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Urgences oncologiques
Formation en soins infirmiers
oncologiques
Professeur Jean-Paul Sculier
ULB
www.oncorea.com
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Les types d’urgences et organisation
• Urgences externes
• Urgences internes
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Les grandes causes d’urgences
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Revue systématique
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Cancer bronchique
269 patients en 3 ans
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244 admissions pour 548 consultations
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31 décès pour 269 patients
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Etude de registre
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Le pronostic
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En résumé
Variable Mortalité
hospitalière
Survie après la sortie
d’hospitalisation
APACHE II < 0,001 NS
IGS II < 0,001 NS
Extension du cancer NS 0,008
Phase du cancer NS 0,0002
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Sélection initiale des patients
ETAPES DE LA MALADIE CANCEREUSE
• diagnostic
• traitement à visée curative
• traitement à visée de rémission
• stade pivot
• soins palliatifs
INDICATIONS POUR LA REANIMATION
• +
• +
• + (ou réanimation d’attente ?)
- sauf traitements expérimentaux (phase I)
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Réanimation d’attente
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Les limitations thérapeutiques
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Le statut des patients
• DNR
• NTBR (DNI …)
• NT
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Admissions en soins intensifs
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Un exemple d’urgence oncologique :
le syndrome de lyse tumorale
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