Management of oncological emergencies on the acute take

Abstract

In 2008, recommendations from the National Confidential Enquiry into Patient Outcome and Death identified large variations in the quality and safety of delivery of systemic anti-cancer therapy. In 49% of cases it was felt there was room for improvement and in 27% of cases treatment actually caused or hastened death. Every hospital with an emergency department and/or specialist oncology beds should therefore have a fully functioning acute oncology service to align acute oncology with urgent care. Many patients will still present via the acute take and therefore acute physicians need to be aware of the role of the acute oncology teams and management of oncology emergencies. This article discusses the role of the acute oncology team, management of acute oncology emergencies, namely neutropenic sepsis, metastatic spinal cord compression and superior vena cava obstruction, and important points for acute teams to consider.

A ressonância magnética faz diferença no manejo do paciente oncológico admitido na emergência?

“…12 MRI examination was used for patients in all age groups, including the pediatric population, which reflects the intrinsic advantages of this imaging modality and greater awareness of the risks associated with radiation exposure. [13][14] As 66.6% of the MRI examinations reviewed in this study yielded positive results, we consider MRI to be good option for the evaluation of urgent and emergent oncological cases; traditional barriers to emergent MRI are being overcome with simplified imaging protocols and new rapid acquisition sequences. 15 The main positive MRI findings in our sample were neurological, spinal, and abdominal/pelvic.…”

“…7 Oncological emergencies are the results of acute conditions caused by cancer or its treatment; they require rapid intervention, as they entail imminent risk of death or serious permanent damage. 19 Emergent surgeries have worse prognoses than do elective surgeries, but they should not be avoided or delayed when immediate intervention is needed in patients with cancer, even those with active disease. 20 Over a 7-day period, most (53.6%) patients were discharged from the hospital.…”

“…22 In addition, certain subgroups of patients such as pregnant women, children or young individuals who require long-term imaging tests, as in the case of cancer patients, the risks of radiation increase, MRI being a tool increasingly used in these situations. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] This study has some limitations. First, due to its retrospective nature, it may have been affected by selection bias.…”