Illnesses requiring immediate medical evaluation (within four hours of occurrence) for children with sickle cell disease

Caregivers should be counselled to seek in-person medical evaluation (within 4 hours of onset) for any of the following symptoms:

Fever, defined as a single oral temperature above a predetermined threshold (typically ≥38 to 38.5°C [equivalent to approximately ≥100.4 to 101.3°F])
Newly palpable spleen or increasing size of previously enlarged spleen
Significant respiratory symptoms (eg, difficulty breathing, shortness of breath, severe cough, chest pain)
Severe abdominal pain, particularly if located in the right upper quadrant
Neurologic symptoms, even if transient (eg, facial droop or asymmetry, slurred speech, weakness or numbness in the arms or legs, seizure)
Priapism lasting >4 hours
Significant increase in pallor, fatigue, lethargy, or jaundice
Pain not adequately controlled by home medications

Refer to UpToDate topics on sickle cell disease for details.

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