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Sickle Cell Anemia In Children, Ambulatory Care
Sickle cell anemia
is a disease that causes your child's body to break down too many red blood cells (RBCs). RBCs carry oxygen to all the organs and tissues. Sickle cell anemia is a serious form of sickle cell disease. The disease causes RBCs to be sickle (crescent) shaped. Your child's risk increases if both his parents have the gene for sickle cell anemia. Your child's healthcare provider can confirm your child has sickle cell anemia from the shape of your child's RBCs.
Common symptoms include the following:
- Pale skin
- Swollen hands and fingers
- Frequent headaches
- Shortness of breath
- Pain throughout his body
Call 911 for any of the following symptoms:
- A cough, shortness of breath, or chest pain
- A new, different, or more severe headache
- An erect penis for 2 hours in your male child
- Vision loss in one or both eyes
- Confusion, problems speaking, or weakness or numbness in the arm, leg, or face
Seek immediate care for the following symptoms:
- A fever
- Sleepiness, paleness, and swollen stomach
- Not acting like himself, a seizure, or fainting
- Pain does not decrease even with pain medicine
- Feeling that he cannot cope with his pain or the disease, or that he wants to die
Medical alert identification:
Have your child wear medical alert jewelry or carry a card that says he has sickle cell anemia. Ask your child's healthcare provider where to get these items.
Treatment for sickle cell anemia
may include ongoing screening for conditions that can develop because of sickle cell anemia. Examples include kidney disease, hypertension (high blood pressure), retinopathy (eye problems), and problems with his lungs.
- Medicines may be given to decrease pain or to decrease sickling of your child's RBCs. Your child may also need medicine to treat or prevent a bacterial infection.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
- Acetaminophen decreases your child's pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.
- Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
- A blood transfusion replaces blood with RBCs that are not sickle shaped.
Help your child manage pain:
- Monitor your child for signs of pain. Watch for redness or swelling in his hands or feet. If he is too young to talk, watch his face and look for other signs of pain. If he is old enough to talk, ask him where he feels the pain and how bad it is. Have him use a pain scale to show you how much pain he feels.
- Apply heat to areas of pain. Use a heating pad or place your child in a warm bath. Do this for 20 to 30 minutes every 2 hours for as many days as directed by your child's healthcare provider. Heat can help decrease your child's pain.
- Massage areas where your child feels pain. This can help decrease pain and may help him relax.
- Help your child balance rest and exercise. Have him rest during a sickle cell crisis. Over time, he can increase his activity to a moderate amount. Activity may help decrease pain. Ask your child's healthcare provider which activities are safe for your child. He may need to avoid activities that increase his risk for injury, such as football.
Prevent a sickle cell crisis:
- Give your child vitamins and minerals as directed. Folic acid can help prevent blood vessel problems that can occur with sickle cell anemia. Zinc may decrease how often your child has pain.
- Give your child liquids as directed. Dehydration can increase his risk for a sickle cell crisis. Ask how much liquid he should drink each day and which liquids are best for him.
- Keep your child out of the cold. Do not let him go from a warm place to a cold place quickly. Keep him warm in the winter. Do not let him go swimming in cold water.
- Ask about which vaccinations your child needs. Vaccinations can help prevent a viral infection that may lead to a sickle cell crisis. Take him to get a flu shot every year as directed. He may also need a pneumonia vaccine every 5 years.
- Talk to caregivers, teachers, and others in your child's school. Tell them that your child has sickle cell anemia. Teach them the signs and symptoms of a crisis, acute chest syndrome, and infection. Teach them what to do if they see any signs or symptoms of these problems.
- Talk to your child about harmful behaviors. Tell your child not to smoke or be around secondhand smoke. Tell him not to drink alcohol. Smoking cigarettes or drinking alcohol increases his risk for a sickle cell crisis.
Follow up with your child's healthcare provider as directed:
Your child may need ongoing screening for conditions that can develop because of sickle cell anemia. Examples include kidney disease, hypertension (high blood pressure), retinopathy (eye problems), and problems with his lungs. Write down your questions so you remember to ask them during your visits.
Care AgreementYou have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.