The Hematological Crisis Continuum: An Integrative Review of Multidisciplinary Management for Acute Hemolytic and Thrombotic Emergencies
Abstract
Background: Acute hematological crises, encompassing conditions like sickle cell vaso-occlusive crises (VOCs), thrombotic thrombocytopenic purpura (TTP), and catastrophic antiphospholipid syndrome (CAPS), represent high-stakes emergencies requiring rapid, precise intervention. Traditional siloed care models often fail to address the multifaceted needs of these patients, leading to delays in diagnosis, suboptimal management, and poor outcomes.
Aim: This integrative narrative review aims to examine the coordinated continuum of care from emergency recognition through definitive treatment, analyzing the specific, interdependent roles of emergency medicine, laboratory science, pharmacy, nursing, physical therapy, psychology, health assistants, health management, and health security.
Methods: A comprehensive literature search of PubMed, CINAHL, Web of Science, and PsycINFO databases (2010-2024) was conducted.
Results: Effective management is predicated on a seamless, protocol-driven continuum. Key findings highlight: emergency medicine’s role in rapid triage and initial stabilization; the laboratory’s critical function in providing timely, accurate diagnostics (e.g., ADAMTS13 activity, peripheral smear); pharmacy’s stewardship of high-risk therapies (thrombolytics, anticoagulants, C5 inhibitors); nursing’s holistic monitoring and pain management; and the supportive roles of physical therapy, psychology, and health assistants. Health management ensures resource availability, while health security safeguards the blood product chain.
Conclusion: Optimizing outcomes for hematological crises demands a paradigm shift from episodic, specialist-centric care to an integrated, system-wide continuum. Institutional investment in structured multidisciplinary frameworks, interoperable technology, and cross-specialty education is essential to standardize care, reduce morbidity and mortality, and improve the patient experience during these acute events.
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Authors
Copyright (c) 2024 Fayez Saleem Aldhaferi, Wejdan Ali Alwan Fadhel, Anwar Ali Mohammed Sharawi, Fahd Omar Amer Alsahafi, Mohammed Ali Mohammed Al-Asmari, Salamah Sarih Salamah Alsharari, Trkei Dhifallah Dahiman Alshrari, Abdallah Ayed H Alshrari, Ahmed Aqla Kh Alsharari, Adel Aqla Khalaf Alsharari, Shouq Addad Mufathi Alenzi, Eman Abdullah Alawaji, Saeeda Hanen Sofyani, Salha Saeed Alahmari
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