ED Pathway for Evaluation/Treatment of Children with Sickle Cell Disease with Fever

History and Physical

Review most recent Hematology Letter
Check Snapshot, look under Problem List, click on Sickle Cell Disease Type

History Physical
  • Duration of fever
  • Presence of other symptoms
  • Hydration
  • Baseline hemoglobin
  • Baseline pulse oximetry reading
  • Previous admissions, ICU admission
  • Complications of sickle cell disease:
    • Acute chest syndrome
    • Aplastic crisis (Parvovirus Infection)
    • Documented bacteremia
    • Stroke, TIA
    • Splenic sequestration
    • Gall bladder disease
    • Osteomyelitis, septic arthritis
  • Last dose of Ceftriaxone
  • Transfusion history
  • Surgical history
  • Vaccination history including Prevnar status
  • Medications:
    • Penicillin prophylaxis
    • Hydroxyurea
    • Folic acid
    • Pain medications
    • Others
  • Allergies
  • VS, Pulse oximetry reading
  • General appearance, jaundice
  • Respiratory status
  • Circulatory status
  • Neurologic status
  • Evidence of focal infection
  • Spleen size
  • Presence of rash or petechiae