So you have established that this patient has sickle cell disease.  She is currently visiting a friend in the area so she had never attended this hospital before.

Her pain has been controlled temporpraily with IV morphine, however you are still concerned by her observations as her RR is 30, and sats are 92% on 15l.  She has been commenced on LMWH and IVT

What other tests could you perform to confirm this diagnosis?

Would you need to involve any other specialities at this point?

What are the indications for transfusion/plasma exchange?

Any thoughts on the pathophysiology of ACS?

Any thoughts on further treatments/management plan?