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Warning-sign checks

Sickle cell crisis: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    These concerns usually need timely follow-up but are not automatically emergencies.

    Call emergency services for trouble breathing, severe chest pain, blue or grey lips, fainting, a seizure, unusual difficulty waking, or signs of stroke.

    Stroke signs include facial drooping, weakness on one side, speech difficulty, sudden confusion, loss of balance, or a sudden severe headache.

    A painful erection lasting four hours is also an emergency because delayed treatment can cause lasting damage.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Contact your usual sickle cell team promptly if episodes are becoming more frequent, pain is changing, home treatment is less effective, or medicine side effects are causing problems.

    Seek urgent medical assessment for:

    • Pain that is severe, unusual, or not improving with your home plan
    • Fever, especially 38.5°C or higher, or the threshold in your care plan
    • Repeated vomiting or difficulty drinking
    • Marked weakness, paleness, or a racing heartbeat
    • A painful erection that persists or keeps returning
    • New abdominal swelling, particularly in a child

    And for anyone, someone who:

    • is vomiting and cannot keep fluids down

Every sign above is quoted from the sofidex article on Sickle cell crisis. If you are not sure, err upward — it is always reasonable to be checked.