The Sickle Cell Patient in the ED – Management of Acute Complications
Evidence-based guidelines and expert panels recommend the following in the management and treatment of pain crisis: Initiate analgesia within 30 minutes of triage. (Consensus – Panel Expertise) Employ individualized prescribing and pain monitoring protocols. (Consensus – Panel Expertise) If no contraindications, give NSAIDs as adjuvant pain therapy. (Moderate Recommendation, Low-Quality Evidence) Avoid meperidine (pethidine) (normeperidine, […]
Managing Sickle Cell Disease in the ED
One of the reasons that managing Sickle Cell pain crises can be challenging is that we often under-dose analgesics in these patients. Use IV opiods for rapid effect. The subcutaneous route is more reliable than the IM route if no IV available. Use NSAIDS sparingly in Sickle Cell Disease! While NSAIDs for acute pain crises […]
Priapism
Non-ischemic (high-flow) Ischemic (low-flow) Physical Exam Typically painless, not fully tumescent Painful, fully tumescent with corpus cavernosa rigidity without involvement of corpus spongiosum and glans penis Aetiology High-flow priapism is extremely rare and most commonly associated with antecedent trauma including blunt trauma, or resulting from needle injury of the cavernosal artery. Low-flow priapism is […]
