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|Health Care Providers - The Child with Sickle Cell Disease|
Painful episodes are common complications in children with Sickle Cell Disease. When the sickled cells are unable to flow through small blood vessels they obstruct blood flow causing vascular occlusion (vaso-occlusion). Vaso-occluision reduces blood flow to an area of the body resulting in pain. This can occur anywhere in The body, including fingers, arms, legs, ribs, abdomen, and organs such as the spleen, brain, and eyes.
During infancy, vaso-occlusive crises (VOC’s) are generally manifested as dactylitis or hand-foot syndrome. This is characterized by soft tissue swelling warmth and/or pain in the hands and/or feet due to ischemia (decreased oxygen) in these small bones. Dactylitis call be recurrent hut usually does not occur after two or three years of age. The most common sites of pain in children over two years of age are the long bones, joints, back, and abdomen.
VOC’s can vary in duration, intensity. location, and time between episodes. They can be mild! moderate, or severe in terms of pain. Sometimes swelling is seen in the area of pain. VOC’s may be preceded by a fever! dehydration, trauma, swimming, exposure to cold and/or emotional stress and unknown factors. Infection may occur at the same time.
MANAGEMENT OF PAIN
Painful episodes can often be treated and managed at home with regular acetaminophen (Tylenol), ibuprofen, or acetaminophen with codeine and hydration (an extra two to four ounces of water or juice every hour). Rubbing or application of heat with a heating pad or hot water bottle to the painful area may also alleviate discomfort.
Sometimes pain is unresponsive to home therapy. During those dines, the child should go to the emergency room for intravenous (IV) hydration and pain medication. IV morphine is usually used. Most of the time this is adequate treatment so that home therapy will then he effective.
In very severe painful crises, the child may need to he admitted to the hospital for IV therapy. Sometimes the child can he taught to give his or her own pain medication by vein. This is called patient controlled analgesia, or PCA.
Origin and Distribution of Sickle Cell Disease, Genetics, Sickle Red Blood Cells, Infections ,Splenic Sequestration, Pain, Chest Syndrome, Aplastic Crisis, Strokes, Gall Stones and Jaundice, Growth and Development, Retinopathy, Priapism
|Last Updated on Wednesday, 09 June 2010 14:51|