Protocols - Hemorio

1.INICIAL CLINICAL EVALUATION
SICKLE CELL DISEASE
CLINICAL EVALUATION
- Anamneses and complete physical examination.
- Guiding about the disease and alert signs.
- To provide explanatory leaflet about the disease and sickle cell trait.
- Start Folic Acid and prescribe indicated vaccines
- To provide multidisciplinary attendance – Nursing, Odontology, Nutrition, Social Worker, Psychology,
Physiotherapy (to send to the specifics outpatien unit) .
ON CHILDREN:
- Cephalic perimeter on child up to 12 months.
- Start ATB prophylaxis, up to 5 years.
- To stimulate breastfeeding
- To teach the motherto palpate the spleen (see splenic sequestration)
INITIIAL LABORATORY EVALUATION
- Complete blood test, reticulocyte and erythrocyte sedimentation speed.
- Hb Study (Hb A2, fetal and G6PD dosage).
- Arterial O 2 by pulse oximeter
- Immunohematological study and erythrocytic phenotype
- Biochemistry - glycemia, hepatic and renal function tests, electrolyte, lipidogram and ferritin, serum folate,
dosage of erythropoietin in patients older than 3 year.
- Serology to: hepatitis A, B and C / HIV / HTLV / Sifilis / Chagas Disease
- TAP e PTT
- SAE and Fecal Parasitology Survey
- - Creatinine Clearance
- 24 hour-Proteinuria on 2 nd consultation
- Microalbuminuria on 3 rd consultation (for those who experienced normal proteinuria)
- Abdominal USG
FOR BABIES: Exams on the mother (Hb eletrophoresis + serology)
FAMILIAR STUDY:
Hb eletrophoresis for the father, mother, children and siblings
2.PERIODIC CONTROLS
MEDICAL CONSULTATION
- Up to 2 years = consultation 2/2m
- 2 years – 12 years = consultation 3/3m
- 12 years = consultation 4/4m
8