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Fifteen-minute consultation: Recognition of sickle cell crises in the paediatric emergency department
  1. Shrina Patel1,
  2. Christopher Dadnam2,
  3. Rebecca Hewitson2,
  4. Indu Thakur3,
  5. Jeff Morgan2
  1. 1 General Medical Department, Morriston Hospital, Swansea, UK
  2. 2 Paediatric Emergency Department, Cardiff and Vale University Health Board, Cardiff, UK
  3. 3 Paediatric Haematology Department, Cardiff and Vale University Health Board, Cardiff, UK
  1. Correspondence to Dr Christopher Dadnam, Cardiff and Vale University Health Board, Cardiff CF14 4XW, UK; chmdadnam{at}hotmail.com

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.

  • pain
  • resuscitation
  • adolescent health
  • analgesia
  • pathology

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Footnotes

  • SP and CD are joint first authors.

  • Correction notice The layout of this article has been changed slightly since it was published online.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.