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Immediate priorities
First-hour stabilization
High-acuity triage for suspected acute chest syndrome in sickle cell disease
Respiratory distress
Hypoxemia relative to baseline
Continuous pulse oximetry
Target SpO2 92% or higher
Higher target for pregnancy or chronic hypoxemia baseline individualized
Supplemental oxygen
Nasal cannula escalation to face mask as needed
High-flow nasal cannula for persistent hypoxemia
Early blood bank notification
Type and screen
Extended red cell phenotype matching plan
Early hematology consultation
Transfusion strategy planning
Alloimmunization history review
Early ICU team notification triggers
Rapidly rising oxygen requirement
Altered mental status
Hemodynamic instability
Respiratory failure escalation
Noninvasive ventilation for increased work of breathing without contraindications
Close monitoring for fatigue and worsening hypoxemia
Intubation preparation
Difficult airway risk assessment
Post-intubation ventilator strategy for ARDS physiology
Post-intubation hypotension risk mitigation
Conservative induction dosing
Vasopressor readiness
Hemodynamic and monitoring goals
Monitoring bundle
Frequent vital signs
Respiratory rate trending
Temperature trending
Cardiac monitoring for hypoxemia and anemia stress
QT-prolonging medication review
Strict intake and output
Avoid fluid overload
Fluids strategy
Euvolemia goal
Isotonic maintenance only if poor oral intake
Avoid aggressive boluses without shock physiology
Shock pathway if present
Sepsis protocol integration
Point-of-care ultrasound for volume status
Key concepts
Working definition
New pulmonary infiltrate on imaging
With fever or respiratory symptoms
With chest pain or hypoxemia
Acute decline can occur within hours
Close reassessment cadence
Early multimodal therapy
Oxygenation support
Prevent hypoxemia driven sickling
Antibiotics for atypical and typical pathogens
Early administration in febrile or infiltrate cases
Lung expansion therapy
Incentive spirometry to reduce atelectasis
Transfusion for oxygen delivery and HbS reduction
Simple transfusion for moderate disease
Exchange transfusion for severe or progressive disease
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.