#EMConf: Kidney Stones
Thu, 02/28/2019 - 7:10am
Who gets CT?
- Avoid ordering CT of the abdomen and pelvis in young otherwise healthy emergency department (ED) patients (age <50) with known histories of kidney stones presenting with symptoms consistent with uncomplicated renal colic.
- If you do a CT in an older person (>50), you’ll find another source of the pain ~30% of the time
Who gets BMP?
- Single kidney + Concern for infection; Even if obstruction, other kidney can compensate
Who gets admitted?
- Stone + Infection
- One Kidney/ Transplant
- Intractable symptoms
- Stone > 10 mm; Urology guidelines recommend admission.
- Strainer for collection and to see if stone passed
- urology follow up + NSAIDS + return precautions
- +/- Flomax: ?benefit for > 6 mm but beware of dizziness and orthostatic hypotension
Will I get another stone?
- 75% will get another in 20 years: 40% will get repeat in 1 year
Iced Tea caused my stones?
- Iced tea does not cause kidney stones, this is a misconception in general public
- Lifestyle modification: control sugar + lose weight + reduce sodium.