Questionnaire/history:

Neutrophil count ≤ 0.5×109 /L?

Temperature > 38 or any symptoms and/or signs of suspected sepsis?

Past medical History: - Infection (eg bacterial sepsis, HIV, TB, EBV, CMV, measles, varicella)? - Haematological disorder (eg aplastic anaemia, myelodysplasia, acute leukaemia)? - B12 and/or folate deficiency? Current medication? - Anticancer treatment? - Immunomodulatory treatments? - Carbimazole? - Clozapine? - Olanzapine? Known drug allergies?

Management: Referral to secondary care - If critically unwell: refer to emergency department via a 999 ambulance

- If stable: ev direct referral to local medical assessment unit, haematology or oncology

- If delay in admission (> 1 hour): consider prehospital antibiotics (with anti-pseudomonal cover (eg Piperacillin/Tazobactam)

Reference(s): NICE [NG51]: Neutropenic sepsis: prevention and management in people with cancer

NICE CKS: Neutropenic sepsis