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Red Cell Exchange
(Click on and Option Below)
Sample Consults
Sickle Cell Crisis
1) Diagnosis –
2) Obtain Vascular Access
a. If IJ or subclavian line is placed verify catheter tip placement
is in SVC not right atrium by X-ray
3) Check ionized HgbS level prior to procedure
4) Premedicate with Benadryl (25 mg PO or IV) and Tylenol (650 mg PO or PR
5) Red cell exchange to lower HgbS from ___ to <30% or not greater than 3%
of pre-procedure HCT today.
6) Post procedure Hgb / HCT and Hgb Electrophoresis
7) Risks and Benefits explained to patient, informed consent obtained &
witnessed
8) May need to replace protein bound meds or hold until after procedure
**Results of pre-procedure Hgb S may not be known before beginning procedure
**If patients temperature is >100 degrees, policy requires specific order to
“Transfuse in spite of Temperature Elevation”
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