ED Pathway for Evaluation and Treatment of Children with Suspected Nephrolithiasis

MD Orders

Laboratory

Intravenous Fluids

For clinical dehydration, ongoing losses
Normal Saline bolus 20 ml/kg

Analgesia

Assess and treat pain (use appropriate pain scores)

Oral
Acetaminophen 15 mg/kg PO (maximum dose 650 mg)
Ibuprofen 10 mg/kg PO (maximum dose 600 mg)
Oxycodone 0.1 - 0.15 mg/kg PO (maximum dose 10 mg)
Intravenous
Ketorolac 0.5 mg/kg (maximum dose 30 mg)
Morphine 0.05 – 0.1 mg/kg IV

Radiology

Use ED Order set for suspected nephrolithiasis