Neutropenia Emergencies
Patient has temp 100.5 — what now
Medical emergency
Patient brushing teeth — what do you change
Soft toothbrush
Most common cause of iron deficiency in adults
Blood loss
Platelet level below this increases bleeding risk
<100,000
ANC level indicating severe neutropenia
< 500
First step
Blood cultures
Patient needs injection — what do you avoid
IM injections
Lab that is LOW in iron deficiency and reflects iron storage
Ferritin
Tiny non-blanching spots on skin
Petechiae
First sign of infection in neutropenia
Fever
Next step
Broad-spectrum IV antibiotics
Patient with HIT — what do you do
Stop heparin
Lab that is HIGH in iron deficiency
TIBC
Medication to avoid
Aspirin / NSAIDs
FIRST action when neutropenic patient has fever
Blood cultures then IV antibiotics within 1 hour
Why infections look atypical
No inflammatory response
Priority symptom to report
Bleeding or altered mental status
Anemia with neurological symptoms
Pernicious anemia (B12 deficiency)
Condition where heparin causes clotting instead of bleeding
HIT
Growth factor used to increase neutrophils
Filgrastim (Neupogen)
Diet teaching
Avoid raw foods
Best pain med
Acetaminophen (NOT NSAIDs)
Treatment route for B12 deficiency
IM injection (cyanocobalamin)
Most dangerous complication
Intracranial bleeding
MOST important prevention measure
Hand hygiene