|Natalie Lane, MD|
|George Hsu, MD|
3 to 17 Years
– Pediatric patients (> 3 yrs and <18yrs) with a previous diagnosis of sickle cell disease (including Hgb S Beta Thalassemia +, Hgb S Alpha Thalassemia, Hgb S HPFH) ) seen in the pediatric emergency room setting for acute vaso-occlusive pain crisis.
– Patients not to have sequelae indicative of complicated disease outside of acute VOC:
1. Acute chest syndrome (new pulmonary infiltrate and hypoxemia)
2. Aplastic Episode
3. Evidence of infection
4. Pregnancy or CHF
5. Fever (> 38.4)
6. Cholangitis or cholecystitis
7. Hypoxia (SaO2 <90% on RA), or O2 saturation decrease of more than 5% from patient's baseline 8. Unstable Vital Signs 9. Patients who have received intravenous pain medicine within 24 hours of visit to the emergency department. 10. History of allergic reaction or serious reaction to Ketamine. 11. History of significant psychiatric illness 12. Patients with no refractory pain after receiving conventional analgesia regimen per protocol.