oncological emergencies

[kris02]

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Hi all,
I am a paramedic student in Australia and i am currently researching oncological emergencies and particularly the managment of oncological emergencies in the prehospital setting.
I know that this is not a highly researched area and there is not a lot of information out there but if anyone could help me out with this it would be greatly appreciated.
Kind regards
Kris

 

[docB]

Oh, you beat me to it. Well I'll post here as well and we'll see which thread takes off (or which one gets closed by the mods). I hope you didn't put it up on more than these two forums.

I don't know of any info on this. The only oncologic emergencies I have even seen are neutrapenic fever and sepsis in the chemo crowd and superior vena cava syndrome. I've only seen a real SVC syndrome once but the onc (to his credit) did come in in the middle of the night to help manage the patient. Neither of these have any real EMS issues except trying to isolate the neutrapenics as well as possible.

I suppose hematologic emergencies would include sickle cell crisis, hematopoetic crises, acute anemia, porphyrias, G6PD issues and so on but those are really distinct form onc problems.

 

[southerndoc]

Don't forget one of the worst oncologic emergencies: cauda equina syndrome or cord compression from tumor extension.

 

[DropkickMurphy]

What about superior vena caval syndrome from compression of the SVC by a large thoracic tumor (lung CA, etc)? I've seen that twice....presented with marked hypotension and a very dramatic appearance due to resultant engorgement of the vascular structures above the level of the obstruction.

EDIT: I've really got to start reading down before posting. I guess that's what I get for visiting SDN after a night at the bar.

 

[viostorm]

I think the worst gyn emergency I ever had was when the race of the child did not match the race of the father.

 

[southerndoc]

I think the worst gyn emergency I ever had was when the race of the child did not match the race of the father.

The topic is oncologic, not gynecologic emergencies!

Then again, a baby is a tumor, so it still fits. 🙂

 

[12R34Y]

Regardless, of the onc emergency I think the prehospital treatment is the same. Take them to the hospital quickly and drop them off.

seriously.

later

okay, i'm editing this now b/c after reading it may sound mean/arrogant or something. First off many a preshospital provider may not even recognize that something is in fact a oncological emergency. Most of these things require some lab analysis of some sort. If the patient is septic looking then you treat them like sepsis and go to the hospital. They won't find out until the get labs back that they have a platelet count of 4 or a WBC count of 200,000 or something funky.

so in reality you'd just treat their s/s. if spo2 is low you give 'em some O's. If dehydrated, hypotensive...start a line give 'em some fluids etc...

later

 

[viostorm]

Ha ha! whoops ...