Hello everyone and welcome back to EM Basic Pediatrics.

I am Zach Hodges, a pediatric resident at the Children's Hospital of Georgia at Augustine University.

I'm here with Eric Ring, Assistant Professor of Pediatric Hematology and Oncology here at the Children's Hospital, Georgia.

Dr. Ring, how are you?

I'm doing well, Zach. Thanks for having me.

We also have Dr. Dan McCullum. He is an emergency medicine physician here at Augusta University.

Dan, how are you? I'm doing great, Zach. Thanks for hosting us again.

Dr. Ring, will you tell us a little bit about yourself and your educational background?

I am currently a practicing pediatric hematologist, oncologist, at the Children's Hospital of Georgia

at Augusta University and the Augusta Cancer Center. I completed fellowship training at the University

of Alabama, Birmingham, and a pediatric residency in Greenville, South Carolina. Thanks. Today we're

excited to discuss the management of children with sickle cell disease who present to the emergency

department with fever. The basis of our discussion will be the 2014 National Heart, Lung,

and Blood Institute report on the management of sickle cell disease,

but we will also mention several other recent publications.

You can find all of our references in our show notes.

Dr. Ring, get us started with some background information on sickle cell disease.

Sickle cell disease is a hemoglobinopathy that affects every organ in the body via hypoxemia

and vascular insufficiency.

Sickle cell disease results from a homozygous autosomal recessive mutation resulting in hemoglobin sickle or hemoglobin

a low oxygen affinity hemoglobin. High levels of hemoglobin s and low oxygen states lead to

polymerization of hemoglobin inside the rBC, causing rigidity in its sickle

...