Neutropaenic Sepsis

The topic of neutropaenic sepsis was central to one of the SEAs we covered today at the half-day release session.  For those trainees who would like to read and learn a bit more about this potentially fatal condition I have attached the following links.

 

Although NICE guidance on the condition with regards management in Primary Care is limited to just four lines the advice is quite succinct and easy to follow:

 

“suspect neutropaenic sepsis in patients having anticancer treatment who become unwell…refer immediately for assessment in secondary or tertiary care.”

 

The Map of Medicine pathway highlights clinical signs that patients with neutropaenic sepsis may present with and once again stresses the importance of immediate referral to hospital.  Finally, the following YouTube clip (North West London Cancer Network) offers a patient’s first hand experience of neutropaenic sepsis and other good clinical advice.

 

Neuropathic Pain

NICE have released an update to their guideline on neuropathic pain.  First line medications now include Amitriptyline, Duloxetine, Gabapentin and Pregabalin.  During your training in General Practice you will see patients who experience neuropathic pain and for whom you may need to prescribe medications such as the ones above.  It is worth understanding how they work, how you prescribe them, what monitoring they may require and what the typical side effects might be.

 

Although neuropathic pain is only one form of chronic pain it would seem to account for a significant proportion of patients presenting with chronic pain.  It is important to consider how chronic pain may affect all aspects of a patient’s life and the limitations the pain may impose.  Paintoolkit.org is a website which provides resources and advice which may be useful both to doctors and patients.

 

An on-line CPD module can be found via Pulse.