Sickle cell disease (SCD) may be associated with a wide range of complications. The presence of one or more red flags for a patient with SCD in the Emergency Department may be a sign that something significant may be evolving.

Patient selection: sickle cell disease


Red flags:

(1) temperature < 36°C or > 38°C

(2) heart rate > 90 beats per minute

(3) respiratory rate > 20 breaths per minute

(4) shortness of breath

(5) headache

(6) confusion or altered mental status or deteriorating mental status

(7) seizures

(8) chest pain

(9) priapism

(10) pregnancy

(11) vision changes

(12) red and swollen joint

(13) vomiting

(14) severe abdominal pain

(15) effusion or consolidation seen on chest X-ray

(16) WBC count > 12,000 per microliter

(17) acute drop in hemoglobin or hematocrit

(18) low reticulocyte count

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