Objectives: to assess compliance of a district general hospital in North East London with the national and trust guidelines for assessing paediatric sickle cell patients presenting to A&E with pain.

Methods: Retrospective data was collected from April 2023 to January 2024 using patient notes (paper and electronic) across various parameters: timing of nursing triage, pain score on admission, initial analgesia prescribed, does analgesia correspond to correct protocol, pain score after analgesia, re-assessment of pain.

Results: 20 patients were identified over the period. 90% patients (n=18) were triaged within 30 minutes in A&E; 85% patients(n=17) had analgesia prescribed within 30 minutes of presentation. 52% patients (n=10) had analgesia prescribed according to the correct protocol. 75% patients (n=15) were reassessed after initial analgesia. Only 32% had regular paracetamol and ibuprofen prescribed.

Conclusion: Documentation of initial management was inconsistent, which may have contributed to the mixed results of pain protocol adherence. We proposed the introduction of an electronic proforma to standardise documentation and patient care. We also introduced a sickle cell passport to help families with language barriers better advocate for themselves in A&E.

TBU...