20th February 2025

A patient with sickle cell disease presents to hospital with thigh and shoulder pain that is thought to be due to a vaso-occlusive crisis.

A patient with sickle cell disease presents to hospital with thigh and shoulder pain that is thought to be due to a vaso-occlusive crisis. They are admitted to hospital for analgesia. Their pain proves very difficult to control and they have not been able to mobilise on the ward as a result of this. Four days after admission they suddenly develop chest pain and shortness of breath. On assessing the patient, their observations are: heart rate of 115, saturations of 92% on room air, blood pressure of 146/89 and respiratory rate of 21. An ECG shows a sinus tachycardia and you perform a chest x-ray, which is below:

Given the likely diagnosis, what is the most appropriate next step in management?

Select the SINGLE most appropriate option from the list below. Select ONE option only.