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After a short period of observation in the ED, he looks well and has been eating and drinking normally and playing. On examination she is febrile, well perfused with a CRT of less than 2sec, heart rate of 155 and respiratory rate of 35. The child is back to his normal self, febrile with a temperature of 38.60 How would you manage her?
SCD, therefore, is not only a mechanical disease but there are also many other cellular and plasma factors as well as endothelial interaction that generate chronic inflammation. Infections, fever, acidosis, hypoxia, dehydration and exposure to extreme temperatures can trigger VOC even though often no cause is identified.
Babies in the neonatal unit will typically wait until they are well enough for the examination e.g. NIPE is not performed for baby’s who are ventilated, on CPAP or have lots of different lines inserted. Other important questions to ask: Have they been feeding well? Was the baby head down presentation from 36 weeks onwards?
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