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Blood disorder crisis must be treated ‘as urgently as cardiac arrest’

Sickle cell awareness vital, specialist says, after coroner finds patient received wrong care
A computerised image illustrating the effects of sickle cell disease

Sickle cell awareness is vital, nurse specialist says, after coroner finds patient received ‘wrong’ care

A computerised image illustrating the effects of sickle cell disease
Picture: iStock

A leading nurse has urged healthcare staff to treat patients in a sickle cell crisis as seriously as if they were having a cardiac arrest.

Brent Sickle Cell and Thalassaemia Centre service director Lola Oni made the comment after a coroner’s finding that a man who had sickle cell disease might not have died had medical staff recognised his symptoms and given him a blood transfusion sooner.

A timely blood transfusion is one treatment option

Specialist nurse consultant Dr Oni
Lola Oni

Specialist nurse consultant Dr Oni told Nursing Standard: ‘You’ve got to treat patients in a sickle cell crisis as if you are treating someonewho is having a cardiac arrest, which means urgency.’

Evan Smith died on 25 April 2019 at North Middlesex University Hospital in London after developing sepsis following a procedure to remove a gallbladder stent a week earlier.

In a crisis, the sickle-shaped red blood cells block small blood vessels, which can cause excruciating pain and damage to the organs. A timely blood transfusion is one treatment option.

Barnet Coroner’s Court heard that nursing staff at the trust did not have training in managing sickle cell disease. Since Mr Smith’s death, the trust has provided extra training for staff on the condition.

Complications can arise quickly and unexpectedly

Coroner Andrew Walker said that if Mr Smith had received a blood transfusion a day sooner he would not have died when he did. He concluded that while staff were providing medical care it was the ‘wrong’ care, but he did not make a finding of neglect.

Dr Oni said a change in attitude to the disease, which affects approximately 15,000 people across the UK, was paramount. ‘Staff don’t appreciate that sickle cell disease is a multifactorial, multisystemic condition whereby complications can arise very quickly and unexpectedly,’ she said.

‘Patients could be having a clot in the brain or be in renal failure. Unless you are doing the appropriate observations you will miss those things.’


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