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Vital Signs

Sickle-Cell Pain Management Guidelines at a Glance

For Americans who suffer from sickle-cell disease, which occurs primarily in African Americans and Hispanics of Caribbean ancestry, this incurable, inherited blood disorder is synonymous with extreme pain. When the disease’s characteristic abnormal, sickle-shaped red blood cells become stuck in blood vessels, blocking them and cutting off the flow of blood and oxygen, this blockage can cause a pain crisis so severe that patients must be treated in the hospital with pain-killing drugs.

Many sickle-cell patients in crisis end up in busy hospital emergency departments, where they must be treated for their pain, evaluated for new symptoms and monitored for possible life-threatening complications--such as stroke, infections and kidney damage--in an accelerated timeframe. To assist ED clinicians in assessing and treating these patients, the American Pain Society (APS) has developed a quick reference guide based on its previously published, full-length Guideline for the Management of Acute and Chronic Pain in Sickle-Cell Disease.

The reference guide is a chart that can be mounted on a wall in the ED to give doctors and nurses quick yet accurate access to information on treating sickle-cell patients who have acute pain emergencies. The chart contains APS’ algorithm for assessing and treating acute sickle-cell disease in an ED environment--based on recommendations in the evidence-based, peer-reviewed full-length Guideline--along with validated tools for pain assessment. APS has also produced a handy, pocket-sized version of the ED guide as an additional way to provide fast access to the pain management algorithm.

Both versions of the Emergency Department Quick Reference Guide can be purchased from APS at (847) 375-4715 or www.ampainsoc.org (click on “Publications”). The Society also offers a Special Guidelines Package--the full-text Guideline, the wall chart and a packet of 10 pocket-sized Quick Reference Guides--for $24 ($18 for APS members) plus shipping and handling.