Pain and Case Management

Emergency Department Vaso-occlusive Crisis Management

The Emergency Department Vaso-occlusive Crisis Management algorithm was adapted from the National Heart, Lung and Blood Institute Expert Panel recommendations for the management of VOC. A task force led by Paula Tanabe, PhD, RN, FAEN, FAAN, was formed to develop the algorithm. Task force members included representatives from the North Carolina College of Emergency Physicians (David Dubow, MD, Brian Burrows, MD), the North Carolina Emergency Nurses Association (James Gibbs, RN) and Community Care North Carolina (Mike Lancaster, MD, Amelia Mahan, MSW, LCSW, and Theo Pikoulas PharmD, BCPP). In February, 2015, the NCENA formally endorsed the algorithm as best practice for ED’s in the State of North Carolina. 

These recommendations are meant to provide EDs with an evidence based approach to best practice for patients experiencing and seeking treatment of a VOC in an ED setting. Recommendations for acute pain management, as well as recommendations for disposition, discharge, opioid prescribing and referrals are made. For further information contact: Paula Tanabe at

ED SCD Case Management Referral Form

The ED SCD Case Management Referral Form is designed for use in emergency departments. Social workers, case managers, physicians or nurses in North Carolina, can complete the brief screening form and FAX it to the # provided at Community Care North Carolina (CCNC). CCNC is North Carolina’s Medicaid managed care approach. The form will be faxed to the Central Call Center who will identify the patients’ individual case manager and contact them to ensure the individual is connected with their individual case manager and primary care provider, as well as assist with other unmet needs. They can assist with obtaining insurance, prescription questions, and making other referrals as needed. This is a unique program for emergency departments with the goal of linking patients to the services they need.