Acute Symptons

Acute Chest Syndrome And Sickle Cell Disease
In The Pediatric Patient.

Sickle Cell Disease: Is a generic disease that affects hemoglobin, oxygen transport in the body and patient quality of life. This disease is most common in African American, Hispanic, Greek and Arabs. Note: Sickle Cell is inherited from both parents. Sickle cell is a blood disease in wish the red blood cells that are responsible for carry oxygen from the lungs to other part of the body are behaving in an abnormal way because they contain with abnormal hemoglobin.

Normal Red Blood Cells Are:
Soft, smooth and flexible and has donut shape and move flexible in small blood vessels called capillaries.
Sickle Shape Cells:
Move slowly and block small blood vessels and have a cashew shape and can cause serious health problems such as:
Acute Chest Syndrome – is caused by lung infection or sickle cells that trapped in the small blood vessels.
Anemia – low hemoglobin
Dyspnea- difficulty or labored breathing
Acute Chest syndrome
Acute Chest Syndrome is noted as a common complication for children with sickle cell disease, especially between the age of two and four years old. Hospitalization for sickle cell patients increases during winter months for children. Most of their symptoms are:
Hypoxia
Chest pain
Dyspnea
Tachynea
Decrease hemoglobin
Infection (viral or bacterial)
Note:Children under 10 years old are presented more with fevers.
Adults: present more often with dypnea and pain in the arms and leg.
Acute Chest Syndrome is the most common cause of death in sickle cell patient.

Treatment
Acute Chest Syndrome patient should be monitored closely at least for 48 hours.
Chest X Ray
Laboratory testing including hemoglobin level and white blood count
Monitor hydration and fluid status
Control pain level
Prevent thoracic splinting
Spirometry can be used to help lung function
Antibiotic
Blood transfusion
Note: Treat all sickle cell patients that are admitted in the hospital for pain and other issues with Acute Chest Syndrome medication because pain sometimes could trigger off ACS. “Despite the fact that Acute Chest Syndrome is the leading cause of death in patients with sickle cell disease, diagnosis is often delayed, optimal treatment is unknown, and the exact cause of a crisis is often difficult to identify”.
Quality of Life
Children that are diagnosed with Acute Chest Syndrome and sickle cell are mostly in pain. It limits their activity of daily living (ADL). It affects their social life and also their education. The most we as a therapist can do is support , educate and listen to their experience and understand their health care better.