nhs forth valley formulary 11 - Community Pharmacy

Forth Valley Formulary Eleventh Edition 2012/13Appendix 17Neutropenic sepsis is a life-threatening medical emergencyManagement of Unwell Patients Receiving ChemotherapyPatient complains of feeling unwellALL PATIENTS WITHIN 28 DAYS OF CHEMOTHERAPY SHOULD HAVE A PHYSICALASSESSMENT UNLESS SITUATION CONSIDERED IMMEDIATELY LIFE-THREATENINGYES2 OR MORE OF THE FOLLOWING PRESENT?• Temp>38ºC OR 20BPM• Altered Mental StatusNoTemperatureYES >38ºC? NOCheck UrgentFBC*Manage as ClinicallyAppropriateRefer toAcuteMedicalReceivingTeam,FVRHNeutrophils< 1 x 10 9 /L* See guidance on obtaining urgent FBCNeutrophils>1 x 10 9 /LReview and repeat FBC dailyuntil clinical improvement. Ifsubsequent neutrophil < 1 andstill unwell arrange admissionunder acute medical receivingteamObtaining an urgent FBC after the last lab van collection1.Call FVRH switchboard on 01324 566000 and request that switchboard organisesa contract taxi to collect an urgent blood sample, giving the address of thepick-up point and making sure the sample goes to FVRH. (Switchboard has beengiven financial code V79110-4640 to cover the taxi cost).2.Contact the on-call haematology technician (through FVRH switchboard 01324566000) to inform them that an urgent sample is on its way and giveinstructions on who to call with the result.3.Ensure that the details of who to phone with the result are also clearly marked on the lab form.4. If the result is to be given to the out of hours service, please phone the out of hours hub after 5.30 pm on01324 616138 to warn them to expect the result.5. Ensure that relevant clinical details are also posted on ‘Taycare’ special notes.Written April 2010. Reviewed by Paul Baughan, Marie Hughes, Joanne Robinson, Vicky Chisolm, Fiona Galbraith,Sheila Kowalczyk, Duncan Lamont, Mary Orzel, Karen MacLure. Updated June 2011. Review June 2013Page 85