Galloway and Harwood-Nuss listed criteria for hospital admission for a patient with sickle cell disease who is having a sickle cell crisis. The authors are from the University of Florida in Jacksonville.
Features of a sickle cell crisis:
(1) often last 4-5 days
(2) usually can be managed as an outpatient with oral or parenteral narcotics and fluids
Indications for hospital admission - one or more of the following:
(1) multiple visits to the Emergency Department during the same crisis
(2) fever >= 101°F (38.3°C)
(3) clinical evidence of significant infection
(4) painful crisis not adequately controlled after 4-6 hours of aggressive therapy as an outpatient
(5) severe or life-threatening complications
(5a) priapism
(5b) pulmonary infarction
(5c) congestive heart failure
(5d) acute cholecystitis
(6) anemia with falling hematocrit and/or reticulocyte count < 5%
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