EM Cases · Sickle cell crisis
Acute chest syndrome — the hypoxic sickle resus station
ACEM Fellowship resus station testing ACS recognition, opioid dosing, antibiotics, incentive spirometry, and simple versus exchange transfusion thresholds.
On this page
Study tools
Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
A young adult with HbSS, vaso-occlusive pain evolving into fever, hypoxia and a new pulmonary infiltrate.
Station brief
Format. Clinical-management (resus) station, 11 minutes total — 4 minutes reading, 7 minutes active assessment. You are the Emergency Medicine consultant leading the resuscitation.
Candidate instructions. Manage the patient. State actions and reasoning aloud. The examiner plays nursing and laboratory staff.[2]
References5ShowHide
- [1]Yawn BP, Buchanan GR, Afenyi-Annan AN, et al. Management of sickle cell disease: summary of the 2014 evidence-based report by expert panel members JAMA, 2014.PMID 25203083
- [2]Vichinsky EP, Neumayr LD, Earles AN, et al. Causes and outcomes of the acute chest syndrome in sickle cell disease. National Acute Chest Syndrome Study Group N Engl J Med, 2000.PMID 10861320
- [3]Chou ST, Alsawas M, Fasano RM, et al. American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support Blood Adv, 2020.PMID 31985807
- [4]Biller E, Zhao Y, Berg M, et al. Red blood cell exchange in patients with sickle cell disease-indications and management: a review and consensus report by the therapeutic apheresis subsection of the AABB Transfusion, 2018.PMID 30198607
- [5]van Beers EJ, van Tuijn CF, Nieuwkerk PT, et al. Patient-controlled analgesia versus continuous infusion of morphine during vaso-occlusive crisis in sickle cell disease, a randomized controlled trial Am J Hematol, 2007.PMID 17617790