Sickle Cell Crisis admission

Patients can present to ER with severe pain in chest, bones etc with history of Sickle Cell Anemia. Usually you can confirm with Hb Electrophoresis which takes more than a day to test. Most of them usually have a history of Sickle cell diagnosis.

ER:

Routine Labs, EKG, CXR

IV Fluids, Encourate PO fluids

Pain Management

Oxygen

Hospitalist:

Continue IV Fluids, Pain Management-usually narcotics with Zofran, Oxygen

Urology consult for Priapism

Hb Electrophoresis if diagnosis needs to be confirmed

Hematology Consult for severe anemia. They may need Folic Acid, Hydroxyurea

Blood Transfusion if very anemic

Minimize too many blood draws

Flu shot, Pneumococcal vaccine prior to discharge.

They may need high doses of iv narcotics. Some may be addicted to narcotics and can demand iv Dilaudid but we should give benefit of doubt to them when they complain of pain.