Many institutions, however, do not have enough patients with sickle cell disease to justify the creation of an entire establishment for management of acute pain. In this instance facilities, including the program at Brigham and Women's Hospital in Boston, use the outpatient chemotherapy infusion suite as an alternative for the emergency room. The chemotherapy infusion suite has highly skilled nurses who are accustomed to handling patients with severe illness and severe pain. The ability to move patients quickly into a setting where they can be evaluated and begun on treatment is a major advantage. Clearly, flexibility by the staff in the chemo-infusion suite is of paramount importance since the onset of sickle cell crises is unpredictable.
Patients receiving chemotherapy are on a regular schedule and visits are planned ahead of time.
This is not the case in general for patients with sickle cell disease. If flexibility in the system can be developed, an excellent program can move forward for the care of these patients. Pain Service Sickle cell disease is a multi-system chronic illness. The major manifestation of sickle cell disease, however, is severe, recurrent episodes of pain. Patients who are hospitalized should have their care coordinated by the comprehensive care team in conjunction with the pain service.