Continuing Professional Development: Neutropenic Sepsis

OverviewNeutropenic sepsis is the development of a profound and potentially life-threatening episode in patients that are extremely vulnerable due to their diminished ability to fight off infection. This reduced capacity to respond to infective agents – neutropenia—is caused by a near total absence of the body's specialist white cells, called neutrophils. One of the most commonly found causes of neutropenia are the chemotherapy regimens that patients treated for cancer need to take. There are an increasing number of such regimens being prescribed and, also, a trend towards oncology patients being treated—or recovering from treatment - at home (Dikken, 2009). The initial signs of these patients becoming overwhelmed by an opportunistic infection are easy to miss as the signs and symptoms are vague. The importance of sepsis being suspected and responded to by paramedic staff is of the utmost importance, as the disease process will progress with alarming speed to a point where it is difficult to support or resuscitate the patient either in the community or in hospital settings.This article presents an overview of sepsis and how neutropenia disguises the typical presentation, as well as a discussion of pre-hospital care delivery by paramedic staff.Learning OutcomesAfter completing this module you will be able to:▪ To understand the differences between infection, sepsis, severe sepsis and septic shock▪ To be aware of the term neutropenia and how this complicates sepsis▪ To appreciate the patient groups most likely to be at risk of neutropenic sepsis▪ To recognise the importance of a high ‘index of suspicion’ for these patients▪ To consider some potential prehospital developments in the response and early support of patients with sepsis and neutropenic sepsis.

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