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Time- And Cost-Effective Strategies For Patients With Sickle Cell Disease

  1. Limit the use of oxygen.
    Oxygen may be detrimental because of the potential for myelosuppression and has never been shown to improve outcomes. Administer supplemental oxygen only for hypoxic patients.
  2. Consider oral rehydration and oral opiates, especially in children.
    Oral opiates are associated with shorter time-to-opiates. Consider oral opiates and hydration especially when pain is perceived to be mild with potential for discharge.
  3. Limit laboratory testing.
    In patients presenting with simple pain without other symptoms – especially if discharge is likely – laboratory tests are not necessary. Liver function tests and markers of hemolysis are not indicated unless patients have worsening icterus or significant decreases in hemoglobin from baseline.
  4. Order an incentive spirometer for all admitted patients.
    This simple intervention may decrease the incidence of inpatient acute chest syndrome, which is a high-cost, high-mortality event.

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Last Modified: 07/23/2017
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