2.2.4 Eligibility of Children Requiring Supportive Care

Any pediatric oncology patient, whether or not they are eligible to receive chemotherapy in the Satellite Centres, is eligible for supportive care in the satellite context.  Thus all patients will be eligible to receive the following supportive care in the satellite centre:

1. Management and Adjustment of Supportive Care Drugs: anti-convulsants; supplements, (e.g. Magnesium, Potassium and Phosphate)
2. Adminstration of Blood Products:
   1. Assuming the availability of irradiated blood products where such are indicated.
   2. Under emergency circumstances, any blood products may be administered.
3. Varicella-Zoster Immune Globulin (VariZig) (see Section 4.4)
4. Intravenous Immune Globulin (IVIG)
5. Growth Factors, e.g. G-CSF
6. Antiviral Therapy (Acyclovir):
   1. With suitable renal and electrolyte monitoring and/or on an in- or out-patient basis.
7. Gastrostomy Management
8. Intravenous or Inhaled Pentamidine
9. Total Parenteral Nutritional (TPN) Support
   1. Where appropriate expertise exists. Institutional pediatric TPN Guidelines should be in place and should be compatible with those contained in Section 4.5 TPN Document.
   2. If no guidelines are in place, those appended should be adopted.
10. Pain Management
11. Palliative Care

Note: With regard to the care of patients with fever and neutropenia, the need for nutritional support will have to be assessed and, if necessary, either instituted in the satellite centre or referred back to the tertiary centre.  Patients on Antifungal Therapy (on renal and electrolyte monitoring, as either in- or out-patients), whose TPN needs cannot be addressed in the satellite context, should be transferred to the tertiary centre.