2.3.2 Limitations on Satellite Practice

The following practice and procedures will occur in the tertiary context ONLY:

1. Continuous infusion of chemotherapeutic agents that is longer than four hours.
2. Administration of drugs out of the scope of practice or dosed above maximum doses in scope of practice.
3. Management of fever in leukemia patients in induction phase of treatment protocols.
4. Initial diagnostic CT Scans are ideally carried out in a pediatric radiology department. Since particular components of diagnostic imaging are critical to contemporary protocol enrolment, it is strongly recommended that diagnostic imaging be obtained in the tertiary center. If CT evaluation is necessary in an emergency, pediatric protocols must be used. Modify with respect to fungal infection.
5. Administration of drugs by the intrathecal route.
6. Bone marrow aspiration: When blood tests indicate a possible relapse, the child must be transferred to the tertiary centre where the bone marrow aspiration will be done, in order to permit sample collection for appropriate studies.