In the management of a sickle cell crisis, what is the initial priority of treatment?

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Multiple Choice

In the management of a sickle cell crisis, what is the initial priority of treatment?

Dehydration worsens sickling by increasing blood viscosity and promoting HbS polymerization, which can accelerate a vaso-occlusive crisis. Restoring intravascular volume quickly helps dilate the microcirculation, improves tissue perfusion, and reduces the tendency for red cells to sickle. Because of this pathophysiology, initiating aggressive IV hydration with isotonic fluids (for example, normal saline) is the first active step in management. Analgesia is essential and should be started promptly to treat pain, and oxygen is provided only if there is hypoxemia. Antibiotics are considered if an infection is suspected. But the immediate, foundational action to blunt the crisis is rehydration, which addresses the underlying physiologic trigger.

Dehydration worsens sickling by increasing blood viscosity and promoting HbS polymerization, which can accelerate a vaso-occlusive crisis. Restoring intravascular volume quickly helps dilate the microcirculation, improves tissue perfusion, and reduces the tendency for red cells to sickle. Because of this pathophysiology, initiating aggressive IV hydration with isotonic fluids (for example, normal saline) is the first active step in management.

Analgesia is essential and should be started promptly to treat pain, and oxygen is provided only if there is hypoxemia. Antibiotics are considered if an infection is suspected. But the immediate, foundational action to blunt the crisis is rehydration, which addresses the underlying physiologic trigger.

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