Telephone Triage Guidelines - St. James's Hospital

HAEMATOLOGY ONCOLOGY TELEPHONE TRIAGE GUIDELINESINFECTIONACTION: ANY GRADE OF INFECTION (NEUTROPENIA)Patients must be assessed immediately and urgently by clinical staff withexperience of handling neutropenic patients.SIGNS OF INFECTION IN NEUTROPENIC PATIENTSMay include any of the following Pyrexia > 37.5°C on a single reading or < 35°C Rigor or other signs of fever (cold, sweating, shivering) Any signs of infection (sore throat, cough, urinary symptoms, skin lesions) Diarrhoea Any unexplained clinical deterioration, even in the absence of fever. Unexplained abdominal pain Feeling dizzy Other concerns/symptomsFocal signs of infection may or may not be presentIf the patient is apyrexial but symptomatic – has the patient any of the following symptoms: Shortness of breath Cough Rigors Nausea &/or vomiting Diarrhoea Sore throat / ulcers / oral thrush Pain on passing urine Central venous catheter infection Confusion (may be noticed more by carer?)Refer to relevant symptom management section within these guidelines.Note: Patients with CLL not on treatment may be lymphopenic. Please check lastlymphocyte count and discuss with haematology doctor or CNSHOPe Directorate, St. James‟s Hospital V2 20125