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Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis Sickling leads to vascular occlusion, end-organ ischemia, and decreased RBC lifespan, which, in turn, leads to pain crisis, acute anemia, sequestration, infection, and acute chest syndrome (ACS.) times maintenance. N Engl J Med.
Other causes of sickling: acidosis, dehydration, inflammation, infection, fever, and blood stasis. Ultrasound Sensitivity 88-100%, specificity 68-94% LR+ of 14.6 (95% Fluid management Goal is euvolemia Dehydration – needs IV fluid resuscitation. Look for B lines, consolidation, pleural effusion. times maintenance.
Check : [vitals, SOB, Chest Pain, Ultrasound] If the patient has Abdominal Pain, Chest Pain, Dyspnea or Hypoxemia, Headache, Hypotension , then these should be considered the primary chief complaint (not syncope). Also consider non-hemorrhagic volume depletion, dehydration : orthostatic vitals may uncover this [see Mendu et al. (3)].
Prevalence and treatment of pain in EDs in the United States, 2000 to 2010. Evaluation by ultrasound of traumatic rib fractures missed by radiography. Effects of hydration and dehydration on blood rheology in sickle cell trait carriers during exercise. References: Chang HY, Daubresse M, Kruszewski SP, Alexander GC.
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