ED - Acute renal colic and suspected ureterolithiasis
Last Updated: 5/25/2016 12:28:08 PM
Order Set
  Associated Pathway(s)
 Acute renal colic and ureterolithiasis - kidney stones (1 - 65 years) - http://www.curbsideup.com/link/2151
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  Inclusion Criteria
Inclusion Criteria ( Any one criteria present )
  • Clinical concern for ureterolithiasis
Exclusion Criteria
  • Complex urological surgical history (simple stents ok in adults)
  • History of complex ureterolithiasis
  Symptomatic treatment
  Does the patient have severe pain (pain score >5)?
Yes
Morphine IV
0.05 mg/kg IV, Once, Max 4 mg
  Does patient have any contraindications to ondansteron?
      Allergy or hypersensitivity, long QT disorders
No
Ondansteron IV
0.15 mg/kg IV, EVERY 8 HOURS, PRN, nausea, vomiting, Max 8 mg
  IV fluids
NS bolus
20 mL/kg, IV, Once, Max 1,000 mL
  Does the patient had any contraindications to ketorolac?
      Pregnancy, Allergy or hypersensitivity, G6PD, renal impairment, severe hypovolemia, bleeding or coagulation disorder, gastritis or PUD, long bone fracture
No
Ketorolac IV
0.5 mg/kg, IV, Once, (max: 15 mg)
  LABORATORY
  Labs
CBC with Differential
Lab, One time
Basic metabolic panel
Lab, One time
Urinalysis With Microscopic
Lab, One time
Urine culture
Lab, One time
  Reproductive age female?
Yes
Urine pregnancy
Lab, One time
  Greater or equal to 18 years and NOT pregnant
  Are any of the following present?
      Fever or signs of sepsis, Elevated Creatinine (> 1.8), Elevated WBC (> 16)
Yes
CT abdomen/pelvis stone protocol
Indication: concern for ureterolithiasis
No
Renal ultrasound
Indication: concern for ureterolithiasis
  Less than 18 years OR pregnant
  Radiology imaging
Renal ultrasound
Indication: concern for ureterolithiasis
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