The vaso-occlusive crisis is caused by sickle-shaped red blood cells that obstruct capillaries and restrict blood flow to an organ, resulting in ischaemia, pain, necrosis and often organ damage. The frequency, severity, and duration of these crises vary considerably. Painful crises are treated with hydration, analgesics, and blood transfusion; pain management requires opioid administration at regular intervals until the crisis has settled. For milder crises, a subgroup of patients manage on NSAIDs (such as diclofenac or naproxen). For more severe crises, most patients require inpatient management for intravenous opioids; patient-controlled analgesia (PCA) devices are commonly used in this setting. Vaso-occlusive crisis involving organs such as the penis or lungs are considered an emergency and treated with red-blood cell transfusions. Diphenhydramine is sometimes effective for the itching associated with the opioid use. Incentive spirometry, a technique to encourage deep breathing to minimise the development of atelectasis, is recommended.
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A vaso-occlusive crisis is a common painful complication of sickle cell anemia in adolescents and adults. It is a form of sickle cell crisis. A condition that is most common in those of African, Hispanic, and Mediterranean origin, although it is not limited to just these races. It occurs when the circulation of blood vessels is obstructed by sickled red blood cells, causing ischemic injuries. The most common complaint is of pain, and recurrent episodes may cause irreversible organ damage. One of the most severe forms is the acute chest syndrome which occurs as a result of infarction of the lung parenchyma, this can rapidly result in death of the patient if not properly managed immediately. The management of an acute event of vaso-occlusive crisis is the use of potent analgesic (Opioids), Rehydration with Normal saline or ringers lactate, treatment of malaria (whether symptomatic or not) using Atemisinin Combination Therapy, use of adjunct therapy such as Oxygen via face mask, especially for acute chest syndrome, use of antibiotics because they usually have occult infection due to a "functional asplenia". Related symptoms are dactylitis, priapism, abdominal pain and jaundice.
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