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Febrile Neutropenia (Fever Card)

Dear Colleague:

I am happy to provide you with information about the new "fever card" initiative.  Beginning August 2009, patients who are undergoing chemotherapy treatment will receive a pocket-sized fever card with instructions on how to assess temperature and the treatment they must seek if they develop a fever.

As you know febrile neutropenia is a life-threatening oncological emergency requiring immediate attention and treatment.  Early intervention patients (and their families) undergoing chemotherapy must be aware of this risk and act promptly when fever is detected.

The process for Fever Card use is the following:

• Patient/family receives a fever card and education at LRCP
• The fever card is kept accessible by the patient
• At the first onset of fever, the patient seeks treatment at the nearest Emergency Department
• The fever card is presented to ER staff upon triage/registration

I look to your support in communicating this regional initiative to the various providers and stakeholders in your organization.  If you have any questions about the fever card, I ask that you contact Harry Milne at 1-519-685-8600 extension 53638, or by email at Harry.Milne@lhsc.on.ca.

Thank you for your support.

Respectfully,

Ted Vandenberg M.D.

Medical Director, Regional Systemic Treatment Program

Fever - London Residents

When to call for help:

• If you have a fever of 38°C (100.4°F) or higher:
• Monday to Friday 8:30 am - 4:00 pm - call the Telephone Triage Nurse.
• After hours, call LRCP and listen to the menu options - press "2" to reach the switchboard operator.
• Provide clinic/physician information from your fever card and switchboard will page the on-call cancer doctor.

Alternatively, London ERs can be accessed for this service.

Fever - Patients Outside of London

• If you live outside of London, go to your nearest Emergency Department.
• Notify staff that you are receiving chemotheraphy and that you have a fever.
• Show staff your fever card.

Fever Card Question & Answer

What is the purpose of the fever card?

The fever card reminds the patient who is on chemotherapy and their family that febrile neutropenia might occur as a result of treatment.  Information on the card directs the patient to seek immediate attention and provides suggested treatment to providers who may/may not be familiar with managing febrile neutropenia.

How should the patient use the fever card?

The patient should keep the fever card readily availiable and refer to it if he/she develops a fever of 38°C.  The patient with a fever should report to the nearest ER department and present the card to the triage officer and/or attending physician.

Who is responsible for handing out the card?

The patient's primary nurse at LRCP is responsible for providing the patient with the fever card and providing education on how to use it.

When will the fever card be available?

Patients will begin to receive the fever card mid-August 2009.

 

Download the Q&A Sheet (pdf)

Download the Febrile Neutropenia Guidelines (pdf)

Download the Fever Card (pdf)

Download Alberta Health Services article - "Management of Adult Febrile Neutropenia"

Download Ottawa Hospital article - "Risk Stratification and Febrile Neutropenia"