Telephone Triage Guidelines - St. James's Hospital

HAEMATOLOGY ONCOLOGY TELEPHONE TRIAGE GUIDELINESMUCOSITISASKACTIONGrade 1 & 2: Painless ulcers, Erythema. Mild soreness in absenceof lesions.Offer support, education and follow up asnecessary Advice on relevant mouth care andfrequency required. (Use soft toothbrushat least 4 times daily, brush tongue,avoid alcohol based mouthwashes, howto keep mouth moist, etc.) Arrange for prescription for BMX ifnecessary. Encourage good oral intake of fluids andsoft diet. Check if patient has oral Candida. Arrange for review and prescription ofantifungal medication.If post transplant, neutropenic orlymphopenic discuss with haematologydoctor and CNS as ulcers may be viral andantiviral treatment may need to beincreased.Encourage patient to contact department oftreatment within working hours ifsymptoms persist, or become worse.Grade 3: Evidence of dehydration Unable to eat or drink for24 hours Treatment change noteffective within 6 hours Whitish covering of oralmucosaRequires medical attention within the next24 hoursGrade 4: ? Temperature >38C Unable to drink fluids Respiratory distress Bleeding from oral mucosa Pain not controlled bycurrent analgesia Blistered or crackedtongueHOPe Directorate, St. James‟s Hospital V2 2012Seek immediate medical attentionPatient to attend HODC/WSW/DBU/A&Efor assessment +/- admission19