Needs of sickle cell patients often overlooked in ER: doctors

The Scarborough Hospital has set up a new sickle cell “crisis protocol” that it hopes will help emergency department staff better meet the needs of sickle cell patients.

Doctors at the hospitalacknowledged that the current process is flawed and doesn’t meet the needs of people living with sickle cell.

The new protocol was implemented last month in what physicians are calling a move to “serve its diverse population.”

According to Doreen Alexander, president of the Sickle Cell Awareness Group of Ontario, this effort does not resolve the fundamental lack of understanding going into sickle cell care.

Sickle cell disease is a blood disorder which causes abnormally shaped red blood cells. This condition often causes extreme bouts of pain referred to as “crisis.”

These individuals are in pain and require an industrial amount of narcotics that physicians and nurses were really uncomfortable with.

— Dr. Eric Hurowitz

Alexander says a major concern for sickle cell patients is not being able to receive the large amount of medication required to deal with pain during crisis. Alexander says  physicians sometimes misunderstand a patient’s need for a lot of narcotics to be similar to the wants of drug addicts.

“[Patients with sickle cell] do suffer a lot because one of the things they encounter in the emergency department is being told that they’re drug addicts looking for a fix instead of being looked at as an individual who really needs to be treated,” Alexander said.

“There is this disconnect,” Scarborough physician Dr. Eric Hurowitz said. “These individuals are in pain and require an industrial amount of narcotics that physicians and nurses were really uncomfortable with. Unfortunately there is a really distinct group of people who require this care.”

This is a major point of contention for suffers and their families as, Alexander has found, those in crisis who seek emergency attention may be deemed less of a priority and subject to longer wait times or turned away altogether.

Dr. Peter Azzopardi says the belief that all sickle cell sufferers belong to a distinct group is a misconception.  Sickle cell, he says, is not limited t people of African or Mediterranean ancestry.

“As our cultures become more diverse, this isn’t just a problem that you only see in the black population anymore. We’re also seeing children of basically any background showing up with cases of the sickle cell disease that we wouldn’t normally look for,” Azzopardi said.

Medical staff understand that the sickle cell disease causes shortened and painful lives. What is still being overlooked is who to care for and to what degree.