Enhancing the care of patients with sickle cell disease

Assessing and managing people with sickle cell disease presenting with vaso-occlusive crisis in the emergency department

Sickle cell disease is a group of inherited blood disorders characterised by atypical haemoglobin molecule structures (haemoglobin S) which can manifest as painful vaso-occlusive crises, chronic anaemia and progressive organ damage. This article aims to raise greater awareness of sickle cell disease, its acute manifestations and the potential for rapid clinical deterioration that can occur in patients with this condition. The article outlines the main aspects of the assessment and management of patients presenting to the emergency department (ED) with vaso-occlusive crisis, describes the barriers to effective care that they commonly experience and explains how their care could be improved. The authors emphasise the importance of timely management of these patients by ED staff, including emergency nurses.

Biological basis of child health 10: function and formation of blood and common blood disorders in children

This article, the tenth in a series on the biological basis of child health, focuses on blood. Blood has a crucial role in the transport of substances such as respiratory gases, nutrients and antibodies, as well as in acid-base balance, fluid balance, blood clotting and the immune system. This article describes the composition, formation and function of blood, outlines normal blood count values and explains the effects of low blood cell counts in children. It also provides an overview of the blood disorders that are commonly seen in children, including anaemia, sickle cell disease, clotting disorders and blood cancers. It is essential for children's nurses to have knowledge and an understanding of blood, including its physiology and pathophysiology, to provide optimal care and support to children and young people and their families.