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Discharge Instructions for Sickle Cell Anemia and Sickle Cell Crisis (Pediatric)

Your child has sickle cell anemia. That means the red blood cells are shaped like a sickle or a half-moon, and don’t carry oxygen as well as normal, round blood cells. Sickle cell anemia runs in families, and commonly affects African-Americans. Sickle cell anemia can be controlled, but not cured.

A sickle cell crisis happens when many sickled cells stick together and pile up in the blood vessels. During a sickle cell crisis, your child can have severe pain in the chest, abdomen, arms, and legs. The crisis can last for hours, or even days, and can happen several times a year. Here’s what you can do to help your child.

What to watch for

  • Watch for sores (ulcers) on your child’s legs. These are caused by poor blood flow and are a sign that your child’s sickle cell anemia is not under control.

  • Watch for swollen, painful, red, or hot hands and feet or a swollen abdomen (belly).

  • Watch for yellowing of the eyes or skin.

  • Watch for any possible signs of infection, such as fever or shortness of breath.

  • In boys, watch for an erection that doesn’t go away.


  • Get treatment right away for any fever of 101°F (38.3°C) or greater, infections, illnesses, or other health problems that your child has. This includes flu, colds, and skin infections.

  • Call your child’s doctor if you are unsure about how to treat your child. It is very important your child get proper treatment of health problems to avoid complications of sickle cell anemia.

  • During a sickle cell crisis, make sure you continue to give your child his or her pain medicine as prescribed by your child’s doctor. If the pain continues, call your child’s doctor.

Home care

  • Encourage your child to get plenty of activity, but not to the point of becoming overly tired. Be sure your child drinks plenty of fluids during activity.

  • Your child should avoid very strenuous activities and rough contact sports, such as football.

  • Encourage your child to drink plenty of liquids, especially during warm weather, in order to avoid dehydration.

  • Dress your child in warm clothes if he or she will be outside during cold weather or will be in air-conditioned buildings during hot weather.

  • Don’t allow your child to swim in cold water.

  • If your child must travel by air, he or she should fly in pressurized aircraft only. Talk to your child’s doctor about extra safety steps if your child must travel in a nonpressurized plane.

Follow-up care

Make a follow-up appointment as directed by our staff.


When to seek medical treatment

Seek emergency medical care for your child if he or she has any of the following:

  • Fever greater than 101°F (38.3°C)

    • In a child 3-36 months, a rectal temperature of 102°F (39.0ºC) or higher

  • Difficulty breathing

  • Chest pain

  • Seizure

  • Severe headaches

  • Swelling in the abdomen (belly)

  • Sudden weakness

  • Weakness on one side of the body

  • Loss of feeling and movement

  • A painful erection of the penis lasting more than 4 hours

Call your child's doctor

Call your child's doctor right away if your child has any of the following:

  • Fever

    • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

    • A fever that lasts more than 24 hours in a child under 2 years old, or for 3 days in a child 2 years or older

    • Your child has had a seizure caused by the fever

  • Swollen hands or feet

  • Pain that doesn’t get better with medicine

  • Sudden paleness of the skin or nail beds

  • Worsening yellowish color of the skin or eyes (jaundice)

  • Trouble hearing

  • Trouble with vision or seeing

  • Change in speech

  • Limping, joint swelling, or joint/muscle pain


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