Nephrolitiasis algo v1

  • Suspected Nephrolithiasis
    • Consider common symptoms and risk factors. Examination may be non-specific.
      • Initial Assessment
        • Checks
          • Assess VS (fever, tachycardia, HTN)
          • Assess pain, provide appropriate analgesia Consider narcotic or ketorolac
          • Assess hydration, provide fluids as needed Consider NPO status
        • Laboratory Testing
          • Ultrasound
            • Stone Identified
              • Consult Urology? (See Criteria notes on p 2)
                • Yes
                  • Urology Consult
                    • Admit
                    • Discharge (See Discharge notes on p 2)
                • No
                  • Discharge? (See Criteria on p 2)
                    • Yes
                      • Discharge (See Discharge notes on p 2)
                    • No
                      • Admit
            • No Stone Identified but secondary signs
              • Is CT necessary? (See Imaging notes on p 2)
                • No
                  • Consult Urology? (See Criteria notes on p 2)
                    • Yes
                      • Urology Consult
                        • Admit
                        • Discharge (See Discharge notes on p 2)
                    • No
                      • Discharge? (See Criteria on p 2)
                        • Yes
                          • Discharge (See Discharge notes on p 2)
                        • No
                          • Admit
                • Yes
                  • Order CT low-dose, unenhanced
                    • Positive Result
                      • Consult Urology? (See Criteria notes on p 2)
                        • Yes
                          • Urology Consult
                            • Admit
                            • Discharge (See Discharge notes on p 2)
                        • No
                          • Discharge? (See Criteria on p 2)
                            • Yes
                              • Discharge (See Discharge notes on p 2)
                            • No
                              • Admit
                    • Negative result
                      • Re-evaluate clinically for alternative diagnosis
                        • Off algorithm
            • Negative or Inconclusive but hihg suspicion
              • Is CT necessary? (See Imaging notes on p 2)
                • No
                • Yes
            • negative or Inconclusive and low suspicion
              • Re-evaluate clinically for alternative diagnosis
                • Off algorithm

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