ED Pathway for Child with Acute Non-Traumatic Scrotal Pain
IMMEDIATE UROLOGY CONSULT
- Call urology and ultrasound simultaneously (the viability of the testis
decreases significantly when torsion exists for 6 or more hours)
- If Urology will be delayed (e.g. they are out of hospital), then obtain
ultrasound. Otherwise, these patients should be seen ASAP by Urology.
- Residents can order ultrasound without conferring with ED fellow/attending
- Ultrasound techs should make these patients a priority
- IV access: 20 cc/kg normal saline bolus (don’t delay US for IV placement)
- Pain control: IV morphine 0.1 mg/kg (don’t delay US for IV placement)
- Consider ondansetron (Zofran) if vomiting
- UA/urine culture
- Do not manually detorse!