The EM Educator Series: The Sick Oncology Patient

Author: Alex Koyfman, MD (@EMHighAK) // Reviewed by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!

Case 1:

A 55-year-old female with a history of breast cancer presents with progressively worsening shortness of breath.

Case 2:

A 60-year-old male with a history of metastatic renal cell cancer presents with nausea, vomiting, acute on chronic abdominal pain, and poor pain control.

Case 3:

A 30-year-old male with no past medical history presents with stroke-like symptoms and chest pain.

Considerations:

• What is the ED approach and management for SVC syndrome?
• What is the ED approach and management for pericardial effusion? Cardiac tamponade?
• What is the ED approach and management for spinal cord compression?
• What is the ED approach and management for hypercalcemia?
• What is the ED approach and management for tumor lysis syndrome?
• What is the ED approach and management for hyperviscosity syndrome?
• What is the ED approach and management for neutropenic fever?

Suggested Resources:

• FOAMed
  • emDocs – Oncology emergencies Part I
  • emDocs – Oncology emergencies Part II
  • EM Cases – Oncology emergencies
  • REBEL EM – Oncology emergencies

• Journal Articles
  • Western Journal of Emergency Medicine
  • Emergency Medicine Clinics of North America