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Renal Colic


This pathway is ideal for the patient with nausea, vomiting and diagnosed kidney stone



Inclusion Criteria

  • Diagnosis of renal colic established by helical CT, IVP or ultrasound
  • Uncomplicated stone
  • Persistent pain or vomiting despite medication
  • Acceptable VS
  • Urology resident notified

Exclusion Criteria

  • Unstable VS
  • Clinical evidence of a UTI (fever, significant pyuria on a cath specimen)
  • Solitary kidney
  • Relative large proximal stone (>6 mm) with high grade obstruction
  • Acute renal failure

Potential Interventions

  • IV Hydration
  • As needed - IV narcotics, IV ketolorac, IV antiemetics
  • Diagnostic tests as needed - Delayed IVP films, ultrasound, CT
  • Serial exams and vital signs
  • Strain urine for stone capture and analysis, U/A if not yet done
  • Urology consultation as needed.

Discharge Criteria

Home

    • Acceptable VS
    • Pain and nausea resolved or controlled
    • Passage of stone

Admit

    • Persistent vomiting or uncontrolled pain after 14 hours
    • Diagnosis of coexistent infection or significant abnormality
    • Change in diagnosis requiring further therapy or workup

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