Title : Early nursing recognition and management of oncologic emergencies: A scoping review of emergency and supportive/palliative care approaches
Abstract:
This scoping review systematically maps the evidence on nursing interventions for early recognition and management of oncologic emergencies in adults with cancer. Oncologic emergencies represent time-critical conditions including neutropenic sepsis, malignant spinal cord compression, tumor lysis syndrome, hypercalcemia, acute airway obstruction, superior vena cava syndrome, and catastrophic bleeding complications of cancer disease progression or antineoplastic treatment toxicity that frequently trigger unplanned emergency department visits, intensive care admissions, and rapid clinical deterioration. Early nursing recognition, prompt triage, coordinated supportive management, and palliative care integration are essential to prevent avoidable morbidity and mortality, yet robust evidence on nursing-led approaches remains fragmented and incompletely synthesized across healthcare settings, cancer populations, and care delivery models. Following PRISMA-ScR guidelines, we conducted a systematic search of PubMed, Scopus, CINAHL, and ScienceDirect databases to identify primary research describing nurse-led assessment protocols, clinical recognition tools, rapid response pathways, patient/caregiver education, telehealth triage, and collaborative care models for oncologic emergencies in emergency departments, acute care units, and inpatient oncology settings. Two independent reviewers screened records, extracted data, and synthesized findings narratively and through evidence mapping. The review identified critical gaps in standardized nursing protocols for emergency detection and acute symptom stabilization, particularly in resource-limited settings and community care environments. Integration of supportive and palliative care alongside acute management is inconsistently documented across the literature. The findings demonstrate that current nursing interventions provide insufficient emergency-specific frameworks for time-critical oncologic complications. There exists an absence of evidence-based acute care pathways, standardized nursing recognition algorithms, and sustainable digital health tools for remote patient monitoring and early symptom escalation. This scoping review provides an evidence-based foundation to inform the development of standardized nursing protocols, educational curricula, and resource-appropriate interventions for emergency and supportive/palliative oncology nursing care, directly addressing the Special Issue's focus on emergency and supportive approaches in oncological healthcare.
Keywords: Nursing Interventions, Oncologic Emergencies, Emergency Care, Early Recognition Triage Protocols, Supportive Care, Palliative Care, Nursing Management.
