Pain Management of Acute Complications (1)

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