Pain Management of Acute Complications (1)

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Management of Acute Complications

TREATMENT

LOC

Painful crisis – home management (mild to moderate pain)
  • Oral hydration
  • Warm compresses (not cold)
  • Paracetamol 1 g every 8 hours Child: 10-15 mg/kg 6-8 hourly
  • And/or ibuprofen 400-600 mg every 6-8 hours Child: 5-10 mg/kg 8 hourly
  • And/or oral diclofenac 50 mg 8 hourly Children only >9 years and >35 kg: 2 mg/kg in 3 divided doses

HC 2

 

HC4

If pain not controlled, add:
  • Codeine 30-60 mg every 6 hours (only in patients >12 years)
  • Or oral tramadol 50-100 mg every 6-8 hours (only in patients >12 years)
  • Or Oral morphine at 0.2-0.4 mg/kg every 4 hours and re-assess pain level

(see section 13.1.2) for the WHO analgesic Ladder. If pain still not controlled, refer to RR hospital

 

 

RR

Painful crisis – hospital management (severe pain)
  • IV fluids for rehydration
  • Oxygen, keep oxygen saturation >95%
  • Assess for malaria and other infections
  • Injectable diclofenac Child: 1 mg/kg IM 8 hourly
    Adult: 50-75 mg IM 8 hourly
  • Or Morphine oral (see section 13.1.2)
    Child and Adult: 0.3-0.6 mg/kg per dose and re- assess
  • Or Morphine IV
    Child: 0.1-0.2 mg/kg per dose
    Adult: 5-10 mg dose and re-assess

HC 4

 

 

HC3

 

RR