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Neutropenic Fever Clinical Decision Rule

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1. Neutropenic Fever Clinical Decision Rule

Neutropenic Fever Clinical Decision Rule Neutropenic Fever Clinical Decision Rule Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Neutropenic Fever Clinical Decision Rule Neutropenic Fever Clinical Decision Rule Aka: Neutropenic Fever Clinical Decision Rule , Multinational Association for Supportive Care in Cancer Risk Index , MASCC Risk Index II. Indications Assess risk in III. Contraindications Children under age 16 years (have different rules for risk stratification) IV. Criteria symptom severity (choose one) No symptoms or Mild symptoms: 5 points Moderate symptoms: 3 points not present: 5 points not present: 4 points Solid tumor

2018 FP Notebook

2. Neutropenic Fever Clinical Decision Rule

Neutropenic Fever Clinical Decision Rule Neutropenic Fever Clinical Decision Rule Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 (...) Neutropenic Fever Clinical Decision Rule Neutropenic Fever Clinical Decision Rule Aka: Neutropenic Fever Clinical Decision Rule , Multinational Association for Supportive Care in Cancer Risk Index , MASCC Risk Index II. Indications Assess risk in III. Contraindications Children under age 16 years (have different rules for risk stratification) IV. Criteria symptom severity (choose one) No symptoms or Mild symptoms: 5 points Moderate symptoms: 3 points not present: 5 points not present: 4 points Solid tumor

2015 FP Notebook

3. Australian consensus guidelines for the management of neutropenic fever in adult cancer patients

, the prophylactic and therapeutic use of granulocyte colony-stimulating factor (G-CSF), and choice of antibacterial agent/s as governed by local epidemiology and drug susceptibility patterns. Current guidelines The aim of these guidelines is to develop Australian consensus-based clinical recommendations for the man- agement of neutropenic fever in adult cancer patients that address the current diversity in practice and better inform clinical decision-making while taking into consid- eration best available (...) for Supportive Care in Cancer risk index: A multinational scoring system for identifying low-risk febrile neutropenic cancer patients. J Clin Oncol. 2000; 18: 3038–51. 13 Talcott JA, Siegel RD, Finberg R, Goldman L. Risk assessment in cancer patients with fever and neutropenia: a prospective, two-center validation of a prediction rule. J Clin Oncol. 1992; 10: 316–22. 14 Lingaratnam S, Slavin MA, Mileshkin L, Burbury K, Solomon B, Koczwara B etal. An Australian survey of clinical practices in management

2011 Clinical Practice Guidelines Portal

4. Neutropenic sepsis: prevention and management in people with cancer

by the Joint Standing Committee on Medicines (a joint committee of the Royal College of Paediatrics and Child Health and the Neonatal and Paediatric Pharmacists Group) for further information. [2] Examples of risk scoring systems include The Multinational Association for Supportive Care in Cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients (Journal of Clinical Oncology 2000; 18: 3038–51]) and the modified Alexander rule for children (aged under 18 (...) the Multinational Association for Supportive Care in Cancer risk index: a multinational scoring system for identifying low-risk febrile neutropenic cancer patients (Journal of Clinical Oncology 2000; 18: 3038–51) and the modified Alexander rule for children (aged under 18) (European Journal of Cancer 2009; 45: 2843–9). Neutropenic sepsis: prevention and management in people with cancer (CG151) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

5. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy

, ASCO released a guideline on antimicrobial prophylaxis for FN, as well as recommendations for identifying patients with fever and neutropenia who may be treated as outpatients. The Infectious Diseases Society of America (IDSA) “Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer” was released in 2011. For outpatient identification, validated tools such as the Multinational Association of Support Care in Cancer (MASCC) score or Talcott’s rules, as well (...) That May Be Used to Exclude Patients With Cancer Who Have Fever and Neutropenia From Initial Outpatient Care Even With a MASCC Score ≥ 21 Table 1.Additional Specific Clinical Criteria That May Be Used to Exclude Patients With Cancer Who Have Fever and Neutropenia From Initial Outpatient Care Even With a MASCC Score ≥ 216 The MASCC index ( ) or Talcott’s rules ( ) are recommended tools for identifying patients who may be candidates for outpatient management. (Type of recommendation: evidence-based

2018 American Society of Clinical Oncology Guidelines

6. Outpatient Management of Fever and Neutropenia in Adults Treated for Malignancy

, ASCO released a guideline on antimicrobial prophylaxis for FN, as well as recommendations for identifying patients with fever and neutropenia who may be treated as outpatients. The Infectious Diseases Society of America (IDSA) “Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer” was released in 2011. For outpatient identification, validated tools such as the Multinational Association of Support Care in Cancer (MASCC) score or Talcott’s rules, as well (...) That May Be Used to Exclude Patients With Cancer Who Have Fever and Neutropenia From Initial Outpatient Care Even With a MASCC Score ≥ 21 Table 1.Additional Specific Clinical Criteria That May Be Used to Exclude Patients With Cancer Who Have Fever and Neutropenia From Initial Outpatient Care Even With a MASCC Score ≥ 216 The MASCC index ( ) or Talcott’s rules ( ) are recommended tools for identifying patients who may be candidates for outpatient management. (Type of recommendation: evidence-based

2018 Infectious Diseases Society of America

7. Guideline for the management of fever and neutropenia in children with cancer and hematopoietic stem-cell transplantation recipients: 2017 update.

this, 89 articles were identified for detailed examination, of which 4 articles were eligible for inclusion in this review and 21 further studies were incorporated into a separate systematic review of clinical decision rules. See Figure 1 in the systematic review for a flow chart detailing the study selection process. Strategies for Empiric Management of Pediatric Fever and Neutropenia in Patients With Cancer and Hematopoietic Stem-Cell Transplantation Recipients: a Systematic Review of Randomized (...) of randomized trials (see the "Availability of Companion Documents" field) of interventions applied for the empirical management of pediatric fever and neutropenia (FN). Formulating Questions and Rating Importance of Outcomes The authors used the same key clinical questions to be addressed by the guideline and the importance of outcomes which would inform recommendations from the 2012 clinical practice guideline (CPG). Updated Systematic Review and Meta-Analysis of the Performance of Risk Prediction Rules

2017 National Guideline Clearinghouse (partial archive)

8. Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer

chemotherapy-induced fever and neutropenia. Recent advances in antimicrobial drug development and technology, clinical trial results, and extensive clinical experience have informed the approaches and recommendations herein. Because the previous iteration of this guideline in 2002, we have a developed a clearer definition of which populations of patients with cancer may benefit most from antibiotic, antifungal, and antiviral prophylaxis. Furthermore, categorizing neutropenic patients as being at high risk (...) differences in available antibiotics, in the predominant pathogens, and/or in health care–associated economic conditions exist. Regardless of venue, clinical vigilance and immediate treatment are the universal keys to managing neutropenic patients with fever and/or infection. EXECUTIVE SUMMARY Fever during chemotherapy-induced neutropenia may be the only indication of a severe underlying infection, because signs and symptoms of inflammation typically are attenuated. Physicians must be keenly aware

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2010 Infectious Diseases Society of America

9. Fever Without Source or Unknown Origin-Child

MB, Bachur RG. Clinical predictors of occult pneumonia in the febrile child. Acad Emerg Med. 2007;14(3):243-249. 50. Leventhal JM. Clinical predictors of pneumonia as a guide to ordering chest roentgenograms. Clin Pediatr (Phila). 1982;21(12):730-734. 51. Bleeker SE, Derksen-Lubsen G, Grobbee DE, Donders AR, Moons KG, Moll HA. Validating and updating a prediction rule for serious bacterial infection in patients with fever without source. Acta Paediatr. 2007;96(1):100-104. 52. Mahabee-Gittens EM (...) neutropenia in children with cancer. Adv Exp Med Biol. 2009;634:185-204. 61. Korones DN, Hussong MR, Gullace MA. Routine chest radiography of children with cancer hospitalized for fever and neutropenia: is it really necessary? Cancer. 1997;80(6):1160-1164. 62. Phillips B, Wade R, Westwood M, Riley R, Sutton AJ. Systematic review and meta-analysis of the value of clinical features to exclude radiographic pneumonia in febrile neutropenic episodes in children and young people. J Paediatr Child Health

2015 American College of Radiology

10. International Guideline for the Management of Fever and Neutropenia in Children with Cancer and/or Undergoing Hematopoietic Stem Cell Transplantation

, the Panel agreed that switching to a different class of mold-active antifungal agent should be considered. A pre-emptive antifungal therapy strategy uses clinical, laboratory and radiographic parameters and not merely persistence of fever to determine indication for anti-fungal therapy. This approach has been accepted as an alternative to empiric antifungal therapy in a subset of IFD high-risk adult neutropenic patients. 1 However, there are no studies that evaluated this approach in children. While (...) risk factors in febrile, neutropenic children and adolescents. Pediatr Hematol Oncol 13:217-29, 1996 21. Klaassen RJ, Goodman TR, Pham B, et al: "Low-risk" prediction rule for pediatric oncology patients presenting with fever and neutropenia. J Clin Oncol 18:1012-9, 2000 22. Lucas KG, Brown AE, Armstrong D, et al: The identification of febrile, neutropenic children with neoplastic disease at low risk for bacteremia and complications of sepsis. Cancer 77:791-8, 1996 23. Macher E, Dubos F, Garnier N

2012 SickKids Supportive Care Guidelines

11. Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock

Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock American College of Critical Care Medicine Clinical Practice... : Critical Care Medicine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me on this computer Register for a free account Registered users can (...) & Issues Collections For Authors Journal Info > > American College of Critical Care Medicine Clinical Practice... Email to a Colleague Colleague's E-mail is Invalid Your Name: (optional) Your Email: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw at Critical Care Medicine. Send a copy to your email Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time

2017 Society of Critical Care Medicine

12. Clinical Practice Guidelines for The Management of Candidiasis

Catheters Be Removed in Nonneutropenic Patients With Candidemia? Recommendation 13. Central venous catheters (CVCs) should be removed as early as possible in the course of candidemia when the source is presumed to be the CVC and the catheter can be removed safely; this decision should be individualized for each patient (strong recommendation; moderate-quality evidence) . III. What Is the Treatment for Candidemia in Neutropenic Patients ? Recommendations 14. An echinocandin (caspofungin: loading dose 70 (...) of fever and should be based on clinical assessment of risk factors, surrogate markers for invasive candidiasis, and/or culture data from nonsterile sites (strong recommendation; moderate-quality evidence). Empiric antifungal therapy should be started as soon as possible in patients who have the above risk factors and who have clinical signs of septic shock (strong recommendation; moderate-quality evidence) . 29. Preferred empiric therapy for suspected candidiasis in nonneutropenic patients

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2016 Infectious Diseases Society of America

13. Clinical Practice Guideline for the Management of Anorectal Abscess, Fistula in Ano, and Rectovaginal Fistula

may be used to treat fistula-in-ano asso- ciated with Crohn’s disease. Grade of Recommendation: Weak recommendation based on moderate-quality evi- dence, 2B. Before considering a surgical repair in a patient with a complex Crohn’s-related anal fistula, a detailed examina- tion should be performed to rule out the presence of ac- tive proctitis, or anal stenosis, because these patients are likely better managed with long-term draining setons. t he decision to operate needs to be carefully discussed (...) ntraoperative physical diagnosis in the management of anal fistula. Am Surg. 2006;72:11–15. 53. Gunawardhana PA, Deen KI. Comparison of hydrogen perox- ide instillation with Goodsall’s rule for fistula-in-ano. ANZ J Surg. 2001;71:472–474. 54. Buchanan G, h alligan s, Williams a, et al. effect of mRi on clinical outcome of recurrent fistula-in-ano. Lancet. 2002;360:1661–1662. 55. Garcia-Granero a, Granero-Castro P, f rasson m, et al. management of cryptoglandular supralevator abscesses in the magnetic

2016 American Society of Colon and Rectal Surgeons

14. Pediatrics, Fever (Treatment)

. [ , , ] Temperature elevation may not be the only sign of sepsis in neonates and infants. Other potential signs and symptoms of sepsis unique to infancy should also be assessed. History taking is an important part of clinical decision making. The clinician should ask the patient's parents or caretakers about the following items when they bring in a febrile or ill-appearing child: Immunization history, such as recent vaccination or a history of inadequate immunizations History of exposure to sick contacts (...) instructions simply state "call physician" or "seek medical care." Parents should be educated that the steadily changing weight of their child will result in a need to periodically update the correct dose of medication. [ , ] According to the 2003 clinical policy of the American College of Emergency Physicians (ACEP), response to antipyretic medication does not change the likelihood of a child having a serious bacterial infection and should not be used for clinical decision making. [ ] Previous Next

2014 eMedicine Emergency Medicine

15. Pediatrics, Fever (Diagnosis)

. [ , , ] Temperature elevation may not be the only sign of sepsis in neonates and infants. Other potential signs and symptoms of sepsis unique to infancy should also be assessed. History taking is an important part of clinical decision making. The clinician should ask the patient's parents or caretakers about the following items when they bring in a febrile or ill-appearing child: Immunization history, such as recent vaccination or a history of inadequate immunizations History of exposure to sick contacts (...) instructions simply state "call physician" or "seek medical care." Parents should be educated that the steadily changing weight of their child will result in a need to periodically update the correct dose of medication. [ , ] According to the 2003 clinical policy of the American College of Emergency Physicians (ACEP), response to antipyretic medication does not change the likelihood of a child having a serious bacterial infection and should not be used for clinical decision making. [ ] Previous Next

2014 eMedicine Emergency Medicine

16. Pediatrics, Fever (Overview)

. [ , , ] Temperature elevation may not be the only sign of sepsis in neonates and infants. Other potential signs and symptoms of sepsis unique to infancy should also be assessed. History taking is an important part of clinical decision making. The clinician should ask the patient's parents or caretakers about the following items when they bring in a febrile or ill-appearing child: Immunization history, such as recent vaccination or a history of inadequate immunizations History of exposure to sick contacts (...) instructions simply state "call physician" or "seek medical care." Parents should be educated that the steadily changing weight of their child will result in a need to periodically update the correct dose of medication. [ , ] According to the 2003 clinical policy of the American College of Emergency Physicians (ACEP), response to antipyretic medication does not change the likelihood of a child having a serious bacterial infection and should not be used for clinical decision making. [ ] Previous Next

2014 eMedicine Emergency Medicine

17. Pediatrics, Fever (Follow-up)

. [ , , ] Temperature elevation may not be the only sign of sepsis in neonates and infants. Other potential signs and symptoms of sepsis unique to infancy should also be assessed. History taking is an important part of clinical decision making. The clinician should ask the patient's parents or caretakers about the following items when they bring in a febrile or ill-appearing child: Immunization history, such as recent vaccination or a history of inadequate immunizations History of exposure to sick contacts (...) instructions simply state "call physician" or "seek medical care." Parents should be educated that the steadily changing weight of their child will result in a need to periodically update the correct dose of medication. [ , ] According to the 2003 clinical policy of the American College of Emergency Physicians (ACEP), response to antipyretic medication does not change the likelihood of a child having a serious bacterial infection and should not be used for clinical decision making. [ ] Previous Next

2014 eMedicine Emergency Medicine

18. KDIGO Clinical Practice Guideline for Acute Kidney Injury

Supplements (2012) 2,ivNotice Kidney International Supplements (2012) 2, 1; doi:10.1038/kisup.2012.1 SECTION I: USE OF THE CLINICAL PRACTICE GUIDELINE This Clinical Practice Guideline document is based upon the best information available as of February 2011. It is designed to provide information and assist decision-making. It is not intended to de?ne a standard of care, and should not be construed as one, nor should it be interpreted as prescribing an exclusive course of management. Variations in practice (...) and the strength of the recommendation. Thus, there were 22 (36.1%) recommendations graded ‘1’ and 39 (63.9%) graded ‘2.’ There were 9 (14.8%) recommendations graded ‘1A,’10(16.4%)were‘1B,’3(4.9%)were‘1C,’and0(0%)were ‘1D.’ There were 2 (3.3%) graded ‘2A,’ 10 (16.4%) were ‘2B,’ 20 (32.8%) were ‘2C,’ and 7 (11.5%) were ‘2D.’ There were 26 (29.9%) statements that were not graded. Some argue that recommendations should not be made when evidence is weak. However, clinicians still need to make clinical decisions

2012 National Kidney Foundation

19. Sepsis: recognition, diagnosis and early management

guideline 47 3 Use of biomarkers to diagnose and initiate treatment 47 4 Validation of clinical early warning scores in pre-hospital and emergency care settings 48 5 Derivation of clinical decision rules in suspected sepsis 48 Update information 50 Sepsis: recognition, diagnosis and early management (NG51) © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 3 of 50This guideline is the basis of QS161. Ov Overview erview (...) oung people and adults with suspected sepsis T T emper emperature in suspected sepsis ature in suspected sepsis 1.4.11 Do not use a person's temperature as the sole predictor of sepsis. 1.4.12 Do not rely on fever or hypothermia to rule sepsis either in or out. 1.4.13 Ask the person with suspected sepsis and their family or carers about any recent fever or rigors. 1.4.14 T ake into account that some groups of people with sepsis may not develop a raised temperature. These include: people who

2016 National Institute for Health and Clinical Excellence - Clinical Guidelines

20. Appropriate Use Criteria: Imaging of the Abdomen and Pelvis

of the Abdomen and Pelvis Copyright © 2019. AIM Specialty Health. All Rights Reserved. 5 Description and Application of the Guidelines The AIM Clinical Appropriateness Guidelines (hereinafter “the AIM Clinical Appropriateness Guidelines” or the “Guidelines”) are designed to assist providers in making the most appropriate treatment decision for a specific clinical condition for an individual. As used by AIM, the Guidelines establish objective and evidence-based criteria for medical necessity determinations (...) evaluation ? CT or MRI abdomen and/or pelvis when ultrasound is unavailable or is expected to be limited due to body habitus Rationale The incidence of acute appendicitis is estimated at 3.4 million cases per year in the U.S. Typical signs and symptoms, including right lower quadrant pain, fever, anorexia, nausea, and vomiting, should lead to surgical consultation. When the diagnosis cannot be made on clinical exam alone, imaging modalities including ultrasound, CT, and MRI may be indicated. Alternative

2019 AIM Specialty Health

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