Practice Variation in Emergency Department Management of Children With Sickle Cell Disease Who Present With Fever

Pediatric Emergency Care
Katherine EisenbrownD C Brousseau

Abstract

Urgent medical evaluation is recommended for patients with sickle cell disease (SCD) and fever. Clear recommendations exist regarding certain aspects of treatment, but other areas lack evidence. We determined practice variation for children with SCD presenting with fever to the emergency department (ED). Retrospective chart review of children ages 3 months to 21 years with SCD presenting to the ED with fever greater than or equal to 38.5°C in the ED or preceding 24 hours. Visits from 3 sickle cell centers were included. Outcomes included blood culture, complete blood count, antibiotic treatment, chest x-ray, urinalysis, electrolytes, and hospital disposition. Differences greater than 10% were considered clinically meaningful. The population included 14,454 visits, of which 4143 (29%) were febrile and met all inclusion criteria. A complete blood count and blood culture were obtained at 94% of visits, and antibiotics were given at 91%, with no differences among sites. Meaningful differences existed for disposition, with 52%, 43%, and 99% of patients admitted to the inpatient units at hospitals A, B, and C, respectively. Differences were seen in obtaining a urinalysis (33%, 17%, and 21%), electrolytes (2%, 50%, and 12%), and chest...Continue Reading

References

Oct 1, 1986·The Journal of Pediatrics·H S ZarkowskyD Wethers
Apr 18, 2000·Archives of Pediatrics & Adolescent Medicine·M H Gorelick, K N Shaw
Apr 2, 2010·American Journal of Preventive Medicine·Kathryn L Hassell
Dec 7, 2010·Lancet·David C ReesMark T Gladwin
Jan 10, 2012·The Pediatric Infectious Disease Journal·Angela M EllisonKim Smith-Whitley
Jan 24, 2013·The Pediatric Infectious Disease Journal·Angela M EllisonKim Smith-Whitley
Jan 29, 2014·Pediatrics·Shabnam JainEvaline A Alessandrini
Feb 17, 2015·Pediatric Blood & Cancer·Katherine EisenbrownDavid C Brousseau
Mar 18, 2015·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Angela M EllisonElizabeth R Alpern

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Citations

Mar 20, 2020·Pediatric Quality & Safety·Christopher McKinneyRachelle Nuss
Jan 4, 2021·Journal of the Pediatric Infectious Diseases Society·Joshua WolfMari M Nakamura

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