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Annual IASCNAPA Workshop Reveals the Hard Truth
by Bill Schultz, MHS, PA-C
Washington, D.C. – Before a standing room only crowd, Craigie D. Sanders, Esq. and Dr. Zora Rogers
presented a comprehensive review of priapism in males with sickle cell disease (SDC).
The presentations laid the background for IASCNAPA’s annual Nursing Care in Sickle Cell Disease
workshop, which was held in this city on September 18 at the Washington Hilton and Towers. This was
the latest is a series of workshops conducted over the past 7 years designed to work toward developing
practice guidelines for management and therapies of SCD complications.
Craigie Sanders discusses the issue with an IASCNAPA member
The workshop’s two featured speakers were invited by the IASCNAPA Board of Directors to address members
and guests prior to the drafting of consensus practice guidelines for priapism.
Mr. Sanders, a land use attorney from Durham, NC, presented a compelling story of his experience
as a patient with SCD and priapism. His talk, entitled “Priapism: The HARD Truth”, detailed his
struggle with the complication, providing a heart wrenching glimpse at its psychological impact.
His opening remarks warned participants that his discussion would be frank but factual.
His slide presentation began with a quote from Plato, “Be kind, for everyone is fighting a
hard battle.” He described his own battle, which he said has caused embarrassment, but much more
pain than embarrassment. He said the battle has also involved accusatory health care providers
that have insinuated the problem was a sexual event. He skillfully and tastefully described his
worst episode,
which lasted almost 4 days and left him very traumatized.
Sanders had a five point take home message about what he thought nurses needed to know about
priapism from the patient’s perspective. 1) Define priapism as a non-sexual event, 2) Be part of the
patient’s support network, 3) Educate others in the support network on steps to help patients avoid
priapism and actions to take if priapism occurs, 4) Educate other health care providers
about priapism, and 5) “Be kind…”, referring to Plato’s quote.
Dr. Zora Rogers and IASCNAPA member Debbie Boger, RN, PNP,
both at Children’s Medical Center Dallas
Dr. Rogers followed Sanders at the podium. She is an attending Pediatric Hematologist at the
Children’s Medical Center Dallas at the Southwestern Comprehensive Sickle Cell Center, UT Southwestern
Medical Center in Dallas, Texas. She is a recognized authority on sickle-related priapism and is
the lead investigator in the NIH-NHLBI Comprehensive Sickle Cell Centers study of the
epidemiology of priapism involving over 1600 American SCD patients.
Rogers walked the audience of nurses, nurse practitioners, physician assistants, and
physicians through the pathophysiology of priapism in SCD, which was first described by Dr.
Lemuel Diggs in 1934. Dr. Rodger’s overview included the prevalence,
acute interventions, natural history, and secondary prevention of priapism.
Dr. Rogers concluded that priapism is a common complication of SCD, frequently occurring
without relation to puberty. She thought the Clinical Trials Consortium of the NIH-NHLBI
sponsored Comprehensive Sickle Cell Centers Program would verify the epidemiology of the problem.
She said that aspiration and irrigation with dilute adrenergic agents is effective in terminating prolonged episodes of priapism. She thought that the currently available secondary prevention strategies, such as oral adrenergic agents, require investigation in randomized controlled trials. Lastly, she indicated that new approaches to identify patients
at risk and secondary prevention of recurrent episodes are urgently needed.
IASCNAPA Secretary Allison Sakara, CRNP, MSN, PNP
records workshop proceedings
Following the presentations and a refreshment break, workshop participants reconvened to hammer
out the first draft of the priapism practice guidelines. IASCNAPA Board member,
Janice Beatty, RN, BSN, facilitated this interactive session while Allison Sakara, RN projected
in real time a record of the proceedings.
At the conclusion of the workshop a consensus draft was
finalized. With further refinement,
the practice guidelines will be posted on the IASCNAPA website.
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