sepsis and feb neut

Hi.

Today we chatted about the spectrum that is SIRS, SEPSIS, SEVER SEPSIS and SEPTIC SHOCK,  including the principles of GOAL DIRECTED THERAPY, and source control. 

Here is the seminal Rivers Trial. 

We also discussed Febrile neutropenia (fever>38.3 once, or persistent >38.0) and neutrophil <0.5

The key points beings examine the patient "gum to bum" as mucositis is the most likely cause of infection. Thorough investigation should be sent including cultures.

Yet in 30-40% of 'feb neuts' no infection is discovered.

They should be treated with broad spectrum AB as per hospital protocol.

LHSC protocol is Pip tazo.

There are some stable patients that can be sent home. Here is an article outlining criteria for Low risk feb neuts that can be managed as an outpatient. 

Happy hump day.