Specialty · Oncology
Symptom monitoring between cycles, neutropenic sepsis thresholds applied to every contact, treatment preparation, and coordination across the teams a cancer patient is under at once.
In the product
Oncology monitoring — cycle 3, day 9
EmergencyOutbound 19:40 · Margaret F. · 62 · FEC-T cycle 3 · expected nadir day 7–10
Primum
Have you taken your temperature today?
Caller
It was 38.3 about an hour ago. I felt shivery earlier but I've a blanket on now and I'm grand.
Temp ≥ 38.0 on SACT within nadir → neutropenic sepsis pathway, immediate
Primum
I need you to go to hospital now — take your alert card and go straight to the acute oncology unit, not to a waiting room. Don't take paracetamol, it will mask things. Is there someone who can drive you?
Caller
My son is here.
Primum
Good. Leave now. I'm ringing the unit so they're expecting you.
Sepsis pathway
Patient en route · unit expecting · no antipyretic advised
Overview
The dangerous period in systemic anti-cancer therapy is the fortnight when the patient is not in the unit. Neutropenia peaks, toxicity develops, and the patient — who has been told not to be a nuisance — waits to see whether the temperature settles. Neutropenic sepsis kills people who felt well that morning.
Primum makes structured contact through that window: temperature, symptoms, toxicity grading against CTCAE, oral intake, adherence for oral agents. Any fever on treatment is treated as neutropenic sepsis until proven otherwise, with immediate instructions and the acute oncology service alerted. Everything else — treatment preparation, bloods, appointment coordination across teams — is handled so the patient is not the one holding it together.
Capabilities
One threshold that must never be missed, and three programmes that keep treatment on track.
A temperature of 38°C or more, or rigors, or feeling unwell with a normal temperature while on treatment, produces immediate instructions to attend, the alert card referenced, and the acute oncology service notified — no triage delay, no call-back.
Mucositis, diarrhoea, neuropathy, rash, nausea, fatigue and hand-foot syndrome graded to CTCAE on every contact, so the oncologist sees a trajectory across cycles rather than a snapshot at clinic.
Adherence, timing and tolerability for oral agents, plus interaction checks against anything a different team has prescribed since the last cycle.
Bloods, imaging, infusion, surgical review and palliative care coordinated in the right order, with preparation instructions for each — so the patient is not the one reconciling four appointment letters.
How it works
Contact at the points where neutropenia and toxicity are known to peak.
01
Regimen, cycle number, expected nadir and the patient's own risk factors loaded, with the contact schedule set from the protocol.
Regimen-aware
02
Temperature, toxicity, oral intake and adherence captured at each contact, in the patient's own language, with follow-ups where an answer needs one.
CTCAE graded
03
Neutropenic sepsis criteria checked first on every contact, then dose-limiting toxicity thresholds against your own tables.
Sepsis criteria first
04
Acute oncology alerted and the patient instructed to attend, or the graded record written back and the next cycle's bloods confirmed.
AOS alert / write-back
01
Regimen, cycle number, expected nadir and the patient's own risk factors loaded, with the contact schedule set from the protocol.
Regimen-aware
02
Temperature, toxicity, oral intake and adherence captured at each contact, in the patient's own language, with follow-ups where an answer needs one.
CTCAE graded
03
Neutropenic sepsis criteria checked first on every contact, then dose-limiting toxicity thresholds against your own tables.
Sepsis criteria first
04
Acute oncology alerted and the patient instructed to attend, or the graded record written back and the next cycle's bloods confirmed.
AOS alert / write-back
Benefits
Most unplanned oncology admissions are preceded by two days of symptoms nobody heard about.
Door-to-antibiotic time is the measure that matters, and it starts when the patient decides to ring. Structured contact removes the decision.
Graded toxicity across the whole cycle, not the patient's recollection at clinic, is what makes a dose reduction the right size.
One diary across every team removes a burden that falls on people least able to carry it.
In practice
The first is the reason the programme exists.
Fever during the expected nadir. Immediate instruction to attend with the alert card, and the acute oncology service notified before the call ends.
Frequency crosses threshold with reduced oral intake. Escalated for assessment and hydration rather than managed at home.
Four doses missed after nausea. Adherence pattern recorded, antiemetic reviewed, oncologist informed before the next cycle.
Bloods, scan and infusion re-sequenced correctly, fasting instructions sent, and transport booked.
Pick one regimen and let us run structured contact through days five to twelve. We will show you what was reported, how it was graded, and how many contacts produced an escalation nobody would otherwise have heard about.