1) SCD pain is complex and real (despite lack of objective findings).
- 1/2 have no objective findings.
- Those with higher baseline Hgb have higher risk of pain crisis.
- Adult patients increased pain frequency have higher mortality.
2) Evaluate for potentially critical masqueraders.
3) Give pain medications fast; strongly encourage intranasal fentanyl as first-line opioid.
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Department of Emergency Medicine
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Charlotte, NC 28203