Sickle cell fever and pain

One of the most challenging effects of sickle cell disease is the severe pain and fever periodically experienced by children with the disease. Pain is caused by the sickle-shaped blood cells getting stuck in narrow blood vessels, blocking the flow of blood. Because this can lead to organ damage or stroke, it is important that the pain be diagnosed and treated as quickly as possible. Fever may also signal a serious health crisis.

Appropriate medicines must be given as quickly as possible to prevent serious complications. For this reason, Dayton Children’s tracks how quickly children presenting with pain, fever or both are treated.

Dayton Children’s also has helped parents or caregivers learn how to numb the site where medications will be given before the child arrives at the hospital so there is minimal delay in giving the needed medications.

Category	2004-2005	2005-2006
I. Fever
% of patients who received antibiotics within 60 minutes of arriving at the emergency department	100%	77.8%
II. Pain
% of patients who received pain medications given within 60 minutes of arriving at the emergency department	64%	54.2%
III. Pain and fever
% of patients who received antibiotics and pain medications within 60 minutes of arriving in the emergency department	% of patients who received pain meds in the emergency department: 100% % of patients who received antibiotics in the emergency department: 50%	% of patients who received pain meds in the emergency department: 66.7% % of patients who received antibiotics in the emergency department: 66.7%
Median time for pain and fever presentation to administration of medication (Goal: <60 minutes)	56.5 minutes	55 minutes
Median length of stay for children admitted with pain and fever	3.0 days	2.0 days
Mean length of stay for children admitted with pain and fever	3.9 days	3.05 days