Imagine you are a parent and your child has cancer. You know fever can be an emergency, but you forgot the thermometer at home. He was feeling well, and you had a long packing list of which to keep track. It was a mistake.
Suddenly on the trip, he develops chills. You think he may have a fever, but you can’t be certain because he is otherwise feeling fine. The chills fade, and he returns to his normal self. An hour or so later, he again complains of feeling cool and clammy. You start to worry. You need to find a thermometer to measure his temperature. The closest convenience store is 25 minutes away. On your way, you decide to phone the oncologist on call and ask for advice. She recommends that he be taken to the emergency department for further evaluation.
Halfway to the convenience store, you turn around and start driving to the hospital. By the time you arrive, you realize that your son is becoming sleepier. He has a fever to 38.4 degrees Celsius in the emergency department, but you can’t quite remember if that is above the cut-off for fever when converted to Fahrenheit. By the time the labs return, an hour or more have passed. You are told that your child is moderately neutropenic, meaning a subset of his white blood cells or his absolute neutrophil count is lower than normal. This is to be expected since he has been undergoing chemotherapy for his leukemia. You notice the monitors beeping in the background. The physician informs you that his heart rate is elevated and his blood pressure is dropping, He needs to be taken to the pediatric intensive care unit.
Now, pause. You can step out of this scenario. But for many families, this is real life.
What if this could have been prevented? What if there was a non-invasive method that you could use to alert you when your immunocompromised child spiked a temperature in the range defined as fever within the oncologic population? What if there was a way to know if your child’s ANC was moderately low or severely low without them having to undergo another blood draw?
Today’s medical community is building a future where this is possible. For example, Zansors is creating wearable sensors that capture personal health information, and will develop a sensor that conveniently and continuously monitors temperature accurately.
For more on Zansors’ work, listen in to this video (featuring yours truly). There’s an exciting future ahead for pediatric healthcare:
Imagine the relief these parents would feel if they had constant monitoring on their child’s temperature. The validated tool can be applied anywhere on the skin and simply forgotten about. It is programmed to sound an alarm when your child spikes a low-grade fever twice in one hour or a higher-grade fever once, indicating the need for him or her to be evaluated in the emergency department. Beyond this, it also uses sensors to calculate the ANC without requiring that blood be drawn. This avoids a painful procedure and reduces infectious risk while simultaneously aiding the healthcare professionals in the emergency department to reduce the level of risk of serious bacterial infection and tailor the antibiotic therapy appropriately.
There is a critical hour when a cancer patient spikes a fever. In this hour, antibiotic administration is invaluable. Because the sensor alerts the patient and the parent or guardian to the emergency at any time and in any place, care can be delivered as soon as possible. If patients go too long without receiving the antibiotics necessary to fight serious bacterial infections, it places them at higher risk of developing sepsis or septic shock. It can lead to decompensation - which means costly and lengthier hospital stays that could be avoided if patients received antibiotic therapy sooner.
Zansors is on the forefront of saving lives with noninvasive sensors and tools that lead to earlier antibiotic therapy in the immunocompromised cancer pediatric patient. Zansors is building a sensitive tool that is advancing the best practice for pediatric cancer patients.
In the future, sensors will allow patients and parents to live more freely without worry about the inaccuracy of temperatures or the definitions of fever. I can’t wait to see the day it happens. Imagine all those lives changed.
Cherilyn Cecchini, M.D., is a senior resident in general pediatrics at Children’s National Medical Center. She will enter hematology/oncology fellowship at St. Jude Children's Research Hospital this spring. Her research interests include palliative care, communication during end of life care planning, and the concept of returning to normalcy near death.