Sickle Cell Facts for Teachers and School Nurses

Tips for helping students with sickle cell disease manage their health

Teachers and school nurses need to take certain actions to help children with sickle cell disease maintain their health. Simple accommodations can prevent serious complications and hospitalizations. Take a proactive approach by knowing the basics about sickle cell disease and what steps to take if a child with sickle cell disease becomes ill at school. 

Everyday needs of children with sickle cell disease

Give plenty of fluids

Make sure the child has water readily available at all times in class. The child should be allowed to carry a water bottle at all times and to drink water during class, during physical education or at any other time.

Why it is important

Fluids assist red blood cells in moving more easily throughout blood vessels, which ultimately decreases the number of pain crises.

Provide liberal bathroom privileges

Allow the child to have free access to the bathroom. Provide a bathroom pass for an older child so all school personnel will be aware that permission has been granted.

Why it is important

Children with sickle cell disease need to go to the bathroom more often due to their high fluid intake and because their kidneys do not function as well as those in healthy children.

Avoid physical exhaustion

Allow the child time to rest when needed, or slow down the activity. This is particularly important during physical education. If a parent prefers that a child be excused from any activity, permission should be granted. If a child has difficulty carrying textbooks, allow a rolling backpack or an extra set of books.

Why it is important

Children with sickle cell disease tire more easily than other children. Physical exhaustion may trigger a pain crisis. A pain crisis may lead to hospitalization and school absences.

Avoid extreme temperatures

Keep the child out of the cold as much as possible. In hot weather, allow for frequent breaks with plenty of fluid to avoid dehydration. Avoid frequent changes in temperature. Temperatures in the classroom must also be regulated. Classrooms that are too cold or too hot may cause complications requiring hospitalization. Allow the child to wear a coat, hat and gloves as needed. Do not apply ice to injuries.

Why it is important

Temperature extremes can trigger a pain crisis. A pain crisis may lead to hospitalization and school absences.

Common complications

Pain crises

Living with pain is a challenging part of sickle cell disease.

  • Pain may be treated with acetaminophen, ibuprofen or a narcotic drug prescribed by a doctor. It is important to check for fever and follow the fever precautions listed below before giving medication.
  • If no fever is present, administer medications as directed, and as soon as possible.
  • Give plenty of fluid. To help ease the pain, try warm compresses or distractions, such as quiet activities and listening to music.
  • If a child’s pain cannot be managed, call the parents immediately so they may seek medical attention.

Acute chest syndrome

Acute chest syndrome is believed to be caused by sickled red blood cells clogging blood vessels in the lungs. It can also be associated with respiratory infection. Contact the parents immediately if the child has any of these symptoms:

  • Fever (temperature 101°F or above)
  • Chest pain
  • Congested cough
  • Labored breathing
  • Rapid breathing

Anemia

Normally red blood cells live for 100 to 120 days. In sickle cell anemia, red blood cells live only 15 to 20 days. Due to the shorter life span of the sickled red blood cells, children with sickle cell are frequently anemic. Some symptoms of anemia are:

  • Pale color of lips
  • Headache
  • Weakness
  • Fatigue, decreased energy or sleeping for long periods of time

Jaundice

Jaundice, or yellow coloring of the eyes or skin, is caused by bilirubin, a byproduct of red blood cells. Since children with sickle cell disease break down more red blood cells, they have increased amounts of bilirubin.

Stroke

Sickled cells can block blood vessels in the brain and keep the brain from getting enough oxygen. If you notice cognitive changes in the child or changes in school performance, discuss these concerns with a parent as soon as possible.

Call a parent immediately if you notice any of the symptoms listed below. If a parent is not available, the symptoms are severe, or the student has a change in mental status or an extended seizure, call 911.

  • One-sided weakness or paralysis
  • Facial asymmetry
  • Difficulty swallowing
  • Seizure
  • Slurred speech
  • Very severe headache
  • Sudden-onset vision change

Call 404-785-1112 to speak with one of our hematology school teachers if you have questions.