Sickle cell crisis

Hans Bradshaw, Dale P Woolridge

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The analgesic approach to sickle cell vaso-occlusive crisis (VOC) depends on the episode's severity, which can vary between patients and even within individual's successive presentations. An improving understanding of VOC pathophysiology is outlined by a broad and informative literature. The first interventions in managing VOC pain are supportive therapies. Recommendations to decrease VOC duration by administration of oxygen and IV fluids are physiologically well grounded, and such interventions form part of nearly all VOC care protocols. Mild VOC pain can be treated with oral acetaminophen or NSAIDs. Administered by a variety of methods, opioids can safely and effectively relieve VOC pain. Orally administered controlled-release preparations of morphine have been used with success in VOC, as long as they are supplemented with additional medication as needed. The patient controlled analgesia (PCA) technology is of high potential utility in the ED management of VOC. The role of corticosteroids in treating VOC continues to evolve. Data of primarily historical interest suggest potential utility of hydrocortisone monotherapy.

Original languageEnglish (US)
Title of host publicationEmergency Department Analgesia: An Evidence-Based Guide
PublisherCambridge University Press
Pages365-379
Number of pages15
ISBN (Print)9780511544835, 9780521696012
DOIs
StatePublished - Jan 1 2008

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Pain
Delayed-Action Preparations
Patient-Controlled Analgesia
Non-Steroidal Anti-Inflammatory Agents
Acetaminophen
Morphine
Opioid Analgesics
Analgesics
Hydrocortisone
Adrenal Cortex Hormones
Oxygen
Technology
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Bradshaw, H., & Woolridge, D. P. (2008). Sickle cell crisis. In Emergency Department Analgesia: An Evidence-Based Guide (pp. 365-379). Cambridge University Press. https://doi.org/10.1017/CBO9780511544835.056

Sickle cell crisis. / Bradshaw, Hans; Woolridge, Dale P.

Emergency Department Analgesia: An Evidence-Based Guide. Cambridge University Press, 2008. p. 365-379.

Research output: Chapter in Book/Report/Conference proceedingChapter

Bradshaw, H & Woolridge, DP 2008, Sickle cell crisis. in Emergency Department Analgesia: An Evidence-Based Guide. Cambridge University Press, pp. 365-379. https://doi.org/10.1017/CBO9780511544835.056
Bradshaw H, Woolridge DP. Sickle cell crisis. In Emergency Department Analgesia: An Evidence-Based Guide. Cambridge University Press. 2008. p. 365-379 https://doi.org/10.1017/CBO9780511544835.056
Bradshaw, Hans ; Woolridge, Dale P. / Sickle cell crisis. Emergency Department Analgesia: An Evidence-Based Guide. Cambridge University Press, 2008. pp. 365-379
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