In suspected sickle cell crisis, which action is most appropriate?

• A. Transport without intervention
• B. Administer oxygen
• C. Administer epinephrine
• D. Give only IV fluids

Answer: (B)

Suspect sickle cell crisis because deoxygenated HbS causes the red cells to sickle and obstruct blood flow, leading to tissue hypoxia and pain. Providing supplemental oxygen raises the oxygen saturation of hemoglobin, which reduces HbS polymerization and helps restore microvascular perfusion. This directly addresses the factor driving the crisis—hypoxia—and can lessen ongoing ischemia and pain. Other measures like fluids or analgesia remain important, but oxygen is the immediate step that prevents more sickling. Epinephrine has no role in this scenario, and transporting without addressing hypoxia could allow the crisis to worsen.