• Sherraine Della-Moretta, Luca Delatore, Michael Purcell, Ying Huang, Melanie Heinlein, Eric Adkins, and Payal Desai.
• Department of Internal Medicine, Columbus, OH.
• Ann Emerg Med. 2020 Sep 1; 76 (3S): S21-S27.

Study ObjectiveSickle cell disease (SCD) is an inherited hematologic disorder that affects approximately 100,000 US individuals and results in greater than 200,000 emergency department (ED) visits annually in the United States, with pain being the most common complaint. The objective of this retrospective study is to determine the effect of implementing individualized pain plans in the treatment of patients with SCD in the ED on time to first opioid, length of stay, and disposition.MethodsAt The Ohio State University Wexner Medical Center, a multidisciplinary group including hematologists and ED physicians was formed and enacted a protocol for using individualized pain plans, with the goal of decreasing time to treatment for patients with SCD who presented to the ED with chief complaint of pain. In this retrospective study, data from the year before through the year of implementation were gathered. Generalized linear models were fit to compare time to first opioid, length of stay, and disposition before and after protocol implementation.ResultsData showed a 48% decrease in time to first opioid and a 22% decrease in length of ED stay after protocol implementation. No significant change was found in disposition or length of inpatient admission before and after protocol initiation.ConclusionThe use of individualized pain plans in the treatment of patients with SCD in the ED is a useful method of not only ensuring rapid and adequate treatment but also decreasing use of health care resources.Copyright © 2020 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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