Management of Vaso-occlusive Episodes in Persons with Sickle Cell Disease in the Emergency Department Topic Brief-Management of Vaso-occlusive Episodes in Persons with Sickle Cell Disease in the Emergency Department Topic Brief

Management of Vaso-occlusive Episodes in Persons with Sickle Cell Disease in the Emergency Department Topic Brief

Pdf Summary

This topic brief provides evidence-based recommendations for the treatment of vaso-occlusive episodes (VOE) in individuals with sickle cell disease (SCD) presenting in the emergency department (ED). VOEs are the most common reason for ED visits in individuals with SCD. The brief discusses the pathophysiology of SCD, including the chronic end organ damage and various medical complications associated with the disease. It emphasizes the importance of early and aggressive pain management for VOEs, including the administration of opioids within 30-60 minutes from pain onset. However, there are several barriers to timely opioid administration, including misconceptions about individuals with SCD being addicted to opioids, systemic racism, ED crowding, and high ED utilization. Unconscious bias is also discussed, highlighting the need for healthcare providers to be aware of and address their biases when treating individuals with SCD. The brief also provides a summary of the NHLBI recommendations for the treatment of VOE in the ED, which include rapid and individualized pain assessment, the use of opioids and adjunctive agents, and the consideration of non-pharmacologic strategies. It emphasizes the importance of implementing processes to facilitate the timely administration of opioids in busy EDs. Finally, the brief discusses the impact of high ED utilization on the treatment of VOE in individuals with SCD and the need for case management and referral systems to address social and behavioral health factors that contribute to ED visits.

Meta Tag

vaso-occlusive sickle cell disease

vaso-occlusive SCD

vaso-occlusive chronic disease

vaso-occlusive pain

vaso-occlusive opioids

vaso-occlusive NHLBI guidelines

vaso-occlusive triage

vaso-occlusive unconscious bias

vaso-occlusive stigma

Keywords

vaso-occlusive episodes

sickle cell disease

emergency department

pain management

opioids

chronic end organ damage

medical complications

barriers to opioid administration

systemic racism

ED crowding