Sickle cell pain episodes (1571)

Key points below

What is sickle cell pain?

Sickle cell pain is caused by sickled red blood cells that stick together in the blood vessel. This blocks the flow of blood which causes pain. It is the most common problem of Sickle Cell disease. Common areas of pain are the arms, legs, back, chest and belly (abdomen). In children under 2 years of age, the hands and feet may hurt and be swollen. This is called dactilytis.

What can be done to prevent the pain?

Drink lots of fluids. There are some things that may bring on a pain episode. If you know the cause, there are some things you can do to help prevent pain.

Being tired. Rest periods should be taken when playing sports or being active.
Infections. Watch closely for signs of infection. If your child has signs of infection, they may have a pain crisis.
Being outside in hot or cold weather for long periods of time. Take a break inside.
Being dehydrated. It is very important to drink a lot of fluids. This is especially true in hot weather.

What should be done for sickle cell pain?

Check for fever. If a fever is 101.5°F (38.6°C) or higher, go to the Emergency Department immediately. Do not give Ibuprofen (Motrin, Advil) or Acetaminophen (Tylenol).
If there is no fever, you can give ibuprofen (Motrin, Advil) or acetaminophen (Tylenol). Give the prescribed dose, based on age and weight. Do not give more often or give more medicine than what the directions say.
Ibuprofen or acetaminophen should help the pain after about an hour. If it doesn’t help, you may need a stronger pain medicine by mouth. Your doctor may have prescribed Oxycodone or morphine. These medicines should be used only if Ibuprofen and Tylenol are not helping the pain.
If the stronger pain medicine is needed more than every 4 to 6 hours while awake or at night for more than 2 days, you/your child needs to be seen the next day by their primary doctor or in the Emergency Department. A better treatment plan is needed for pain. IV pain medicine and IV fluids for hydration may be needed.
A heating pad or warm soaks (wet compress) on the painful area, or a warm bath may help with pain.
It may help to rub or massage the painful area.
Drink lots of fluids. This will keep from getting dehydrated. Good fluids include water, ice, juice, Jell-O®, broth, Kool-Aid® or Popsicles®.
Rest and doing things to take the mind off of the pain will help. Watch TV or listen to music.

What happens in the hospital?

IV fluids and IV pain medicine will be given.
Pain levels will be checked. This will help the nurse know if more help is needed to deal with the pain.
A heating pad may be put on the area to help with pain.
It is important to get out of bed several times a day to sit in a chair or walk. This will help with deep breathing. It also helps keep the arms and legs from getting weak.
Once the pain has improved, the IV pain medicine will be changed to pain medicine by mouth.

ALERT

Call the Sickle Cell clinic if you have any concerns or if there is:

Pain that does not go away.
Special health care needs not covered by this information

If a temperature is 101.5°F (38.6°C) or higher, go to the emergency department right away. You must be seen within 1 hour. Be sure to tell the staff that you or your child has Sickle Cell Disease.

Sickle Cell Clinic. Call (414) 266-2420, Monday through Friday, 8:00 AM to 4:30 PM. Ask to talk with a nurse.
After hours, weekends or holidays. Call (414) 266-2420. You will be transferred to the operator if your call is urgent. Ask for the hematologist on call to be paged.