ABSTRACT
This chapter presents a case study of a 25-year-old man of African descent who is presented to the Emergency Department with a 3-day history of worsening right-sided chest pain. He has a history of sickle cell disease and has been maintained on hydroxyurea for the last few years. Vaso-occlusive crises are one of the important complications of sickle cell disease, and arise as a result of sickled red blood cells pooling in blood vessels, leading to vascular obstruction. The patient likely has vaso-occlusion in the pulmonary vessels, and is suffering from acute chest syndrome, a condition that will affect 50" of sickle cell patients in their disease course. The acute management of acute chest syndrome initially involves prompt recognition and consideration of this as a diagnosis in patients with sickle cell disease presenting with respiratory symptoms and/or signs. Pain control is a key part of initial treatment and often will require high doses of opiate analgesics.
