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Sickle cell crisis — DipIMC MCQ

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HardMedical EmergenciesSickle cell crisisDipIMC

A patient with sickle cell disease has severe chest and limb pain, fever, breathlessness and SpO2 91% on air. Which complication and initial pathway should be prioritised?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Suspect acute chest syndrome; give oxygen, analgesia and pre-alert

The best answer is “Suspect acute chest syndrome; give oxygen, analgesia and pre-alert”. Chest symptoms, fever and hypoxaemia in sickle cell disease raise concern for acute chest syndrome, a potentially fatal complication requiring urgent hospital assessment. NICE supports prompt analgesia and oxygen when saturation is 95% or below, alongside monitoring, IV access as appropriate and early pre-alert. Improvement in pain does not remove the need to investigate respiratory deterioration.

Reference: NICE CG143, Sickle cell acute painful episode: https://www.nice.org.uk/guidance/cg143/chapter/recommendations