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

Oral Analgesia

Review

Usual home opioid medication (ask patient, family or hematology consultant)
Recent medications given (time, dose)

Oral Analgesia

Use the ED Sickle Cell with Pain Order Set
Administer appropriate dose of Oxycodone
Administer buprofen (if not given within the preceding 6 hours)

Reassess

30-60 minutes following oral dose
If pain persists, proceed to IV therapy
If pain relieved, observe for an additional 90 minutes in the ED

Discharge

Pain controlled for a minimum of 90 minutes following oral therapy
Perscription for 3 days of Oxycodone and ibuprofen for home
Advise patient when next dose of Oxycodone and ibuprofen should be given

Note: Patients who have a good response to oral therapy do not require CBC, reticulocyte screening unless clinically indicated.