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Sickle Cell Crisis, Ambulatory Care

A sickle cell crisis

is a painful episode that occurs in people who have sickle cell anemia. It happens when sickle-shaped red blood cells (RBCs) block blood vessels. Blood and oxygen cannot get to your tissues, causing pain. A sickle cell crisis can also damage your tissues and cause organ failure, such liver or kidney failure. A sickle cell crisis can become life-threatening.

Common symptoms include the following:

  • Fever
  • Pain
  • Weakness or fatigue
  • Abdominal pain and swelling
  • Headaches
  • A painful, erect penis (priapism)
  • Fast heartbeats
  • Shortness of breath

Call 911 for any of the following symptoms:

  • Shortness of breath or chest pain
  • An erection that is painful and does not go away
  • Vision loss in one or both eyes

Seek immediate care for the following symptoms:

  • Feeling like you cannot cope with your pain, or feeling like hurting yourself
  • Behavior changes, a seizure, or fainting
  • A fever
  • Abdominal pain, nausea, or vomiting
  • A different or worse headache
  • New weakness or numbness in your arm, leg, or face
  • New pain in any part of your body
  • Dark urine, or urinating less than usual or not at all
  • Dizzy, lightheaded, or faint

Medical alert identification:

Wear medical alert jewelry or carry a card that says you have sickle cell anemia. Ask your healthcare provider where to get these items.

Treatment for a sickle cell crisis

may include any of the following:

  • IV fluids treat dehydration and help reduce sickling of RBCs.
  • Oxygen helps increase oxygen levels in your blood and make it easier for you to breathe.
  • A blood transfusion replaces blood with RBCs that are not sickle shaped.
  • Surgery may be done to remove part of your spleen.

Self-care:

  • Medicines may be given to decrease pain or to decrease sickling of your RBCs. You may also need medicine to prevent a bacterial infection or help you breathe more easily.
  • 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 you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

Prevent a sickle cell crisis:

  • Take vitamins and minerals as directed. Folic acid can help prevent blood vessel problems that can come with sickle cell anemia. Zinc may decrease how often you have pain.
  • Drink liquids as directed. Dehydration can increase your risk for a sick cell crisis. Ask how much liquid to drink each day and which liquids are best for you.
  • Balance rest and exercise. Rest during a sickle cell crisis. Over time, increase your activity to a moderate amount. Exercise regularly. Avoid exercise or activities that can cause injury, such as football. Ask about the best exercise plan for you.
  • Stay out of the cold. Do not go quickly from a warm place to a cold place. Do not go swimming in cold water. Stay warm in the winter.
  • Do not smoke cigarettes or drink alcohol. These increase your risk for a sickle cell crisis. Smoking can also delay healing after treatment. Ask your healthcare provider for information if you currently smoke and need help quitting.
  • Ask about what vaccinations you need. Vaccinations can help prevent a viral infection that may lead to a sickle cell crisis. Get a flu shot every year as directed. You may need pneumonia vaccines every 5 years.

Follow up with your healthcare provider as directed:

You may need ongoing screening for conditions that can develop because of sickle cell disease. Examples include kidney disease, hypertension (high blood pressure), retinopathy (eye problems), and problems with your lungs. Write down your questions so you remember to ask them during your visits.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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.

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