Objectives National data reveal that 60% of the 4.5 million annual emergency department (ED) visits by patients with cancer result in admission. Many of these visits are due to a febrile illness. Current literature provides limited guidance on how to treat non‐neutropenic febrile ED patients. This study characterizes clinical outcomes of non‐neutropenic febrile patients with cancer presenting to an academic, Comprehensive Cancer Center affiliated ED. Methods Retrospective chart review of 101 randomly selected adult patients with active cancer presenting with a chief complaint of fever or a documented fever in the ED and an absolute neutrophil count above 1000 between October 2015 and September 2016. Descriptive statistics were calculated. Results The primary malignancies represented were hematologic (24%), gastrointestinal (13%), head and neck (13%), and genitourinary (8%). Sixty‐two percent were on chemotherapy, 15% on radiation therapy, and 12% were on targeted therapy. Severe illness outcomes occurred in 39% and 83% were admitted with a median length of stay of 4 days. Among admitted patients, 24% experienced a length of stay ≤2 days. A return visit to the ED or an in‐system hospitalization within 7 days of the index visit occurred in 10% and death occurred within 7 days of the index visit in 4%. Conclusion A majority of patients presenting to the ED with non‐neutropenic fever are admitted (83%), of whom nearly a quarter experience a length of stay of ≤2 days with infrequent serious illness outcomes. Future efforts should focus on the development of risk stratification tools in this population to avoid potentially unnecessary hospitalizations.

D istribution system pipes are the final barrier in the multiplebarrier approach for providing safe drinking water. Maintaining the integrity of the distribution system is of utmost importance in protecting public health. A cross-connection is any unprotected actual or potential connection or structural arrangement between a potable water system and any other system through which it is possible to introduce substances other than the potable water with which the system is supplied (FCCCHR, 1993). Thus, it is a basic tenet of water distribution system design and operation that cross-connections and backflow present risks to public health. OCCURRENCE OF CROSS-CONNECTIONS IS WIDESPREADCross-connections have traditionally been thought of as physical connections to distribution system piping, but intrusions of water into the distribution system from leaking joints and pipes can also be considered a specific type of cross-connection. If a physical cross-connection exists, as long as the pressure in the distribution system is lower than the pressure exerted by the pollutant or contaminant (i.e. liquid, gas, or solid) outside of the system, then backflow-the undesirable reversal of flow into the distribution system-will occur. The pressure differential that causes backflow may occur because the pressure in the distribution system drops and becomes subatmospheric (backsiphonage), or may occur if the pressure of liquid external to the system increases (backpressure).This work was derived from the research report Determining Vulnerability and Occurrence of Residential Backflow with the permission of the Water Research Foundation. The full report is free and available to Foundation subscribers by calling 303-347-6121 or logging on to www.waterresearchfoundation.org. istrib barrie ing th tance unpro b

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