طفل عمره ٦ سنوات معروف بفقر الدم المنجلي، جاء بألم شديد في الساقين والظهر منذ الصباح بعد يوم لعب في الحر وقلة شرب. الحرارة ٣٧٫٨، والنبض ١٢٤، والتشبع ٩٥٪. يقيم ألمه ٩/١٠. ما الأولوية؟

A 6-year-old with sickle cell disease has had severe leg and back pain since morning after a day of play in the heat with poor drinking. T 37.8 °C, HR 124, SpO2 95%; pain 9/10. What is the priority?

1. Fluid restriction to avoid cardiac overload
2. Cold packs on the legs to reduce pain
3. Wait for the pain to settle, then give mild analgesia
4. Rapid strong analgesia and IV fluids

Answer: D) Rapid strong analgesia and IV fluids. Sickle cell pain crises need rapid analgesia (often opioids) and fluids, with oxygen if saturation falls. Cold worsens sickling; dehydration and heat are triggers.