Majority of Patients in ED With Sickle Cell Crisis Not Triaged Appropriately

FRIDAY, Oct. 10, 2025 (HealthDay News) — A majority of patients with sickle cell disease (SCD) with vaso-occlusive crisis (VOC) are assigned to emergency severity index (ESI) 3, impacting the length of time it takes for them to receive analgesia, according to a study published online Oct. 7 in Blood Advances.

Abdulaziz Khalid Abu Haimed, M.B.B.S., from the University of Maryland Medical Center in Baltimore, and colleagues compared the time from triage to administration of first analgesia (TTFA) and time to second analgesia administration (TTSA) among adults with SCD presenting to the emergency department with uncomplicated VOC for those who were assigned ESI acuity level 2 versus 3. The analysis included 66 visits: 23 and 43 visits were assigned ESI 2 and ESI 3 (34.8 and 65.2 percent, respectively).

At triage, the median pain score was 9/10. The researchers found that four patients left the emergency department without receiving analgesia. Of the remaining 62 patients, the median TTFA was 65 and 178 minutes for those assigned ESI 2 and ESI 3, respectively; median TTSA did not differ significantly (72 versus 78 minutes). Only ESI correlated with TTFA in an analysis including age, gender, SCD genotype, pain score at presentation, and ESI acuity level (hazard ratio, 5.731).

“A patient with sickle cell disease assigned an ESI 2 compared to 3 is about six times more likely to receive pain medication quicker,” Haimed said in a statement. “Ensuring we assign patients the recommended ESI is one small intervention that can significantly improve the quality of care and overall experience in the emergency department.”

One author disclosed ties to the biopharmaceutical industry.

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