Assessment and Management of Acute Painful Sickle Cell Crisis

Assessment and Management of Acute Painful Sickle Cell Crisis - Flowchart Assessment and Management of Acute Painful Sickle Cell Crisis Assessment and Management of Acute Painful Sickle Cell Crisis

Flowchart

Suspected sickle cell vaso-occlusive crisis:
Acute pain in spine, abdomen, chest or joints in a patient of Afro-Caribbean, Arabic or Indian origin

End

Key observations (Table 1.1)
Oxygen, IV access
Relieve pain (see text)

Table 1.1

Focused assessment (see text)
Urgent investigation (Table 104.1)

104.1

Refer to haematologist
Seek urgent advice if:

Suspected acute chest syndrome (Table 104.2)
Abdominal symptoms
Neurological symptoms
Priapism (Table 104.2)

Refer to haematologist
Seek urgent advice if:

Suspected acute chest syndrome (Table 104.2)
Abdominal symptoms
Neurological symptoms
Priapism (Table 104.2)

Refer to haematologist
Seek urgent advice if:

Suspected acute chest syndrome (Table 104.2)
Abdominal symptoms
Neurological symptoms
Priapism (Table 104.2)

Suspected acute chest syndrome (Table 104.2) Table 104.2
Abdominal symptoms
Neurological symptoms
Priapism (Table 104.2) Table 104.2

Make a working diagnosis of vaso-occlusive crisis from:

Known/likely sickle cell disease
Presence of likely precipitant
Typicality of symptoms and exclusion of other causes where possible

Make a working diagnosis of vaso-occlusive crisis from:

Known/likely sickle cell disease
Presence of likely precipitant
Typicality of symptoms and exclusion of other causes where possible

Make a working diagnosis of vaso-occlusive crisis from:

Known/likely sickle cell disease
Presence of likely precipitant
Typicality of symptoms and exclusion of other causes where possible

Maintain adequate analgesia

Prevent/treat hypoxaemia and dehydration

Exclude/treat infection