Sickle cell anaemia 2: management approaches of painful episodes

The first of this two-part series highlighted how sickle cell disorders were the most common genetic disorder in the UK. It also described how recurrent sickle cell painful episodes led to many social restrictions on a sufferer's life. In the UK, painful episodes still remain the main reason for the hospital admission of people with sickle cell disease. This often means lengthy periods spent as an inpatient for many sufferers, as well as a lifetime reliant upon health professionals to prescribe strong analgesics in an attempt to try and control the painful symptoms associated with sickle cell disease. Readers should note that the term 'painful episode' is now used in preference to 'crisis'. Despite recommendations that initial hospital management of sickle cell painful episode should be aimed at providing rapid pain control, this article will show that choosing the right analgesic is not always easy to decide. National guidelines may aid this process, incorporated alongside increased patient empowerment and the important role of the nurse.