Sickle Cell Disease with Fever Clinical Pathway – Emergency Department – Diagnostic Studies

Sickle Cell Disease with Fever Clinical Pathway – Emergency Department

Diagnostic Studies

  • Evaluate all children for bacteremia with CBC with differential, blood culture
  • Assess Hgb and reticulocyte count for aplastic crisis
  • Additional testing is based on history and PE
Laboratory Testing
  • All children—CBC with differential, reticulocyte count, blood culture
  • BMP, Type & Screen as indicated
CXR
Viral Testing
  • Influenza-like illness, send quad
  • RRP may be helpful in children with prolonged fever
UA POC
  • Evaluate if clinical suspicion for UTI, history of previous UTI, renal anomaly
  • If urine POC is positive, send urine culture
Serum HCG All post-menarchal females and all females > 12 yrs
Type and Screen
  • Pale, persistent tachycardia, ill-appearing
  • Suspected splenic sequestration
  • Acute chest syndrome
  • Suspected aplastic crisis
  • Hgb < 5 g/dL or Hgb drop > 2 g/dL from baseline Hgb
  • Reticulocyte count < 2% lower than baseline, unless hemoglobin > 10 g/dL