25th July 2024

An 18-year-old male presents to A&E with abdominal distention and discomfort

An 18-year-old male presents to A&E with abdominal distention and discomfort. He appears pale and has a palpable spleen 2 cm below the left costal margin. He has a past medical history of sickle cell disease and has 3 previous attendances with painful crises in the last 12 months.

Observations are: BP 85/40, HR 115, RR 22, Sats 95% on RA (room air), T (temperature) 36.5ᵒC.

His FBC shows Hb 82 (130-180 g/​L) with raised reticulocytes, and you notice his baseline Hb on previous bloods is 95.

What is the most important next step in this patient’s management?

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