Do you refer all patients with new findings of CNS or epidural mets/tumor to ED for evaluation or are there some that can be managed completely outpatient?
Interesting question:
- Sending patients to the ED for non-emergent conditions is not advised. Our EDs around the country are struggling for a variety of reasons (e.g., they are often holding patients awaiting placement or admission), thus our society will benefit by us avoiding sending patients to t...
I think that a decision to refer to the ER depends on the patient's symptoms, the size/type of CNS lesion, and your practice setting. Small asymptomatic or incidentally discovered brain metastases may not require management in an ER or inpatient setting. Leptomeningeal disease, by comparison, is som...
Agree with the comments above and Dr. @Dr. First Last' concerns regarding not only the broader implications of ED overuse but also the long wait times and poor experiences generally experienced by cancer patients.
I will add that one commonly encountered issue that can result in the inappropriate esc...
I would bet that most rad oncs do NOT routinely send people with brain mets to the ER. It would be an interesting poll question.
If the patient has no impending neurologic emergency, we manage as an outpatient with steroids and radiation. Why send to ED where the doctors are busy with trauma and patients are likely to be exposed to COVID-19? If there's impending cord compression then admit and treat inpatient.