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#35788 Acute pain protocol for sickle cell crisis – quality improvement project
  1. Siyun Xie1,
  2. Elizabeth Nguyen1,
  3. Jameson Dowell2,
  4. Esteban Esquivel1,
  5. Moe Ameri3,
  6. Melissa Victory Brodman3 and
  7. Adebukola Owolabi4
  1. 1Anesthesiology, University of Texas Medical Branch, Galveston, USA
  2. 2John Sealy School of Medicine, University of Texas Medical Branch, Galveston, USA
  3. 3Internal Medicine, University of Texas Medical Branch, Galveston, USA
  4. 4Anesthesiology, UT MD Anderson, Houston, USA


Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)

Application for ESRA Abstract Prizes: I don’t wish to apply for the ESRA Prizes

Background and Aims Pain from sickle cell crises can be challenging to manage when patients experience intractable pain with high opioid requirements. We aim to decrease average hourly pain score by 20% over first four days of admission and decrease average length of stay by 20% for sickle cell admissions to UTMB by implementing an acute pain protocol for hospitalists and the Acute Pain Service to standardize pain management.

Methods Being devoid of patient identifiable information, this study is exempt from IRB review requirements as per UTMB policy. We conducted a cohort study with a retrospective review of a control group (18 inpatient sickle cell patients) and a protocol group (18 patients) with the acute pain protocol implemented.

Results The protocol group’s average hourly pain score for day 1 (5.6/10), day 2 (3.7/10), day 3 (3.4/10) and day 4 (3.8/10) were lower compared to the control group for day 1 (6.2/10), day 2 (4.2/10), day 3 (5.2/10) and day 4 (5.6/10). Average hourly pain scores for days 1-4 were lower by 24% (difference averaged over 4 days) in protocol group vs control group. The protocol group’s average days of admission was lower (5.9) than the control group (7.5) with a 21% difference.

Abstract #35788 Figure 1

Average hourly pain score

Abstract #35788 Figure 2

Average length (days) of hospital admission

Conclusions We achieved our aim with faster pain control and shorter hospital stays. Next steps include creating a protocol for emergency physicians for earlier pain control. Overall, protocol-based pain management facilitated faster pain control, leading to more effective medical management – an approach that can be applied to hospital-wide admissions involving pain.

  • acute pain
  • sickle cell
  • quality improvement
  • protocol-based pain management

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