2161

Fever, non-neutropenic patients:

All children with central lines require blood cultures with new febrile episodes. If the patient is clinically well, caregivers are reliable, and there are no focal infections requiring treatment, empiric antibiotic therapy is not required.

‎BC Children's resources

• C & W online Formulary Pediatric Drug Dosage Guidelines
• SHOP (electronic Policies, Order Sets, Procedures and Standards) is the website for BC Children's and Women's clinical support documents
• Family Library search our collection of print books, eBooks, CDs and DVDs, games, and teaching tools on health topics.
  

BC Children's chemotherapy/biotherapy policies

• Medication Administration Hazardous Drugs including Chemotherapy & Biotherapy (PDF)
• Personal Protective Equipment (PPE) (PDF)

Central line care

• Central Line Videos for Nurses
• Central Venous Line (CVL) Dressing Change (PDF)
• Heparin Locking CVL (PDF)
• Changing the Needleless Connector on a CVL (PDF)
• Accessing, Dressing and De-Accessing an Implanted Port (PDF)
• Assessment and Vascular Care Chart (PDF)

• APHON Patient & Family Resources
• National Cancer Institute
• BC Cancer - A comprehensive cancer control program for B.C.
• Children's Oncology Group
• St Jude Cure4Kids - Cure4Kids is an online education resource for healthcare professionals
• U-Link Canada - Available clinical trials within Canada; can also assist families with support for travel and accommodation costs when accessing clinical trials outside of local treatment centre.