ED Pathway for Evaluation and Treatment
of Children with Suspected Nephrolithiasis
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Stone Visible on US
US Positive for Secondary Signs only
and
No Stone Visible
OR
US Negative / Inconclusive
and
High Clinical Suspicion
US Negative / Inconclusive
and
Low Clinical Suspicion
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Low dose, Unenhanced CT Stone Protocol
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Pain Control and Hydration
YES
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Positive for Nephrolithiasis?
NO
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YES
NO
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Urology Consult
Admission Criteria
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Inpatient
  • Concern for infection: fever, UTI, sepsis
  • Solitary Kidney
  • Bilateral renal obstruction
  • Renal insufficiency
  • Kidney transplant
  • Complex medical history
EDECU
EDECU admission criteria: Uncomplicated nephrolithiasis requiring IV pain control/hydration
Posted: October 2009
Revised: October 2011, April 2018
Authors: M. Zonfrillo, MD, J. Lavelle, MD, J. Piro, RN, S. Kim, MD, K. Darge, MD
References