Provider Communication and Fever Protocol for Children With Sickle Cell Disease in the Emergency Department

Area of Science:

• Pediatric Hematology
• Emergency Medicine
• Infectious Disease Management

Background:

• Fever in children with sickle cell disease (SCD) requires prompt antibiotic treatment to prevent serious complications.
• Timely administration of parenteral antibiotics is crucial for managing febrile SCD patients in the emergency department (ED).
• Effective communication between specialists and ED teams can impact patient outcomes.

Purpose of the Study:

• To evaluate if pre-arrival communication between pediatric hematologists and ED providers influences the time to antibiotic administration in febrile children with SCD.
• To identify potential strategies for improving the efficiency of care for this high-risk population.

Main Methods:

• Retrospective chart review of patients aged 2 months to 21 years with SCD presenting to the pediatric ED with fever.
• Ascertainment of prior communication between ED and hematology teams before patient arrival.
• Primary outcome measured: time from ED arrival to parenteral antibiotic administration, compared to the 60-minute recommended maximum.

Main Results:

• Forty-nine patients were analyzed; 43% had prior communication.
• Median time to antibiotics was 79 minutes with prior communication versus 136 minutes without (P=0.012).
• No significant difference was observed in hospital length of stay between groups.

Conclusions:

• Advance communication between pediatric hematologists and ED physicians is associated with faster antibiotic delivery for febrile children with SCD.
• Further interventions are needed to consistently achieve the target of 60-minute antibiotic administration.
• Optimizing interdisciplinary communication is key to improving acute care for pediatric SCD patients.