Sickle Cell Pain Crisis

Treatment:

  1. Oral hydration with 3-4 liters of fluid per day. We sugest to start 0.5 to 1 L NS bolus, then maintainance D51/2NS at 150-250 cc/hr. 
  2. Pain management: These patients are usually on chronic opioids. Start dose of IV morphine based on patient's prior dose requirements, or start with 2-5 mg morphine every 3-4 hours. Convert to PO once IV dose approaches equal analgesic home regimen. Perform assessments every 20 min and escalate as needed. 
  3. Supplemental O2 if hypoxia is present. Provide incentive spirometry. 
  4. Provide stimulant (not osmotic) laxatives. 
  5. Avoidance meperidine (can precipitate seizures), and ketorolac (associated with AKI). 
  6. Evaluate for SCD complications associated with pain (eg, avascular necrosis of the hip, acute chest pain syndrome, splenic sequestration). CBC, retic count, cultures, lytes, BUN, vreatinine, bilirubin, UA, CXR,blood type and screen. 

Revision #3
Created 25 February 2022 06:36:40 by Katarina Soewono
Updated 10 June 2022 05:01:54 by Katarina Soewono