REBEL Cast REBEL Core Cast 126.0 – Peds Hem Onc Emergencies
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Jul 10, 2024 Joanna Piero, a pediatric hematologist oncologist at Staten Island University Hospital, shares her expertise in managing critical pediatric hematology and oncology emergencies. She emphasizes the life-saving importance of administering antibiotics within an hour for patients with fever and neutropenia. Joanna stresses that fever in sickle cell patients is always an emergency, requiring immediate cultures and treatment. She also discusses crucial red flags in pediatric headaches that may suggest a brain tumor, highlighting the need for swift specialist consultations.
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Urgent Antibiotics for Neutropenic Fever
- Start antibiotics immediately for febrile neutropenic patients, ideally within 60 minutes.
- Use central line access for labs and broad-spectrum antibiotics like cefepime with pseudomonal coverage.
Typhlitis Danger in Neutropenic Kids
- Neutropenic enterocolitis (typhlitis) is a critical diagnosis that resembles NEC in oncology patients.
- It can progress to perforation, so tenderness or worsening symptoms require urgent imaging and surgical input.
Treat Fever Urgently in Sickle Cell
- Fever in sickle cell patients is an emergency; always get blood cultures and start broad-spectrum antibiotics like ceftriaxone.
- Admit and consult hematology early due to high risk of acute chest syndrome and complicated management.
Take Home Points Early administration of antibiotics (within 60 min) in patients with fever and neutropenia is life saving. Fever in sickle cell is an emergency and always requires cultures and antibiotics even if the child appears well. Avoid sedation and lying supine and steroids in patients with mediastinal masses. Red flags in patients with ...