Sickle Cell: Acute Pain

Clinical Pathways promote evidence based, safe, and high-value care for patients by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by methodical review of available evidence and consensus among committee members.

Clinical Pathway:

• Sickle Cell Disease: Management of Acute Pain Algorithm 
• Sickle Cell Disease: Management of Acute Pain Synopsis (provides care standards employed for this clinical pathway)

Additional tools associated with this Clinical Pathway:

• Intranasal Fentanyl 
• Intranasal Fentanyl - French 
• Intranasal Fentanyl - Somali 
• Intranasal Fentanyl - Spanish 
• Intranasal Fentanyl - Swahili 

Inclusion and exclusion criteria:

• Inclusion:
  • Patient > 1 year of age with:
    • Sickle cell disease
    • Acute pain crisis
  • Patient being seen in the emergency department
• Exclusion:
  • Patient with sickle cell disease experiencing:
    • Fever
    • Acute chest syndrome, refer to Sickle Cell: Acute Chest Syndrome
    • Suspected stroke, refer to Sickle Cell: Stroke
      

Committee members involved in the development:

• Allison Adam, MD | Emergency Department, Pediatric Emergency Medicine Fellow | Committee Chair
• Leslie Hueschen, MD | Emergency Department | Committee Chair/Member
• Michelle DePhillips, MD | Emergency Department | Committee Member
• Lina Patel, MD | Emergency Department | Committee Member
• Laurence Noisette, MD | Hematology/Oncology/BMT | Committee Member
• Shabnam Arsiwala, MD, FAAP | Hematology/Oncology/BMT | Committee Member
• Amy Johnson, MD, MBA | Hematology/Oncology, BMT, Pediatric Fellow | Committee Member 
• Shailly Gaur, MD | Hematology/Oncology/BMT, Pediatric Fellow | Committee Member
• Charleen Cunningham, RN, MSN, CPN | Emergency Department, Assistant Director of Nursing | Committee Member
• Rae Kingsley, DNP, APRN, CPNP-AC/PC | Rheumatology/Pain Clinic/Rehabilitation for Amplified Pain Syndromes (RAPS) | Committee Member 
• Ibad Siddiqi, PharmD | Pharmacy, Emergency Department Team Leader | Committee Member
• Chris Kennedy, MD | Emergency Department | Committee Member
• Sue Stamm, MSN, RN, CPNP, CPON | Clinical Practice and Quality | Committee Member 

Patient/Family Committee Member:

• Jewel Akpan | Committee Member

 EBP Committee Members:

• Todd Glenski, MD, MSHA, FASA | Anesthesiology, Evidence Based Practice
• Kelli Ott, OTD, OTR/L | Evidence Based Practice

Publication dates:

• Finalized date: 10/2023
• Next expected revision date: 10/2026

If you have any questions regarding this content or identify a broken link, please email evidencebasedpractice@cmh.edu. 

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.