Your patient is a 26-year-old African-American male who is alert but in severe distress, complaining of pain in his hands and feet, as well as abdominal pain. The pain began this morning but has progressed from an initial rating of 5/10 to a 9/10 at the present time. The patient has a history of sickle cell anemia and denies any trauma. Physical examination reveals cool, diaphoretic skin; pain with palpation to all 4 abdominal quadrants; splenomegaly; and a priapism. HR = 132, BP = 140/90, RR = 16. Select the most appropriate acute diagnosis and treatment for this patient.
A) Sickle cell occlusive crisis. Administer oxygen by nonrebreathing mask, isotonic crystalloids, and morphine.
B) Sickle cell disease. Administer oxygen according to pulse oximetry readings, start an IV of normal saline, and administer kertorolac for pain.
C) Sickle cell trait. Administer oxygen according to pulse oximetry readings, and give a 500 mL bolus of isotonic crystalloid solution.
D) Sickle cell disease. Administer morphine for pain.