Acute Chest Syndrome

# Acute Chest Syndrome / Vaso-occlusive Pain Episode
Patient with known history of sickle cell disease who present with concern for acute chest syndrome given segmental pulmonary infiltrate and symptoms of ***. Most likely due to ***. Common triggers include dehydrations, drugs/ETOH, stress, infection, and hypoxia. Patient with*** hx of acute chest syndrome, with *** hospitalizations over the past year for vaso-occlusive pain episodes.
Dx
- CBC, retic count
- CXR, BCx x2, Sputum Cx, Procalcitonin. Consider influenza, viral panel per clinical scenario
- EKG, Troponin. Consider PE eval per clinical scenario
Tx
- Aggressive pain control
- Aggressive fluid resuscitation with maintenance (assuming no heart failure)
- Antibiotics per clinical scenario
- Supplemental O2, Bronchodilator, incentive spirometry
- DVT ppx
- If concern for moderate/severe/very severe acute chest syndrome, consult hematology for exchange transfusion