Management of sickle cell disease: acute episodes in the community and in hospital

This review discusses the presentation and management of acute sickle crises, highlighting which aspects of diagnosis and management can be undertaken in the community and which require urgent referral to hospital. GP’s, community nurse specialists, and community paediatricians should be aware of the different acute presentations in order to provide effective and safe care, and understand warning symptoms and signs which obligate assessment in hospital. It is also important that the parents have a good awareness of the symptoms and when and how to seek help. The common complications which may be encountered in an acute hospital setting are described together with recommendations for their management based on published evidence and the author’s experience.