An Indigenous woman with sickle cell disease has severe limb and back pain, stable vital signs and an elevated reticulocyte count. A prior note

Question

An Indigenous woman with sickle cell disease has severe limb and back pain, stable vital signs and an elevated reticulocyte count. A prior note labels her “drug-seeking”; she requests that her auntie join the discussion. What is the most appropriate initial approach?

Accepted Answer

Treat pain and assess complications with her auntie present

Answer

Admit for transfusion before assessing for acute chest or infectious features

Answer

Use the prior documentation to set a fixed ceiling for analgesic doses

Answer

Withhold opioid analgesia until a pain-service assessment confirms severity

Answer

Discharge with oral fluids because stable vital signs exclude complications

Indigenous cultural safety — RCPSC EM MCQ

An Indigenous woman with sickle cell disease has severe limb and back pain, stable vital signs and an elevated reticulocyte count. A prior note labels her “drug-seeking”; she requests that her auntie join the discussion. What is the most appropriate initial approach?