On this page
- Download leaflet
- Introduction
- Where should I bring my child?
- What will happen when I get to Accident and Emergency Department?
- How quickly will my child get pain relief?
- Will I see a member of the Haematology Team in Accident and Emergency Department?
- Will my child be admitted to hospital?
- Where will my child be admitted?
- What should I do if my child is discharged from Accident and Emergency Department?
- Further information
- References
- Useful websites
Download leaflet
Introduction
This leaflet aims to provide you with general information about the signs and symptoms your child may have when they are having a sickle cell crisis. If you are ever worried about your child please contact your Sickle Cell Team or take your child to the Accident and Emergency Department.
When should I bring my child to hospital?
We try to encourage you to manage your child’s crisis at home whenever possible. However there are some symptoms when you must bring your child to the hospital for an urgent medical review,
Bring your child immediately to hospital if any of the following symptoms are present:
pain that is not controlled by their usual pain medicine
pain that is not like their usual sickle cell pain
severe pain
difficulty in breathing
temperature over 38 ÌC
any symptoms of a stroke such as sudden weakness or numbness of the face, arm or leg, especially on one side of the body, tingling in arms or legs, sudden confusion, trouble speaking or understanding
priapism lasting longer than two hours.
If you do not have transport to bring your child to the hospital, ring 999.
Where should I bring my child?
You should take your child to the Accident and Emergency Department. This is usually at Alder Hey but you may have a hospital closer to you. If you have time, ring your Sickle Cell Team to let them know that you are bringing your child to the hospital. Whenever possible the Sickle Cell Team will see you when you are in the Accident and Emergency Department.
What will happen when I get to Accident and Emergency Department?
When you arrive at the Accident and Emergency Department you will need to book your child in. The receptionist will take your child’s name and date of birth. It is important you tell the receptionist that your child has sickle cell.
You will then be seen by the Triage Nurse. The Triage Nurse will assess your child by taking a history of what has been happening during this episode, take their blood pressure, temperature, pulse, oxygen saturations and assess their pain. It is important you also inform the Triage Nurse that your child has sickle cell as your child will be triaged as a higher priority and will be seen by a doctor sooner.
A doctor will assess your child, order any investigations that may be needed and give treatment. This may be pain relief, fluids or oxygen.
The doctor may ask you:
- What pain medication you last gave your child – how much, what time and how much the medication relieved their pain.
- If your child has had a hospital admission. If there had been an admission, what was it for and what pain medication was used.
- What other medications they are taking now.
How quickly will my child get pain relief?
We aim to give your child pain relief within 30 minutes of them arriving at the hospital and for their pain to start to improve within two hours. (NICE, 2012) Your child will have a pain assessment when they are initially assessed and will have it repeated regularly throughout their hospital admission.
Will I see a member of the Haematology Team in Accident and Emergency Department?
The Accident and Emergency Doctors will ring the Haematology Doctors for advice once they have assessed your child. You can ask the Accident and Emergency Doctors if they have spoken to the Haematology Doctors and what they have been advised.
Will my child be admitted to hospital?
Your child will be admitted to hospital if:
- their pain is not controlled quickly
- they need strong pain medication
- they have any other symptoms apart from pain
- your child requires specific treatment such as intravenous antibiotics, fluids or a blood transfusion
Where will my child be admitted?
Your child will be admitted onto a medical ward in the hospital. The Haematology Team will take over your child’s care once they have been admitted onto the ward. If your child has been admitted at night time the Haematology Team will take over the care from the next day.
What should I do if my child is discharged from Accident and Emergency Department?
If your child is discharged it means that the doctors are happy for you to look after your child at home. If your child is having a crisis you should continue giving regular pain relief as normal and encourage them to rest and have plenty of fluids. If your child does not settle or the symptoms become worse contact your Sickle Cell Team for advice or bring them to Accident and Emergency Department.
Further information
If you have any questions or want any further information please contact your Sickle Cell Team on 0151 252 5070.
References
National Institute for Health and Care Excellence, 2012. Sickle cell disease: managing acute painful episodes in hospital. NICE guidelines (CG143)
Useful websites
Alder Hey Children’s NHS Foundation Trust is neither liable for the contents of any external internet site listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites.
This leaflet only gives general information. You must always discuss the individual treatment of your child with the appropriate member of staff. Do not rely on this leaflet alone for information about your child’s treatment.
This information can be made available in other languages and formats if requested.
PIAG: 0042