Kidney Stones (Renal Calculi)

Rx: (http://www.pemcincinnati.com/bl…/kidney-stones-04-treatment/ ) For pain: NSAIDs (avoid in kidney disease) then Opiates Antiemetics: If the patient is nauseous and vomiting Fluids: You do NOT need to give fluids if your patient is not dehydrated Ix: (http://www.pemcincinnati.com/blog/kidney-stones-02-labs/ ) Urinalysis: No blood on a urinalysis does NOT rule out a kidney stone. Check creatinine Get the Ultrasound […]

Harmless kidney stone or cancer…your call

Top 10 reasons NOT to order a CT scan for suspected renal colic Cancer risk Patient expectations Imaging begets imaging Generally good prognosis Hydronephrosis is not an emergency Imaging begets urology referrals Wait and see Reframing the question UA + US = done Low dose CT

EM Don’ts

Avoid CT of the head in asymptomatic adult patients in the emergency department with syncope, insignificant trauma and a normal neurological evaluation. Avoid CT pulmonary angiography in emergency department patients with a low-pretest probability of pulmonary embolism and either a negative Pulmonary Embolism Rule-Out Criteria (PERC) or a negative D-dimer. Avoid lumbar spine imaging in […]

Ultrasound Vs. CT Scan for Diagnosing Renal Colic

Emergency medicine physicians should consider ultrasound for suspected nephrolithiasis when appropriate. We could be doing a favor for our patients in reducing radiation exposure, and are not putting the patient at increased risk or harm.