Emergency Cover: — What Happens at 2am?

Yes. CION provides an out-of-hours contact number before your first cycle — one that connects you to someone who can assess your symptoms and advise you, not a recorded instruction to present to casualty. Save it before treatment day, and make sure the family member most likely to be with you at night has it too. If you were not given a number at your first consultation, ask your treating team before cycle one starts.

A fever needs a call the same night it appears, not in the morning. During chemotherapy, a fever that would normally mean rest can signal an infection the body cannot fight when white cell counts are low, and it can escalate within hours. Other symptoms that need an out-of-hours call include difficulty breathing, severe abdominal pain, chest pain, confusion, or heavy and unusual bleeding. Your team will tell you, before your first cycle, which of these need the emergency department rather than a phone call.

They will need to be told. Always have your treatment name, the cycle number, and the date of your last treatment ready when you call — either written on paper or on a treatment summary card. On-call staff work across many patients and many treatments, and giving this information quickly means they can advise you faster. Ask for a printed treatment summary at your next appointment if you do not already have one.

You can, and if you need to go urgently, go. Any emergency department can treat you. But tell the triage team immediately that you are on chemotherapy — this changes the priority of your assessment. Where possible, call the CION out-of-hours number first so your team is informed and can communicate with the treating hospital if needed. Always bring your treatment summary card so the emergency team has your diagnosis and cycle details without delay.

That is fine. The on-call team is used to speaking with family members and carers. What helps them is the same information you would give: your name, the treatment you are on, the cycle number, and a clear description of the symptoms. If you are too unwell to speak, a family member who knows these details can get you the right response just as quickly. This is one reason to make sure the person most likely to be with you at night knows the treatment name and has the number saved.

No. A fever during chemotherapy should be reported the same night it appears, regardless of the hour. This is one of the non-negotiable rules of chemotherapy safety. The concern is that your white cell count may be too low to fight even a mild infection, and what looks like an ordinary fever can become serious within hours. Your team would always rather receive a call at 2am that turns out to be nothing serious than hear about a fever that was left until morning.