• TSH Implements Sickle Cell Protocol for ED Patients
    Published March 19, 2012

    The Scarborough Hospital has implemented a new Sickle Cell Crisis Protocol in its Emergency Department in an effort to better serve its diverse community.

    The hospital’s mandate is to meet the unique needs of each and every patient, and by addressing the needs of the large population affected by sickle cell in the Scarborough area, it is one step closer to achieving this.

    Sickle cell disease is a blood disorder. It affects the red blood cells, causing them to be abnormally shaped, rigid and sticky. These irregular cells are fragile, not able to carry oxygen, are prone to rupture and can get stuck in small blood vessels which can slow or block blood flow and oxygen to parts of the body. This causes symptoms such as shortness of breath, fatigue, and delayed growth and development in children. It can also cause unexplained episodes of severe pain (called crisis).

    The disease most commonly affects people from Africa, South or Central America, Caribbean islands and Mediterranean countries.

    People with sickle cell disease come to the Emergency Department in crisis. They are in a tremendous amount of pain and require immediate treatment to stop the sickle cycle and the pain. In the past, a number of barriers prevented patients from getting treatment right away. This new protocol involves a pre-printed, standardized order set that allows triage nurses to expedite treatment.

    By looking at evidence, the needs of the patients in the Scarborough community, and through a partnership with the TAIBU Community Health Center, the hospital developed a protocol that is unique and specifically suited to TSH and its patients.

    “We saw there was a need in the community, and we knew we needed to do something,” says Angela Harrinanan, Pain Service Specialist, Acute Pain Service at TSH. “When TAIBU approached us, we realized we had to come up with a solution right away and worked with them to make it happen.”

    The goal of the new protocol is to provide immediate, effective up-front care to patients and prevent hospitalization.

    “We want to treat and discharge patients within 24 hours and without admission to the hospital,” says Angela.

    The community partnership with TAIBU is key to the success of treating sickle cell patients in crisis. Open communication between the two organizations will allow the hospital to have a better understanding of what issues sickle cell patients are facing and allows for seamless care and follow-up when patients are discharged.

    Both the staff at the hospital and at TAIBU are excited about this new protocol.

    “This is a really, really good thing for our sickle cell patients,” says Lynda Vanden Kroonenberg, Clinical Resource Leader at the Birchmount campus. “It sends a message that we know they are coming to our Emergency Department in a tremendous amount of pain, and we’re ready for them.”

    Liben Gebremikael, Executive Director of TAIBU Community Health Centre, representing a Sickle Cell Coalition group, first brought this issue to the hospital’s attention.

    “The implementation of this protocol is a huge milestone in the Sickle Cell Community and provides great benefit to the Scarborough community and the hospital. It will help reduce wait times in Emergency Departments, shorter hospitalization, if at all, and improve their experience of patient centred care provided by the hospital,” says Mr. Gebremikael.

    “It has been a really great experience working with TSH on this initiative, and to know they are willing to work with community partners is encouraging.  We have confidence that if we see issues in the community, we can bring them to the hospital and they will be properly addressed.”

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