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Publications

Journal Article Ppublish

PubMed: 39969208 DOI: 10.1182/bloodadvances.2023012546

Implementing ASH's guidelines for acute medical care for incarcerated children and adults with sickle cell disease.

Blood Adv 9(11):2744-2750

Authors: Michael R DeBaun, Michelle Staples-Horne, Radha Sadacharan, Paula Braverman, Nirmish Shah, John Strouse, Deana Orsini, Charles Dudley Lee, Elizabeth S Barnert

Affiliations

  • Department of Pediatrics, Vanderbilt-Meharry, Center of Excellence in Sickle Cell Disease, Vanderbilt University School of Medicine, Nashville, TN.
  • Fulton County Department of Health and Wellness, Atlanta, GA.
  • Academic Consortium on Criminal Justice Health, Shrewsbury, MA.
  • Department of Pediatrics, Baystate Health, Springfield, MA.
  • Divisions of Hematology and Pediatric Hematology/Oncology, Duke University School of Medicine, Durham, NC.
  • Department of Medicine, Duke University School of Medicine, Durham, NC.
  • Adolescent Medicine, University of Pittsburgh Medical Center Children's Hospital of Pittsburgh, Pittsburgh, PA.
  • American College of Correctional Physicians, Poway, CA.
  • Department of Pediatrics, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA.

Abstract

Between 2019 and 2021, the American Society of Hematology (ASH) developed clinical guidelines for managing sickle cell disease (SCD), covering acute pain, acute neurological events, and other complications. However, these guidelines lacked implementation strategies for incarcerated individuals, a vulnerable group with unique challenges. In 2024, an ASH special panel of SCD and carceral health experts convened to address acute SCD care in custody settings, emphasizing timely access to emergency care, including acute management for acute strokes, pain management, and fever evaluation. The ASH special panel recommended prearranged emergency plans for transfer to specialized facilities, continuity of care with SCD specialists, and adherence to community-level care standards. Limitations included insufficient population data and absent chronic care guidelines. The ASH special panel urged that future ASH guidelines address SCD management tailored to carceral settings to reduce morbidity and ensure equitable care.

MeSH

Cells, Anemia, Sickle Cell, Emergencies, Pain, Acute Pain, Hematologic Diseases, Child