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NICE publishes draft guidance on sickle cell crises

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Nurses treating sickle cell episodes have been given new draft guidance aimed at improving their care and management.

The National Institute for Health and Care Excellence says that common problems include unacceptable delays in getting pain relief and insufficient or excessive doses.

The draft quality standard is based on the NICE clinical guideline on the management of acute painful sickle cell episodes in hospital.

The draft standard states:

  • a comprehensive assessment of people who present at hospital with an acute painful sickle cell episode is required to make sure they have an accurate diagnosis and are given the right pain relief within 30 minutes
  • patients with an acute painful sickle cell episode should have an evaluation of pain relief every 30 minutes until satisfactory pain relief has been achieved and then at least every four hours
  • acute chest syndrome (ACS) is a leading cause of morbidity and mortality in patients with sickle cell disease and is regularly overlooked as a potential complication
  • people with an acute painful sickle cell episode should be evaluated for acute chest syndrome if they have at least one of the following: irregular respiratory signs or symptoms, chest pain, fever, or indicators and symptoms of hypoxia

Deputy chief executive and director of health and social care at NICE, Professor Gillian Leng, said that the supervision of sickle cell episodes in hospitals is variable over the UK and a common source of complaints from patients.

She said: “Common problems include unacceptable delays in receiving pain relief, insufficient or excessive doses, and stigmatising the patient as drug seeking.”

Professor Leng is urging all registered stakeholders to register their comments on the draft standards via the NICE website.

Sickle cell is one of the most commonly inherited serious genetic diseases in England with between 12,500 and 15,000 sufferers.

Symptoms may include serious anaemia and intense pain and cause harm to major organs.

A sickle cell episode is triggered when the abnormal blood cells block the small blood vessels that supply the body’s tissues.

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