Management of sickle cell disease: management of 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 should understand warning symptoms and signs which indicate the need for assessment in hospital. It is also important that the parents have a good awareness of these symptoms and know when and how to seek help. The common complications which may be encountered in an acute hospital setting are described together with recommendations for management based on published evidence and the author's experience.