The recognition and nursing management of common oncological emergencies in children

Br J Nurs. 2022 Jan 13;31(1):20-27. doi: 10.12968/bjon.2022.31.1.20.


An oncological emergency may be the initial presentation of a cancer, a sign of cancer progression, or a complication of cancer treatment. The most frequently encountered paediatric oncological emergencies include neutropenic sepsis, hyperleukocytosis, brain tumours presenting with raised intracranial pressure, tumour lysis syndrome and superior mediastinal syndrome. These are all life-threatening conditions that require urgent recognition and management. Health professionals working in an emergency department (ED) are likely to be involved in managing these children. This article brings together the current guidance and recommendations for these specific emergencies. It also includes two case studies that demonstrate the challenges health professionals can face while managing these situations. It is important that health professionals have an acute awareness of oncological emergencies. Confidence in recognising the presentations, diagnoses and initial management are essential because these conditions may be life-threatening and time critical.

Keywords: Hyperleukocytosis; Neutropenic sepsis; Paediatric emergency; Paediatric nursing; Paediatric oncology; Raised intracranial pressure; Superior mediastinal syndrome; Tumour lysis syndrome.

MeSH terms

  • Child
  • Emergencies
  • Humans
  • Medical Oncology
  • Neoplasms* / complications
  • Neoplasms* / therapy
  • Nursing Care*
  • Sepsis*