Types of crises in sickle cell disease

A vaso-occlusive crisis happens when sickled red cells obstruct small blood vessels, causing deep pain in bones, joints, the chest, or abdomen. An aplastic or haemolytic crisis can reduce the red-cell supply, leading to marked tiredness, breathlessness, dizziness, or pale skin. Infection can trigger fever and a rapid deterioration. Acute chest syndrome involves chest pain, cough, breathing difficulty, or low oxygen and is an emergency. Splenic sequestration, mainly in children with a spleen that still works, can cause sudden weakness, a swollen abdomen, and shock.

The same person may have different crises at different times. Pain and fatigue can also occur outside a crisis, so a change from the usual pattern matters.

Follow the personalised plan from your sickle cell team, drink fluids if you can keep them down, rest, and use prescribed pain medicine exactly as directed. Avoid taking extra doses or medicines such as anti-inflammatory tablets unless your clinician has advised them. Record when symptoms began, their location, temperature, medicines taken, and any breathing change. A blood test may help clinicians assess anaemia, infection, or another complication.

Seek emergency help for chest pain, trouble breathing, fainting, confusion, severe weakness, a seizure, sudden abdominal swelling, or pain that is not controlled by your plan. Fever in someone with sickle cell disease needs urgent medical advice because infection can worsen quickly. Do not wait for a crisis to become severe if symptoms feel different from usual.

Ask which crisis symptoms are most relevant to you, what your written home plan says, which medicines are safe, and which hospital or sickle cell service to contact day or night.