A severity of a painful crises can be graded based on its intensity and duration.
Criteria of Charache et al for severe painful crises:
(1) >= 3 acute painful episodes per year
(2) episodes last > 4 hours
(3) pain control requires administration of parenteral opioid analgesic
(4) usually treated at Emergency Department or other medical facility
The location of care depends on:
(1) familiarity of the patient and family with painful crises
(2) access to appropriate analgesics
(3) access to health care
(4) severity of concurrent disease that triggered the episode
Pain Intensity (on a 10 cm VAS scale)
0 to 3.9
4 to 6
higher doses NSAIDS, oral opioids
6.1 to 10
therapy in ED or hospital, duration > 4 hours
Interference with work or activities of daily living can also be used to grade pain (see Chapter 37, hemophilic arthropathy).
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Specialty: Hematology Oncology, Clinical Laboratory, Genetics