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© 2021. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Study Objective

Patients with sickle cell disease (SCD) have many emergency department visits because of painful vaso‐occlusive episodes (VOE). Guidelines recommend treatment within 30 minutes of triage, but this is rarely achieved in clinical practice. Our goal was to develop an order set that is being implemented in the ED to facilitate and standardize emergency care for SCD patients in acute pain from VOEs presenting to the emergency department (ED) in New York City (NYC).

Methods

Using a RAND/University of California, Los Angeles modified Delphi panel, we convened a multidisciplinary panel and reviewed evidence on how to best manage SCD pain in the ED. Panelists collaboratively developed then rated 202 items that could be included in an ED order set.

Results

A consensus order set, a practical how‐to guide for managing SCD pain in the ED, was developed based on items that received high median ratings.

Conclusions

The management of acute pain experienced during VOEs is critical to patients with SCD; ED order sets, such as this one, can help standardize pain management, including at triage, evaluation, discharge, and follow‐up care. After implementation in NYC EDs, studies to examine changes in quality care metrics (eg, wait times, readmissions) are planned.

Details

Title
Developing an emergency department order set to treat acute pain in sickle cell disease
Author
Duroseau, Yves 1 ; Beenhouwer, David 2 ; Broder, Michael S 2 ; Brown, Bonnie 3 ; Brown, Tartania 4 ; Gibbs, Sarah N 2 ; Jackson, Kaedrea 5 ; Liang, Sally 6 ; Malloy, Melanie 7 ; Marie‐Laure Romney 8 ; Shani, Dana 9 ; Jena, Simon 10 ; Yermilov, Irina 2 

 Department of Emergency Medicine, Lenox Hill Hospital/Northwell Health, New York, New York, USA 
 Partnership for Health Analytic Research (PHAR), Beverly Hills, California, USA 
 Observation Medicine, Mount Sinai Morningside and West, New York, New York, USA 
 Metropolitan Jewish Healthcare System, Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, New York, USA 
 Department of Emergency Medicine, Mount Sinai Morningside, New York, New York, USA 
 Mount Sinai Beth Israel, Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA 
 Emergency Medicine, Mount Sinai Brooklyn, Icahn School of Medicine at Mount Sinai, Brooklyn, New York, USA 
 Quality and Patient Safety, Department of Emergency Medicine, Columbia University, New York, New York, USA 
 Departments of Hematology, Medical Oncology and Internal Medicine, Lenox Hill Hospital/Northwell Health, New York, New York, USA 
10  Adult Program for Sickle Cell at Mount Sinai Hospital, New York, New York, USA 
Section
The Practice of Emergency Medicine
Publication year
2021
Publication date
Aug 2021
Publisher
John Wiley & Sons, Inc.
e-ISSN
26881152
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2563928312
Copyright
© 2021. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.