Only use supplemental oxygen for patients who are hypoxic (<92%)
Reserve IVF bolus for patients who are hypovolemic
Over hydration may cause atelectasis which may precipitate Acute Chest Syndrome and hyperCl acidosis which could lead to further<unk> ng \
Make sure to use hypotonic fluids: 1/2NS, D5-1/2NS
Over hydration may cause atelectasis which may precipitate Acute Chest Syndrome and hyperCl acidosis which could lead to further<unk> ng \
Make sure to use hypotonic fluids: 1/2NS, D5-1/2NS
Packed red blood<unk> s (transfuse 10 mL/kg over 2hr period)
Indications:
Aplastic<unk> 
Sequestration<unk> 
Hemoglobin <6 with inappropriately low retic count
Hemoglobin <10 with acute<unk>  (e.g. symptomatic dizziness, SOB, chest pain)
Indications:
Aplastic<unk> 
Sequestration<unk> 
Hemoglobin <6 with inappropriately low retic count
Hemoglobin <10 with acute<unk>  (e.g. symptomatic dizziness, SOB, chest pain)
Aplastic<unk> 
Sequestration<unk> 
Hemoglobin <6 with inappropriately low retic count
Hemoglobin <10 with acute<unk>  (e.g. symptomatic dizziness, SOB, chest pain)
Analgesia
IV opioids (morphine or hydromorphone)
Redose in 30min if inadequate
Non-opioid analgesia
NSAIDs (e.g. ketorolac 15mg q6h)
Acetaminophen
IV/IM haloperidol or droperidol 5-10mg
Ketamine (IN 1mg/kg 1ml per nostril or IV 0.3mg/kg)
Nonpharmacologic measures (e.g. heating packs, distraction)
Hydration
Controversial
Dehydration promotes<unk> ng
IVF bolus may lead to atelectasis, pulmonary edema, and acute chest syndrome. Hyperchloremic metabolic acidosis due to normal saline may further precipitate<unk> ng.   
There are no randomized controlled trials that have assessed the safety and efficacy of different routes, types or quantities of fluid.
O2 if hypoxia; otherwise may inhibit erythropoiesis
IV opioids (morphine or hydromorphone)
Redose in 30min if inadequate
Non-opioid analgesia
NSAIDs (e.g. ketorolac 15mg q6h)
Acetaminophen
IV/IM haloperidol or droperidol 5-10mg
Ketamine (IN 1mg/kg 1ml per nostril or IV 0.3mg/kg)
Nonpharmacologic measures (e.g. heating packs, distraction)
Redose in 30min if inadequate
NSAIDs (e.g. ketorolac 15mg q6h)
Acetaminophen
IV/IM haloperidol or droperidol 5-10mg
Ketamine (IN 1mg/kg 1ml per nostril or IV 0.3mg/kg)
Controversial
Dehydration promotes<unk> ng
IVF bolus may lead to atelectasis, pulmonary edema, and acute chest syndrome. Hyperchloremic metabolic acidosis due to normal saline may further precipitate<unk> ng.   
There are no randomized controlled trials that have assessed the safety and efficacy of different routes, types or quantities of fluid.
Dehydration promotes<unk> ng
IVF bolus may lead to atelectasis, pulmonary edema, and acute chest syndrome. Hyperchloremic metabolic acidosis due to normal saline may further precipitate<unk> ng.   
There are no randomized controlled trials that have assessed the safety and efficacy of different routes, types or quantities of fluid.
O2; titrate to pulse oximetry >92%
Incentive Spirometer
Hydration: Oral hydration preferred, IV hydration with hypotonic fluid if patient unable to tolerate PO
Analgesia: pulmonary toilet is important but avoid excessive sedation
Bronchodilators
Antibiotics: 3rd generation cephalosporin + macrolide
Transfusion (leucocyte depleted); consider transfusion to goal of hemoglobin 11 / hematocrit 30 for:
O2 Sat <92% on room air
hematocrit 10-20% below patient's usual hematocrit or dropping hematocrit
Exchange transfusion; consider for:
Progression of acute chest syndrome despite simple transfusion
Severe hypoxemia
Multi-lobar disease
Previous history of severe acute chest syndrome or cardiopulmonary disease
O2 Sat <92% on room air
hematocrit 10-20% below patient's usual hematocrit or dropping hematocrit
Progression of acute chest syndrome despite simple transfusion
Severe hypoxemia
Multi-lobar disease
Previous history of severe acute chest syndrome or cardiopulmonary disease
Hydration
Transfusion and/or exchange transfusion
Urology consult
If persists for >4-6hr:
Aspiration of corpora
Irrigate and infuse 1:1,000,000 epinephrine solution
Aspiration of corpora
Irrigate and infuse 1:1,000,000 epinephrine solution
tPA is not recommended
Exchange transfusion urgently (within 8 hours) to decrease hemoglobinS below 30%
Hydration
Volume resuscitation
Simple transfusion vs exchange transfusion
Any fever of ≥38.5C requires empiric antibiotics (regardless of well appearance or any localized infection found)
Ceftriaxone 50mg/kg (maximum single dose 2g)
Sickle cell crisis
Vaso-occlusive pain crisis
Aplastic crisis
Bony infarction
Dialysis disequilibrium syndrome
Dactylitis
Hemolytic uremic syndrome
Avascular necrosis of femoral head