Sickle cell pain in the emergency department

Sickle cell disease is characterized by unpredictable episodes of extreme pain, known as acute vaso-occlusive episodes (VOE) or pain episodes, caused when sickled red blood cells are unable to move freely through blood vessels. In addition to pain, these changes at the cellular level can also lead to organ damage, stroke and even death. Pain episodes are the most common reason for emergency department (ED) visits and hospitalizations for patients with sickle cell disease. Detailed guidelines and quality indicators for the management of pain episodes currently exist, but both pediatric and adult patients with the disease often experience prolonged periods of waiting for treatment in the emergency department and ineffective treatment of their pain. Delays in treatment are often due to systemic factors, such as the lack of a clear treatment protocol or limited provider experience in treating sickle cell diseaserelated pain. Prolonged waits for effective pain relief can lead to unnecessary suffering, hospitalizations, chronic pain syndromes, other complications and increased health care costs.1,8,10-12 Ensuring patients receive timely, effective pain relief is one of the most important elements of delivering high quality care to individuals with sickle cell disease in the emergency department.   Abstract source