Chills or Fever Management

1. Never use NSAID in thrombocytopenia patients
2. First line: Acetaminophen
3. Second line: Vena, Hydrocortisone (Solucortef)
4. Third line: Morphine or Demerol (血壓低病患不宜)
5. Fever 應視情況給予antipyretics 例如1: Past history of febrile convulsion (child), 2:Cardiac or pulmonary insufficiency patients, 3 Pregnancy patients, 4: High metabolism 會惡化thrombocytopenia ,6. Fever or chills 是cytokine reaction 臨床無法分別tumor fever or infection, (不管是feverpattern or temperature) 排除infection 之後才能當成tumor fever, Myeloid Leukemia 基本上不會tumor fever, 應視為infection 處理, Hodgkin disease, Lymphoma(AILD like, T cell, NKcell) tumor fever 比較常見。