Lovett Paris B, Sule Harsh P, Lopez Bernard L
Department of Emergency Medicine, Thomas Jefferson University & Hospitals, 1020 Sansom Street, Suite 239, Thompson Building, Philadelphia, PA 19107, USA.
Department of Emergency Medicine, Thomas Jefferson University & Hospitals, 1020 Sansom Street, Suite 239, Thompson Building, Philadelphia, PA 19107, USA.
Hematol Oncol Clin North Am. 2017 Dec;31(6):1061-1079. doi: 10.1016/j.hoc.2017.08.009.
Acute painful episodes are the most common reason for emergency department visits among patients with sickle cell disease (SCD). Early and aggressive pain management is a priority. Emergency providers (EPs) must also diagnose other emergent diagnoses in patients with SCD and differentiate them from vaso-occlusive crisis. EPs should be aware of cognitive biases that may misdirect the diagnostic process. Administration of intravenous fluids should be used judiciously. Blood transfusion may be considered. Coordination of care with hematology is an important part of the effective emergency department and long-term management of patients with SCD.
急性疼痛发作是镰状细胞病(SCD)患者前往急诊科就诊的最常见原因。早期积极的疼痛管理是首要任务。急诊医护人员(EPs)还必须对SCD患者的其他紧急病症进行诊断,并将其与血管闭塞性危机区分开来。EPs应意识到可能会误导诊断过程的认知偏差。静脉输液的使用应谨慎。可考虑输血。与血液科协调护理是SCD患者有效急诊科治疗和长期管理的重要组成部分。