Learning Objective #1: understand the admission waiting time for cancer children with febria neutropenia in Taiwan.

Learning Objective #2: know what difference between the waiting time admitted from the outpatient department and from the emergency department.

---

Cancer has become the second leading cause of death of children in Taiwan. Also there are 550-600 newly diagnosis children with cancer every year. For cancer treatment, febrile neutropenia is an emergency complication. Therefore, shortening waiting time, from the arrival of cancer children with febrile neutropenia to the initiation of antibiotics therapy, is of great urgency. To reduce the life-threatening complications due to treatment delay, we thus investigate the admission waiting time and report our findings. This study was performed at the children’s hospital in northern Taiwan from 2005 to 2006 to twenty-four cancer children with a chief complaint of fever above 38? result from neutropenia, and chemotherapy curing. The outcomes of this study are as follows: The median waiting time from admission to diagnosis made by a doctor was 38 minutes. Sixteen children admitted from the emergency department (ED) have 52 minutes median waiting diagnosis time. Whereas eight children admitted from the outpatient department (OPD) have 28 minutes median waiting diagnosis time. The median waiting time from admission to initiation of antibiotics was 90 minutes. To those ED children, the median waiting time from admission to initiation of antibiotics was 85 minutes. On the other hand, those OPD children’s median waiting time was 117 minutes. It is found that the median waiting time is grossly shorter than that of Nirenberg’s report (2004), and most (87.5%, 21 of 24 visits) of the children did not develop sepsis or septic shock. The clinical survey indicates the management of hospital toward cancer children with febrile neutropenia is rapid and timely in Taiwan. Unexpectly, the median waiting diagnosis time for OPD admission is shorter than that of ED admission. We contribute the reason to a trust relationship among cancer children, caregivers and the oncology team.