Emergency Department Clinical Pathway for Evaluation/Treatment
of Children with Sickle Cell Disease with Fever
All children with sickle cell disease and a central venous catheter/apheresis port should be treated according to the Non-oncology with CVC and Fever Pathway.
Review criteria for:
ED RN Standing Order for SCD, fever
ED RN Standing Order for SCD, fever
- As Clinically Indicated
- FLOC/RN team assessment
- RN: IV access, CBC, blood culture
- Complete History, Physical Exam
- Diagnostic Studies
- Consider COVID and/or influenza testing
- As Clinically Indicated:
Clinically Suspected
Acute Chest Syndrome
Acute Chest Syndrome
2-11 mos or
≥ 12 mos and All Low-risk Criteria Not Met
≥ 12 mos and All Low-risk Criteria Not Met
12 mos-16 yrs
Meets All Low-risk Criteria
Meets All Low-risk Criteria
≥ 17 yrs
Meets All Low-risk Criteria
Meets All Low-risk Criteria
Ampicillin
Azithromycin
Send Type and Cross
Azithromycin
Send Type and Cross
Ampicillin
Ceftriaxone
Observe 2 hrs
Observe 2 hrs
Levofloxacin
Admit
Discharge
- Review with Hematology Consultant
- If all Low-risk Criteria are not met, admission is required
- If all Low-risk Criteria are met, eligible for discharge after Hematology consultation
Clinical | Labs, X-ray Findings | PMH, Social History |
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Posted: January 2010
Revised: July 2022
Authors: A. Ellison, MD; C. Witmer, MD; J. Lavelle, MD; C. Jacobstein, MD; C. Norris, MD; R. Cecil, RN, MSN; T. McKnight, CRNP; K. Smith Whitley, MD; S. Myers, MD
Revised: July 2022
Authors: A. Ellison, MD; C. Witmer, MD; J. Lavelle, MD; C. Jacobstein, MD; C. Norris, MD; R. Cecil, RN, MSN; T. McKnight, CRNP; K. Smith Whitley, MD; S. Myers, MD