Neutropenic sepsis is a leading cause of cancer patients’ mortality across the globe. The early detection of the disease is essential for quick management and prevention of untimely convalescent deaths. Various studies have been conducted to determine the most efficient protocols and treatment pathways to manage neutropenic sepsis. Researchers have recommended early detection techniques, such as use of risk stratification medical tools, monitoring cancer patients’ temperature, and door to needle intervention within one hour of patient admission. Additionally, researchers recommend administering intravenous antibiotics immediately a patient shows acute symptoms of the disease. Moreover, different medical entities and interest groups, such as the Intensive Care in Hematologic and Oncologic Patients and the Working Party of the German Society of Hematology and Medical Oncology have devised management guidelines for neutropenic sepsis. The extensive analysis of available research on neutropenic sepsis in cancer patients shows techniques to manage the disease effectively through early detection of its symptoms.
Neutropenic sepsis can be detected early if oncology departments in hospitals are committed to the cause and to reduce mortality rates propelled by the disease. Firstly, all hospitals should have a neutropenic sepsis acute care unit that handles patients with the disease only. The units should be equipped with emergency medication for treating neutropenic sepsis before it develops to septic shock, which is highly fatal ( Wells et al., 2015) . Further, all medical staff, regardless of their medical background, should be trained to identify symptoms of patients with neutropenic sepsis and protocols to use to administer emergency care. All cancer patients should also be trained to self-monitor for sepsis symptoms while at home, such as fever of 38 degrees and above ( Warnock et al., 2018) . Furthermore, nurses should be allowed to administer emergency antibiotic to patients intravenously within one hour of admission, even without the supervision of a physician.
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Moreover, when patients report to medical facilities with symptoms of neutropenic sepsis, they should be subjected to risk stratification checks to avoid unnecessary hospitalization. If a patient exhibits low risk sepsis, they should receive intravenous antibiotic treatment within 24 hours and then be discharged the next day ( Forde & Scullin, 2017) . However, if an oncology patient has high risk neutropenic sepsis, they should be hospitalized and held for observation for over 48 hours. In acute cases, patients with the disease should be admitted to intensive care unit and any intravenous device on them should be removed until they stabilize. Further, the patient with neutropenic sepsis who is allowed to take oral antibiotics should be discharged and then monitored closely through telephone by oncologists ( Kleinpell, 2017) . Patients should have emergency numbers they can dial if they feel unwell and start having high temperatures, which is a prerequisite to early detection and management of neutropenic sepsis.
Finally, interest groups, such as the Working Party of the German Society of Hematology and Medical Oncology and Intensive Care in Hematologic and Oncologic Patients have provided guidelines for the early detection and management of neutropenic sepsis. According to the entities, patients should receive emergency surgery if necessary to eliminate the sepsis source ( Kochanek et al., 2019) . Further, the entities recommend the use of blood purification techniques to treat neutropenic sepsis and constant monitoring of patients’ blood glucose. Furthermore, for the medical bodies identified, oncologists may use high flow nasal cannula to treat sepsis patients. Moreover, the above entities mention that there exists limited research showing the effectiveness of managing neutropenic sepsis using intravenous immunoglobulins, even though the technique should be used cautiously. Therefore, neutropenic sepsis can be detected early and managed effectively in cancer patients, as discussed.
References
Forde, C., & Scullin, P. (2017). Chasing the golden hour – Lessons learned from improving initial neutropenic sepsis management. BMJ Quality Improvement Reports , 6 (1), 1-8. https://doi.org/10.1136/bmjquality.u204420.w6531
Kleinpell, R. (2017). Promoting early identification of sepsis in hospitalized patients with nurse-led protocols. Critical Care , 21 (1), 1-3. https://doi.org/10.1186/s13054-016-1590-0
Kochanek, M., Schalk, E., Von Bergwelt-Baildon, M., Beutel, G., Buchheidt, D., Hentrich, M., Henze, L., Kiehl, M., Liebregts, T., Von Lilienfeld-Toal, M., Classen, A., Mellinghoff, S., Penack, O., Piepel, C., & Böll, B. (2019). Management of sepsis in neutropenic cancer patients: 2018 guidelines from the infectious diseases working party (AGIHO) and intensive care working party (iCHOP) of the German Society of Hematology and medical oncology (DGHO). Annals of Hematology , 98 (5), 1051-1069. https://doi.org/10.1007/s00277-019-03622-0
Warnock, C., Totterdell, P., Tod, A. M., Mead, R., Gynn, J., & Hancock, B. (2018). The role of temperature in the detection and diagnosis of neutropenic sepsis in adult solid tumour cancer patients receiving chemotherapy. European Journal of Oncology Nursing , 37 , 12-18. https://doi.org/10.1016/j.ejon.2018.10.001
Wells, T., Thomas, C., Watt, D., Fountain, V., Tomlinson, M., & Hilman, S. (2015). Improvements in the management of neutropenic sepsis: Lessons learned from a district General Hospital. Clinical Medicine , 15 (6), 526-530. https://doi.org/10.7861/clinmedicine.15-6-526
