Vaso-Occulsive Crises and Management
Suzie Noronha, MD
Triggers for vaso-occlusive crises
- Cold
- Dehydration
- Illness
- Overheating
- Stress
Home pain management - medical
- NSAIDs
- Ibuprofen
- Naproxen
- Oral narcotics
Non-pharmacologic pain management
- Warmth
- Hydration
- Relaxation
- Music
- Journaling
- Massage
- Guided imagery
- Biofeedback
Standard vaso-occlusive crisis management in the ED
- Intravenous fluids
- Oxygen
- NSAIDs
- Narcotics
- Admission if this regimen does not control pain
Transition process
- Transition: Period when patients transfer from pediatric to adult health system
- Young adults with SCD have a higher risk of death during the period of transition:
- Lack of knowledgeable providers
- Lack of continuity of care
- Lack of awareness of personal health details
- Best outcomes with early, frequent discussion of transition and disease education
- Patients need to understand their personal health issues
- Independence with making appointments and requesting refills
- Following through on medical recommendations
- Complete transfer summary made available to receiving provider
Self-advocacy
- Important skill to learn during transition
- Especially important for patients with chronic illness/disability
- Can be nurtured by local support groups
