People living with sickle cell disease can experience severe “pain crises”, or vaso-occlusive episodes (VOE), and are at increased risk for infections, strokes, heart failure, and other serious disease processes. In this 3 part series, we’re talking with experts to learn more about sickle cell disease and its complications and how we can best advocate for and treat these patients in the ED. In part 1, we delved into assessment and management of patients presenting with VOE.

In this episode, we focus specifically on kids presenting with VOE. We know these patients have usually exhausted their home pain control options and are still in excruciating pain when they arrive in the ED. We interviewed Dr. Chris Rees about his recent paper on the benefits of treating kids with VOE with an initial dose of intranasal fentanyl.  The results are pretty impressive! 

Stay tuned for Part 3 of our series where we’ll explore the management of other emergent presentations related to sickle cell disease!

Did this episode change your practice? Let us know on social media @empulsepodcast or at ucdavisem.com

Hosts:

Dr. Sarah Medeiros, Associate Professor of Emergency Medicine at UC Davis

Dr. Julia Magaña, Associate Professor of Pediatric Emergency Medicine at UC Davis

Guests:

Dr. Chris Rees, Assistant Professor of Pediatrics and Emergency Medicine at Emory University

Resources:

Rees CA, Brousseau DC, Ahmad FA, et al; SCD Arginine Study Group and PECARN. Intranasal fentanyl and discharge from the emergency department among children with sickle cell disease and vaso-occlusive pain: A multicenter pediatric emergency medicine perspective. Am J Hematol. 2023 Apr;98(4):620-627. doi: 10.1002/ajh.26837. Epub 2023 Feb 6. PMID: 36606705; PMCID: PMC10023395..

Pediatric Emergency Care Applied Research Network (PECARN)

ACEP Emergency Department Sickle Cell Care Coalition Resources

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Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Productions for audio production services.