Part 1: You are working in the Red Blood Cell Disorders Clinic at McMaster. You are asked see Mr. JM by your preceptor for routine follow up. Mr. JM is a 26 year old male and was diagnosed with sickle cell disease as a child while living in Jamaica. Part 2: It is a few months later and you are now on a rotation working in the emergency department. You see Mr. JM’s name on the tracker and remember seeing him in the RBC Disorders Clinic. You pull the triage assessment and read Mr. JM is presenting with a 2-day history of pain in his arms and back unresponsive to oral hydromorphone at home. Vitals in triage reveal HR 110, BP 110/65, T 36°C, RR 16, SpO2 99% on room air.