Our foremost goal as health care providers must be to keep patients in the medical care system. Only then can we execute our second goal, the delivery of true preventative care to patients with sickle cell disease. In this process we must develop programs to assess the psychosocial needs of these young people. Using this information, we can develop specific individual and programmatic interventions. Organized transition programs can facilitate this process Day Hospital Intermittent episodes of pain are the most consistent manifestation of sickle cell disease.
Pain management involves care of both acute and chronic pain.
One of the important interventions that has improved the care of patients with sickle cell disease is the institution of a day hospital where acute episodes of pain can be managed without resorting to emergency room care. Many, if not most, episodes of acute vaso-occlusive crisis pain can be controlled such that patients can return home if immediate and aggressive intervention with intravenous analgesics and fluids is undertaken. The day hospital offers at least two advantages over the emergency room. First, treatment can begin quickly, often within minutes of the patient's arrival. The nature of emergency room care means that patients with vaso-occlusive crisis pain may wait for long time periods for evaluation and treatment.