scholarly journals Perioperative Management of Paediatric Patients with Sickle Cell Disease

2017 ◽  
Author(s):  
KJ Sullivan ◽  
J Dayan ◽  
M Reichenbach ◽  
M Irwin ◽  
A Pitkin ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Perioperative Management ◽  
Cell Disease ◽  
Paediatric Patients

scholarly journals The Practices of Anaesthesiologists in the Management of Patients with Sickle Cell Disease: Empirical Evidence from Cameroon

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1617
Author(s):  
Dominique Djomo Tamchom ◽  
Aristide Kuitchet ◽  
Raymond Ndikontar ◽  
Serge Nga Nomo ◽  
Hermine Fouda ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Perioperative Management ◽  
Treatment Guideline ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Cell Disease ◽  
Binary Logistic Regression Model ◽  
Cross Sectional ◽  
Elective Surgical Procedures

Patients with sickle cell disease are more likely to undergo surgery during their lifetime, especially given the numerous complications they may develop. There is a paucity of data concerning the management of patients with sickle cell disease by anaesthesiologists, especially in Africa. This study aimed to describe the practices of anaesthesiologists in Cameroon concerning the perioperative management of patients with sickle cell disease. A cross-sectional study was carried out over four months and involved 35 out 47 anaesthesiologists working in hospitals across the country, who were invited to fill a data collection form after giving their informed consent. The data were analysed using descriptive statistics and a binary logistic regression model. Among the 35 anaesthesiologists included in the study, most (29 (82.9%)) had managed patients with sickle cell disease for both emergency and elective surgical procedures. Most of them had never asked for a haematology consultation before surgery. Most participants (26 (74.3%)) admitted to having carried out simple blood transfusions, while 4 (11.4%) carried out exchange transfusions. The haemoglobin thresholds for transfusion varied from one practitioner to another, between < 6 g/dl and < 9 g/dl. Only 6 (17.1%) anaesthesiologists had a treatment guideline for the management of patients with sickle cell disease in the hospitals where they practiced. Only 9 (25.7%) prescribed a search for irregular agglutinins. The percentage of haemoglobin S before surgery was always available for 5 (14.3%) of the participants. The coefficient (0.06) of the occurrence of a haematology consultation before surgery had a significant influence on the probability of management of post-operative complications (coefficient 0.06, 10% level of probability). This study highlights the fact that practices in the perioperative management of patients with sickle cell disease in Cameroon vary greatly from one anaesthesiologist to another. We disclosed major differences in the current recommendations, which support the fact that even in Sub-Saharan countries, guidelines applicable to the local settings should be published.

scholarly journals P10 An audit to assess the prescribing of analgesia in children who present with pain crisis due to Sickle Cell Disease (SCD)

2020 ◽  
Vol 105 (9) ◽  
pp. e11.1-e11
Author(s):  
Masuma Dhanji
Keyword(s):  
Sickle Cell Disease ◽  
Integrated Care ◽  
Sickle Cell ◽  
Care Pathway ◽  
Electronic Prescribing ◽  
List Type ◽  
Cell Disease ◽  
Paediatric Patients ◽  
Pain Crisis ◽  
Integrated Care Pathway

AimTo assess the prescribing of analgesia to manage pain crises in children with SCD. This was to establish whether the Trust was meeting national and local standards. Prompt pain control is essential to reduce length of stay and further complications.1Standards100% of admissions will be prescribed regular paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) at the recommended frequency unless contraindicated in accordance with national guidance.2 3100% of admissions will be prescribed appropriate doses of analgesia with consideration to weight and age in accordance with local policy.4MethodThe audit was registered with the Trust’s audit committee. A list of paediatric patients with the diagnosis of SCD was sought from paediatricians with an interest in haematology. A data collection form was created. Data was collected retrospectively over a one-year period. A total of 60 admissions were reviewed to check whether analgesia was prescribed regularly at the recommended frequency, and at the correct dose. Results were analysed using descriptive statistical analysis. Exclusion criteria included patients with hospital admissions under 24 hours.ResultsA total of 55 admissions were included in the final sample. The audit showed the Trust was non-adherent to both standards assessed. A total of 45% (95% CI [31.9%, 58.1%]) of admissions were prescribed regular analgesia. A total of 78% (95% CI [67.9%, 88.9%] of admissions were prescribed appropriate doses of analgesia. Two main reasons were found as to why analgesia was prescribed at the incorrect dose. This was due to incorrect weights recorded on the electronic system (n=4) and doses based on age only (n=8).ConclusionThe results show prescribers are familiar with the correct doses of analgesia but fail to prescribe analgesia regularly. This highlights an opportunity for education and training in the management of pain crisis in SCD. One recommendation includes development of an integrated care pathway booklet for paediatric patients presenting with pain crisis due to SCD. Integrated care pathway booklets have been implemented for other conditions such as cystic fibrosis yielding positive outcomes. The results have highlighted key issues surrounding the electronic prescribing system such as out-of-date weights remaining on the system unless updated, and default treatment protocols. The electronic prescribing system requires refinement for use within paediatrics. One suggestion includes compulsory weight field on admission. Limitations of this audit included small sample size. There was a lack of data to make suggestions based on different ages.ReferencesRees D, Olujohungbe A, Parker N, et al. Guidelines for the management of the acute painful crises in sickle cell disease. Br J Haemato 2003;120:744–752.National Institute for Health and Care Excellence (2012) Sickle cell disease: managing acute painful episodes in hospital. NICE Guideline (CG143).Paediatric Formulary Committee. BNF for Children (2018–2019). London: BMJ Group, Pharmaceutical Press, and RCPCH Publications; (2018).General Hospital (2015) Management of sickle cell disease in paediatric patients (CG377).

scholarly journals One-third of the new paediatric patients with sickle cell disease in The Netherlands are immigrants and do not benefit from neonatal screening

2010 ◽  
Vol 95 (10) ◽  
pp. 822-825 ◽  
Author(s):  
M. Peters ◽  
K. Fijnvandraat ◽  
X. W. van den Tweel ◽  
F. G. Garre ◽  
P. C. Giordano ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
The Netherlands ◽  
Sickle Cell ◽  
Neonatal Screening ◽  
Cell Disease ◽  
Paediatric Patients

Perioperative Management of Sickle Cell Disease Children Undergoing Adenotonsillectomy

2005 ◽  
Vol 133 (2) ◽  
pp. P79-P79
Author(s):  
R DUKE ◽  
J PANEPINTO ◽  
J SCOTT ◽  
V FLANARY
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Perioperative Management ◽  
Cell Disease

Haematology: drugs, tests, and disorders

2018 ◽  
Author(s):  
Paul Kerr ◽  
Pete Ford
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Perioperative Management ◽  
Anaesthetic Management ◽  
Coagulation System ◽  
Coagulation Disorders ◽  
Cell Disease ◽  
Haematological Disorder ◽  
Coagulation Tests ◽  
Antifibrinolytic Drugs

This chapter describes the anaesthetic management of the patient with a haematological disorder. Topics covered include anaemia, sickle-cell disease, porphyria, coagulation disorders, haemophilia and related disorders, platelet disorders, and hypercoagulability syndromes. For each topic, preoperative investigation and optimization, treatment, and anaesthetic management are described. There is detailed discussion about the perioperative management of the patient taking a drug which affects the coagulation system, including anticoagulants, antiplatelet drugs, and fibrinolytic and antifibrinolytic drugs. Coagulation tests are discussed in detail, and the haematological management of the bleeding patient is described.

A nontransfusional perioperative management regimen for patients with sickle cell disease undergoing laparoscopic cholecystectomy

2006 ◽  
Vol 21 (7) ◽  
pp. 1117-1121 ◽  
Author(s):  
D. R. Leff ◽  
T. Kaura ◽  
T. Agarwal ◽  
S. C. Davies ◽  
J. Howard ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Perioperative Management ◽  
Cell Disease

Haematology

2021 ◽  
pp. 253-290
Author(s):  
Peter Valentine ◽  
Pete Ford
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Perioperative Management ◽  
Anaesthetic Management ◽  
Coagulation System ◽  
Coagulation Disorders ◽  
Cell Disease ◽  
Haematological Disorder ◽  
Coagulation Tests ◽  
Antifibrinolytic Drugs

This chapter describes the anaesthetic management of the patient with a haematological disorder. Topics covered include anaemia; sickle-cell disease; porphyria; coagulation disorders; haemophilia and related disorders; platelet disorders and hypercoagulability syndromes. For each topic, pre-operative investigation and optimisation, treatment, and anaesthetic management are described. There is detailed discussion about the perioperative management of the patient taking a drug which affects the coagulation system, including anticoagulants, antiplatelet drugs, fibrinolytic and antifibrinolytic drugs. Coagulation tests are discussed in detail, and the haematological management of the bleeding patient is described.

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