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Department of Pediatrics : Academic Divisions : Emergency Medicine : Resident Manual : Sickle Cell Disease : Exclusion Criteria Checklist

Exclusion Criteria for Outpatient Management of Febrile Patients with Sickle Cell

If patient has any of the following exclusion criteria, he/she should be admitted.

____Age < 2 years
____Temperature > 104° F
____Unavailable use of a telephone and/or transportation
____History of noncompliance
____Inability to take oral medication
____Inability to fill prescription
____Toxic appearance (overall clinical impression of ill appearance, lethargy, irritability)
____Hypotension
____Poor perfusion
____History of sepsis
____Severe pain
____Dehydration or significant diarrhea or vomiting
____Respiratory distress
____Suspected osteomyelitis
____Suspected meningitis
____Hemoglobin < 6gm/dl or drop of 2 gm or greater from baseline
____WBC >30,000 or < 5,000/mm3
____Platelet count < 100,000/mm3
____Reticulocyte count < 1%
____Infiltrate on CXR
____Allergy to penicillins or cephalosporins
____New or worsened splenomegaly
____History of splenectomy


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