Case 3: Sickle Cell Crisis

A 22-year-old African American male with sickle cell disease (SCD) comes to the emergency department (ED) with pain in all of his extremities typical of his vaso-occlusive crisis (VOC) and requests pain medicine. He has never come to this ED before—he “usually goes to the one across town but [he] won’t go back there because they never give enough pain medicine.” When asked how much pain he has, he states “it’s a 15.” The patient is in obvious distress, writhing in pain. The doctor assesses the patient and addresses the need for pain control.