Hematologist
CION Cancer Clinics
When a sickle cell crisis needs hospital | CION Cancer Clinics
Go to the nearest emergency department or call 108 now if someone with sickle cell disease has any fever or high temperature, chest pain, breathlessness, stroke signs, sudden paleness, a painful erection that will not go down, or pain the home plan is not controlling. Do not wait for the morning. This page lists the danger signs, what happens at hospital, and how to be ready. At CION Cancer Clinics, our haematologist cares for anaemia, bleeding, clotting and inherited blood disorders, with ArogyaSri, CGHS and cashless insurance accepted.
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Medically reviewed by Dr. Basudev PokhrelConsultant Haematologist · last reviewed September 2026, next review due September 2027
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On this page
- Which crisis signs mean you must go to hospital today?
- When is it safe to manage a crisis at home?
- What happens in the emergency department?
- Should you go in now or call your team?
- Which beliefs make families wait too long?
- How can you be ready, and what can this page not tell you?
- Common questions about sickle cell emergencies
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Go now. Do not wait for the morning
Go to the nearest emergency department or call 108 if someone with sickle cell disease has any fever or high temperature, chest pain or breathlessness, sudden weakness, a drooping face or slurred speech, a fit, a sudden very pale look with a swollen tummy, a painful erection that will not go down, or pain that the home plan is not controlling. Say "sickle cell disease" at the desk. Do not give extra medicine first to see if it passes.
Signs that cannot wait
Which crisis signs mean you must go to hospital today?
Each of these can become dangerous within hours. None of them should be watched at home.
Fever
People with sickle cell disease fight some infections poorly, because the spleen often does not work well. A fever can mean a serious blood infection, even when the person seems fairly well.
Chest pain, cough or fast breathing
These can be the start of acute chest syndrome, a lung problem that is one of the most serious complications of sickle cell disease.
Stroke signs
Sudden weakness or numbness on one side, a drooping face, slurred speech, a severe headache, a fit or sudden confusion. Children can have strokes too.
A child suddenly pale and floppy
Blood can pool in the spleen very quickly, a problem called splenic sequestration.
Look for
- A swollen or tender left side of the tummy
- Unusual sleepiness or fast breathing
Pain the plan cannot control
Pain that keeps rising despite the medicines your team agreed, or vomiting that stops you drinking or keeping medicine down.
A painful erection that will not go down
This is called priapism. It needs emergency care to protect the penis from lasting damage. Embarrassment is not a reason to wait.
Not sure whether this applies to you?
Ask an oncologistHome or hospital
When is it safe to manage a crisis at home?
Only when the pain is mild to moderate, there are no danger signs, the person can drink and keep medicine down, and you have a written plan from a haematologist. If any one of those is missing, go to hospital.
What a good home plan says
It names the pain relief to use and how to use it, and it gives a clear point at which you stop trying at home. That point might be a length of time, or pain that is not easing after the medicines in the plan. Keep a copy on your phone and a paper copy at home, so a grandparent or neighbour can follow it too.
Who should have a lower threshold
Babies and young children, anyone who is pregnant, and anyone who has had acute chest syndrome or a stroke before should go to hospital sooner. So should anyone living far from a hospital, where a sudden turn for the worse at night would leave you stuck. In rural Telangana and Andhra Pradesh, plan the route and transport before you need it.
If you are unsure whether it is serious, treat it as serious. No emergency doctor will blame you for coming in.When you arrive
What happens in the emergency department?
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Tell them straight away
Say "sickle cell disease" at the desk and show the hospital card or last discharge summary. This helps the team recognise that the pain and fever need urgent attention.
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Pain relief first
Strong pain relief should be given quickly. NICE guidance in the UK sets a standard of within 30 minutes of arrival. It is reasonable to ask when it will be given.
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Checks and tests
Temperature, breathing and oxygen level. Blood tests for haemoglobin, the part of blood that carries oxygen, and for infection. A chest X-ray if there is any chest symptom, and blood cultures if there is fever.
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Treatment while you are watched
Fluids through a drip, oxygen if levels are low, and antibiotics if infection is possible. Some people need a blood transfusion, which the team decides on from the tests.
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Admission or going home
If pain settles and tests are reassuring, you may go home with an updated plan. Otherwise you are admitted and reviewed by a haematologist.
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Should you go in now or call your team?
Go to emergency or call 108 now
Call your haematology team soon
Any fever or high temperature
A mild cold with no fever, and drinking well
Chest pain, cough with fast breathing
A crisis that settled at home with your plan
Weakness, slurred speech, a fit
Crises coming more often than before
Yellow eyes with dark urine and new tiredness
Yellow eyes that are your usual pattern
Pain not easing with the plan
Questions about medicines or the plan
Commonly believed
Which beliefs make families wait too long?
"We will give paracetamol for the fever and see in the morning."
Bringing a fever down with medicine can hide a serious infection while it keeps spreading. In sickle cell disease the fever itself is the reason to go in, the same night.
"He has had so many crises, this is just another one."
Crises that look familiar can still turn into acute chest syndrome, a stroke or a severe drop in blood. Anything different from the usual pattern, or any danger sign, needs hospital, however experienced the family is.
"The doctors will think we only want painkillers."
Severe pain in sickle cell disease is a recognised emergency. Carrying your card and summaries helps the team see your history quickly. You are asking for standard care, not a favour.
"A small hospital nearby cannot help, so we should travel to the city."
For a danger sign, go to the nearest emergency department first. It can start oxygen, fluids, pain relief and antibiotics, and arrange transfer if needed. A long journey without care can lose precious time.
Before the next crisis
How can you be ready, and what can this page not tell you?
The families who cope best with an emergency are the ones who planned for it on a calm day. A few minutes now saves confusion at midnight.
Keep a crisis bag and card ready
Keep a copy of the latest discharge summary, the written crisis plan, a list of current medicines, the usual haemoglobin level from recent reports and any sickle cell card from a government programme. Save 108 and the number of the nearest hospital with an emergency department. Tell school, college or an employer what the danger signs are.
What this page cannot tell you
It cannot judge how unwell a particular person is. A list of signs is not an examination, and a normal-looking child can still be seriously ill. It also cannot tell you which medicine or amount to use. Your treating haematologist sets that, and changes it as needed.
After the emergency
Book a follow-up with a haematologist. At CION the haematology team reviews what happened, updates the plan and discusses whether longer-term treatment makes sense for you.
Questions we are asked
Common questions about sickle cell emergencies
When should I take someone with sickle cell to hospital?
Straight away if there is any fever or high temperature, chest pain, breathing trouble, stroke signs, sudden paleness with a swollen tummy, a painful erection that will not go down, or pain the home plan cannot control. If you are unsure, go. It is always safer to be checked and sent home than to wait.
Should I call 108 or take them myself?
Call 108 if the person is breathless, confused, very drowsy, having a fit or showing stroke signs, or if you have no safe transport. For pain or fever where the person is awake and able to travel, going directly to the nearest emergency department by car or auto is reasonable if it is quicker.
Is a fever really an emergency in sickle cell?
Yes. The spleen often does not work properly in sickle cell disease, so some bacteria can cause a serious blood infection very fast. This is especially true in young children. A fever needs checking and often antibiotics the same day, even if the child otherwise looks fine.
What should I take to the emergency department?
The most recent discharge summary, the written crisis plan, all current medicines in their packets, recent blood reports and any sickle cell card or scheme card. A phone charger and water help during a long wait. If you can, bring someone who can speak for the patient.
Will they give a blood transfusion every time?
No. Most pain crises are treated with pain relief, fluids and close watching. A transfusion is considered when haemoglobin falls sharply, or for problems such as acute chest syndrome or stroke. The team decides from the tests and how the person is doing, and will explain why.
Can a pregnant woman with sickle cell manage a crisis at home?
It is safer to go to hospital. Pregnancy raises the risk of complications for both mother and baby, and pain in pregnancy can have other causes that need checking. Tell the emergency team about the pregnancy, and let the obstetric and haematology teams know about any crisis.
Is emergency care for sickle cell free?
Government hospitals provide emergency care, and schemes such as Aarogyasri and PM-JAY may cover admissions at empanelled hospitals. Entitlements change, so check current rules. In an emergency, do not delay care to sort out paperwork. Most of it can be done after treatment starts.
Does CION treat sickle cell emergencies?
In an emergency, go to the nearest hospital with an emergency department or call 108, because time matters most. CION's haematology team sees patients for planned care: reviewing what happened, writing or updating a crisis plan, and discussing longer-term treatment. Bring every report from the hospital stay.
Your Haematologist
Meet CION's haematologist. One specialist for your blood report and your plan.
Dr. Basudev Pokhrel reviews blood counts, transfusion needs and blood disorders, and works with the CION tumour board on blood cancers.
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Where to find us
Our centres in and around Hyderabad
Addressed by landmark, because that is how this city navigates. A haematology consultation can be booked at any of these centres through one helpline, and your team will tell you where each test or treatment takes place.
Warangal
Vizag
Sources
- NHS — Sickle cell disease
- NICE — Sickle cell disease: managing acute painful episodes in hospital (CG143)
- NHLBI — Sickle Cell Disease
- National Health Mission — National Sickle Cell Anaemia Elimination Mission
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Pain Crisis: What Triggers It and What HelpsManaging milder crises at home with your planAcute Chest Syndrome: The Dangerous ComplicationWhy chest pain and cough need hospitalStroke Risk and TCD Screening in ChildrenStroke signs and how the risk is checkedSickle Cell Schemes, Cards and Free TreatmentWhat government schemes may coverSickle Cell DiseaseThe full guide to living with sickle cell
Talk to us
Back home after a crisis?
Bring the discharge summary and your reports. CION's haematology team will review what happened and help update your plan. In an emergency, call 108.