Fifteen-minute consultation: Recognition of sickle cell crises in the paediatric emergency department

Arch Dis Child Educ Pract Ed. 2022 Jun;107(3):169-174. doi: 10.1136/archdischild-2020-321338. Epub 2021 Apr 8.

Abstract

Children with sickle cell disease can develop life-threatening and painful crises that require prompt assessment and efficient management by healthcare professionals in the emergency or acute care setting. Due to migration patterns and improved survival rates in high-prevalence countries, there is an increased tendency to encounter these patients across the UK. These factors warrant regular revisions in sickle cell crisis management, along with education for medical personnel and patients to improve clinical care and patient management. The focus of this article is on the initial assessment and management of acute paediatric sickle cell complications in the emergency setting. Specific case studies, including acute pain crises, trauma, splenic sequestration, aplastic crises, acute chest syndrome, infection, avascular necrosis, osteomyelitis and stroke, are discussed. Due to the current COVID-19 pandemic, we have also reviewed specific concerns around this patient group.

Keywords: adolescent health; analgesia; pain; pathology; resuscitation.

MeSH terms

  • Anemia, Sickle Cell* / complications
  • Anemia, Sickle Cell* / diagnosis
  • Anemia, Sickle Cell* / therapy
  • COVID-19*
  • Child
  • Emergency Service, Hospital
  • Humans
  • Pandemics
  • Referral and Consultation