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Prehospital management of sickle cell crisis: a case report

02 June 2022
Volume 14 · Issue 6


Sickle cell disease (SCD) covers a group of inherited conditions that affect the red blood cells. It can cause episodes of intense pain called sickle cell crises. This case study outlines a 10-year-old boy's first presentation of sickle cell crisis. The patient presents with typical sickle cell crisis pain in joints that is exacerbated by movement and related to strenuous physical exercise in the cold. This pain is caused by the sickled red blood cells occluding the microvasculature, causing tissue ischaemia. SCD is a serious disease and requires early recognition through robust clinical assessment to reduce the potential for fatality, complications and morbidity. Understanding the pathology of disease ensures paramedics work appropriately, using their knowledge to identify a patient with SCD and using skills to inform practice. Initiating the correct treatment is paramount in reducing the likelihood of fatal complications.

Sickle cell disease (SCD) is the name given to a group of inherited conditions affecting the red blood cells (erythrocytes). It causes anaemia, episodes of intense pain, as well as conditions such as acute chest syndrome, splenomegaly, gallstones, sight loss and others (Dormandy et al, 2018). SCD increases the utilisation of health services and causes severe lifestyle problems. This is owing to the complexities of treatment alongside factors such as a decrease in social activities because of exacerbated SCD conditions (Thompson, 2006).

It is estimated that people with SCD will live 22 years less than those without SCD because of the chronic complications associated with the disease, which also translate to a reduction in lifetime income (Lubeck et al, 2019).

These long-term complications affect vital organs causing splenic and renal impairment, increased susceptibility to infections and pulmonary hypertension leading to acute chest syndrome (ACS). All of these contribute to declining health and, in some situations, death (Onimoe and Rotz, 2020).

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