Tips on Treating Children
Treating children with vaso-occlusive crisis
A. GENERAL
• Hydration: On average applies 2000cc/m2/24horas of intravenous fluids more electrolyte-free intake by mouth.
• Analgesics
- Acetaminophen: 20 mg / kg / dose every 4-6 hours per hour VO
- Tramal: 1-2 mg / kg / dose IV every 6 hours for hours, alone in crisis
unrelieved painful to acetaminophen or ibuprofen
- Ibuprofen: 5-10 mg / kg / dose every 6 hours VO
• transfusion:
Sequestration crisis
Aplastic crisis
Cor anemic
A.C.V. ischemic
Pneumonia + Hypoxia
vaso-occlusive crises not responding to treatment
Prior to any surgical procedure
Prevention A.C.V. ischemic
Chronic lung or heart failure
Prolonged hematuria
Recurrent Priapism
Pregnancy complicated
TREATMENT OF FEVER WITH OR WITHOUT CHILDREN vaso-occlusive crisis:
• Search infectious outbreak
- Paraclinical: CBC with corpuscular indices, reticulocytes, ESR, Rx of thorax, culture (blood culture, urine culture)
• Antiobioticos: start taking antibiotics prior to culture with ceftriaxone 100mg/k/dia
• Crisis associated
MANAGEMENT OPTIONS:
• Transfusions in acutely ill children
• maintenance transfusions
• Surgery is the most common indication for splenectomy crisis management
very frequent vaso-occlusive disease or splenic sequestration
• supportive therapy
- Hydroxyurea
- Folic Acid
PREVENTIVE IMMUNIZATION
A. Pneumococcus: 2nd dose at intervals of 4-8 weeks between them in over 2
years. Reinforcement every 3-5 años.Menores 2 years starting vaccination schedule
Full (4 doses)
B. Haemophilus influenzae: Outline of the EPI. Dose at 2-4-6 months with booster
12-15 months. Over 59 months: 2 doses with an interval between them in 1-2 months.