An 18-year-old with sickle cell disease arrives in vaso-occlusive crisis with severe back and leg pain rated 9 of 10. Which interventions are appropriate? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
VOC requires aggressive analgesia (IV opioids, often PCA), isotonic fluid at 1 to 1.5 times maintenance (over-hydration worsens pulmonary edema in acute chest syndrome), screening for ACS with chest imaging and pulse oximetry, and oxygen for hypoxia. COLD application is contraindicated because vasoconstriction worsens sickling — WARM packs are preferred. Routine supplemental oxygen in normoxic patients can suppress erythropoiesis and is not recommended; oxygen is targeted to baseline saturation.
Acute chest syndrome triad: new infiltrate plus fever plus respiratory symptoms. Leading cause of mortality in adult SCD. Anticipate exchange transfusion if severe.