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Jacob is an 8-year-old with sickle-cell anemia. He lives with his mother and grandmother in an urban neighborhood. Jacob has experienced several "sickle cell crises;" however, they seem to have become more frequent since he started playing soccer. Jacob is enjoying summer break from school.
Jacob's mother brings him to the hematology clinic at the hospital with complaints of severe generalized pain following a soccer game in which he played the entire game. He is admitted to the pediatric clinic.
His vital signs are temperature 39.6° C (101.8 ° F); pulse 128 beats/minute; respiration 33 breaths/minute; and blood pressure, 76/40. He weighs 58 lbs. His complete blood count reveals: hemoglobin 9 g/L; hematocrit 24%, white blood cell count 14,000 cells/mm3 and platelet count 14,000 cells/mm3. His oxygen saturation is 89%.
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