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<< Managing Acute Complications Of Sickle Cell Disease In Pediatric Patients

Management

The following sections discuss the treatment of the acute complications seen in patients with SCD. (See Table 3.)

Vaso-Occlusive Crisis

Analgesia

Analgesia is the mainstay of management of VOC. Patients who have experienced previous SCD VOC should have a pain crisis plan outlined by their hematologist, and emergency clinicians can initially administer medications found to be effective in prior VOC episodes. EDs managing high volumes of patients with SCD can standardize care by having protocols in place. Standard of care requires that analgesia be administered to patients within 30 minutes of triage and 60 minutes of arrival.11 Although time to analgesia should be rapid for the sake of relieving pain, a single-center retrospective cohort study of 177 children with 414 ED visits for VOC revealed that time to opioid administration had no impact on hospital admission rates.31 However, earlier administration of opioids did demonstrate a decreased ED length of stay.

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Last Modified: 07/23/2017
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