Sickle cell vaso-occlusive pain crisis in adults: alternative strategies for management in the emergency department.

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The gene for sickle cell disease is carried by 8% of the African-American population in the United States. The primary care physician is often called upon to recognize and treat one of the major sequelae of sickle cell disease--vaso-occlusive pain crisis. An injectable nonsteroidal anti-inflammatory drug has recently become available and may offer some improvement in outcome of vaso-occlusive pain crises. We present five case reports reviewing various current therapeutic options, including newer pharmacologic agents, and comment on alternatives to impatient management of pain crises. The use of the emergency department short-term observation unit as an alternative to hospitalization is discussed.





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Sanders, DY, HW Severance and CV Pollack (1992). Sickle cell vaso-occlusive pain crisis in adults: alternative strategies for management in the emergency department. Southern medical journal, 85(8). pp. 808–811. 10.1097/00007611-199208000-00005 Retrieved from

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Harry Wells Severance

Adjunct Assistant Professor in the Department of Medicine

Site Principle Investigator: PROspective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) prospective, randomized, multi-center clinical trial:

Principle Investigator - Duke E.D. Site - "Speed" Study. Pilot phase of Gusto IV. Investigating Abciximab (a GP IIb-IIIa inhibitor) in combination with rapid access to cardiac cath. Funded through Duke Clinical Research Institute. Multi-center trial.

Principle Investigator - Project: proposed mechanisms for afferent pain transmission from myocardial cells to pain centers. Purpose is to identify potential biochemical markers for early anginal presentations. Funded: grants received from Merck & Co. and Roche-Boehringer-Mannheim. Pilot phase paper - in preparation.

Other Interest Areas:
Wounding and medical management of penetrating injuries derived from firearms and blast-related injuries.

Impact of Observation/short-stay strategies on clinical care and inpatient/outpatient systems.

Impact of Emerging Viral Threats on clinical management and social/economic/political systems,

Acute Cardiology - Chest Pain Presentations 
Evolving Technology and AI in improving clinical care/management

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