OVERVIEW

Managing Patients with Oncologic Complications in the Emergency Department (Pharmacology CME) is organized by EB Medicine.

Date of Original Release: January 01, 2018
Date of most recent review: December 10, 2017
Termination date: January 01, 2021.
CME Expiration Date: January 31, 2021

Accreditation:
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. CME expires 1/1/2021

Description:
Whether a patient with cancer presents to the ED with cancer-treatment side effects or complications of the disease itself, timely diagnostic workup and evidence-based management strategies can make the difference in their quality of life. This issue reviews management recommendations for 3 ED presentations of oncologic patients: metastatic spinal cord compression, tumor lysis syndrome, and neutropenic fever. This issue will help you answer the following questions:
• What is the optimal imaging strategy for cancer patients with back pain? Should you go straight to MRI, or are plain radiographs a good first step?
• What is the difference between management of laboratory tumor lysis syndrome and clinical tumor lysis syndrome?
• Should the electrolyte derangements of tumor lysis syndrome be treated the same as for patients not in chemotherapy?
• What is the best method for collecting blood culture samples in cancer patients who present with fever?
• Do all patients with neutropenic fever need vancomycin?

Objectives:
Upon competion of this article, you should be able to:
• Identify conditions due to cancer or cancer therapy that have the potential to cause death or organ damage.
• Initiate treatment for oncologic emergencies, including providing immediate therapies in the emergency department and establishing plans for definitive management.
• Make disposition decisions appropriate to patient condition and expected prognosis.