Discharge Instructions for Sickle Cell Anemia and Sickle Cell Crisis (Pediatric)
Your child has sickle cell anemia. That means the red blood cells are abnormally shaped like a sickle or a half-moon. This can cause the sickle blood cells to become trapped in blood vessels and can affect the blood's ability to carry oxygen. Sickle cell anemia runs in families, and commonly affects African Americans. Sickle cell anemia can be controlled, but not cured. Your child was born with this condition.
A sickle cell crisis happens when many sickled cells stick together and pile up in the blood vessels. During a sickle cell crisis, your child can have severe pain in the chest, stomach, arms, and legs. The crisis can last for hours, or even days, and can happen several times a year. Over time, organ damage can also happen. Here’s what you can do to help your child.
What to watch for
Be on the alert for:
Any possible signs of infection, such as fever or shortness of breath
Swollen, painful, red, or hot hands and feet or a swollen belly
Signs of dehydration
Sores (ulcers) on your child's legs. These are caused by poor blood flow and are a sign that your child's sickle cell anemia is not under control.
Yellowing of the eyes or skin.
In boys, an erection that doesn’t go away
Pain that does not go away with treatment
Abnormal speech, weakness in arms or legs, or uneven face that may mean a stroke
What you can do:
Get treatment right away if your child has a fever of 100.4°F (38°C) or higher, pain, infections, illnesses, or other health problems. This includes flu, colds, and skin infections.
Call your child’s healthcare provider if you are unsure about how to treat your child. It is very important your child get proper treatment of health problems to avoid complications of sickle cell anemia.
During a sickle cell crisis, make sure you continue to give your child his or her pain medicine as prescribed by your child’s healthcare provider. If the pain continues, call your child’s healthcare provider.
Do's and don'ts once home:
Encourage your child to get plenty of activity, but not to the point of becoming overly tired. Be sure your child drinks plenty of fluids during activity.
Your child should avoid very strenuous activities and rough contact sports, such as football. Not all healthcare providers recommend this.
Encourage your child to drink plenty of liquids, especially during warm weather, in order to avoid dehydration.
Dress your child in warm clothes if he or she will be outside during cold weather or will be in air-conditioned buildings during hot weather.
Don’t allow your child to swim in cold water.
If your child must travel by air, he or she should fly in pressurized aircraft only. Talk to your child’s healthcare provider about extra safety steps if your child must travel in a nonpressurized plane.
Make a follow-up appointment as directed by our staff.
Call 911 if your child has any of the following:
Fever of 100.4°F (38°C) or higher, or as directed by your child's healthcare provider
Swelling in the abdomen (belly)
Weakness on one side of the body
Loss of feeling and movement
A painful erection of the penis lasting more than 4 hours
When to call your child's healthcare provider
Call your child's healthcare provider right away if your child has any of the following:
Swollen hands or feet
Pain that doesn’t get better with medicine
Sudden paleness of the skin or nail beds
Worsening yellowish color of the skin or eyes (jaundice)
Trouble with vision or seeing
Change in speech
Limping, joint swelling, or joint or muscle pain
October 08, 2017
DeBaun, MR. Kliegman: Nelson Textbook of Pediatrics. 2011;19:1663-70.
Levy, Adam S., MD