Contents:
- Medical Video: Living With and Managing Sickle Cell Disease | St. Louis Children's Hospital
- When the pain strikes
- Fever
- Stroke
- When to look for medical treatment for students with sickle cell anemia
Medical Video: Living With and Managing Sickle Cell Disease | St. Louis Children's Hospital
When the pain strikes
This is a common health problem for sickle cell disease. Pain can occur in any part of the body (most often in the arms, legs, stomach and back) and can last several hours, days, weeks or more. Pain can be lighter or worse than at present or may become so severe that the child needs to be hospitalized. The unexpected nature of pain associated with sickle cell disease can create a sense of uncertainty that can cause unusual behavior. A child who is usually relaxed and caring in class can become angry, uncooperative, and unresponsive.
Many children with sickle cell disease suffer pain every day and still behave "normally," focusing on their school work and being involved in class activities. It is important to recognize when student pain is worse than usual or no longer tolerated.
Which must be done
Be responsive to pain complaints. A student will know whether their pain is mild or moderate and will overcome it, either by calling their parents or going to the hospital. If a child has pain during the school day, the school can help by giving the child time to rest and then return to class, if possible. Don't encourage students to just endure pain. In clinics or hospitals, doctors often use a 1-10 scale to assess pain. Use this type of scale to check regularly on students to find out the difference between the usual pain level and when an emergency contact needs to be called.
Create individual treatment plans for each student with sickle cell disease. The treatment plan must have input from teachers, school nurses, students, and their families. This plan can include instructions on providing pain medication, including those responsible for giving medication, and how to decide which medication to give to students. Students with sickle cell disease are often prescribed strong drugs, including narcotics (for example, Tylenol with Kodeine, Darvocet), anti-inflammatory drugs (for example, Toradol, Advil) or steroids (for example, Prednisone) to relieve pain. Leaving school or being absent due to illness is not desirable for students, however, always notify parents if their child's health status changes during the school day.
Fever
Children with sickle cell disease have a greater risk for certain bacterial infections compared to other children. Fever from a temperature of 38 Celsius or higher, can mean the child has an infection. Infection is the leading cause of death in children with sickle cell disease, and must be hospitalized frequently. If a fever is accompanied by pain in the ribs or chest, coughing, and difficulty breathing, this may be a sign of acute chest syndrome, which is a serious medical emergency.
Which must be done
Be aware of signs of fever. The teacher must have access to an individual care plan for students with sickle cell disease who explain instructions about what to do if a fever occurs during the school day. Children with sickle cell disease and having a fever should be examined by a doctor to evaluate the child for health problems, such as pneumonia or other infections; so contacting parents of students immediately is the best thing.
Stroke
Sickle cell disease is one of the most common causes of small strokes. Stroke is a small brain injury that can affect learning ability. Between 10% and 20% of children with sickle cell disease will experience symptoms of stroke, which means that strokes will produce physical changes in students. Most commonly, strokes can occur if sickle red blood cells are trapped into the walls of blood vessels and block blood flow to the brain.
Stroke signs include severe headache, dizziness, changes in vision, sudden weakness (not because of pain) in one part of the body or side of the face, numbness, usually on the face or limbs, sudden inability to speak, or seizures. More than 25% of children with sickle cell disease suffer silent stroke at the age of six. Silent strokes do not have the same clear signs of normal stroke symptoms, but can be proven by changes in behavior, concentration, or a sudden decline in students in the quality of learning in their school. Silent strokes are a serious problem that requires consulting a doctor who specializes in the brain and behavior.
What needs to be done
Beware of signs of stroke. The teacher can identify changes in student behavior that may be related to symptoms of a stroke or silent stroke associated with sickle cell disease. If a stroke is suddenly suspected, parents must be contacted immediately and the child must be rushed to the hospital. Children who suffer from strokes or based on medical tests show that they are at high risk of stroke may need a monthly hospital examination to receive blood transfusions to prevent strokes. Make a plan to help children attend missed school activities. If a student with sickle cell disease begins to show a gradual decline in academic performance, attention, or memory, the teacher must contact the parents of students so that medical attention can be given if needed.
When to look for medical treatment for students with sickle cell anemia
Symptoms that suddenly or get worse, such as chest pain or abdominal pain, fever (above 38 degrees), or signs of stroke (for example, weakness or numbness on both sides of the body, unable to speak, suddenly dizzy or headaches, difficulties with memory, blurred vision) need immediate medical help. Remember, always notify parents if their child's health status changes during the school day.
