Question

According to the Centers for Disease Control and Prevention (2017), approximately 100,000 Americans have sickle cell...

According to the Centers for Disease Control and Prevention (2017), approximately 100,000 Americans have sickle cell disease. Red blood cells that contain sickle hemoglobin are inflexible. This results in the cells adhering to blood vessel walls which slows or stops blood flow. This diminished or absent flow limits the amount of oxygen reaching cells and leads to attacks of sudden pain or crisis. Many clients with sickle cell disease also experience chronic pain.

Hulihan, M., Hassell, K., Raphael, J., Smith-Whitely, K., & Thorpe, P. (2017, November 24). CDC Grand Rounds: Improving the lives of persons with sickle cell disease. Morbidity and Mortality Weekly Report, 66 (46), 1269-1271.

Initial Discussion Post:

What are some of the obstacles the RN may encounter when trying to manage the acute and chronic pain associated with sickle-cell disease?
Identify an intervention that can be implemented to overcome one of these obstacles.
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Answer #1

Individuals all ages with sickle cell disease (SCD)are at risk for the development of multisystem acute and chronic condition associated with morbidity..In optimal acute care first 24hours of presentation is critical and dangerous time for patients with SCD..Many of the emergency department providers are unaware of the analgesics therapy,parenteral opioids with severe pain followed by continuous reassessment of pain and re-admission of analgesics treatment and condition of severity level and its complications..Lack of knowledge of SCD,may patient treated only with parenteral opioids and it need higher dose of suboptimal administration of analgesics in the acute care management..there is inadequate acute care experience leave many people with SCD reluctant to seek medical attention.. patient with SCD have mistrust,lack of control and interest in hospital care..

  To overcome this obstacles emergency providers should understand the pathology of SCD and its mechanism..There is significant need for patient advocacy focus on education to improve clinician attitudes and knowledge about SCD..SCD patients should treated the patient high acuity and patient should receive a rapid assessment and documentation of pain and its severity..They should receive opioids parenteral analgesics within 60 minutes of arrival in the ED..Reassessment should be performed atleast every 30 minutes in the ED and every 1 to 2 hours in the inpatient settings..we should not undertreat the patient with SCD..Use individualized care plan..patient should be transitional with a plan for followup care with Primary care physician and specialist,get help from social workers for high utilizing population..

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