ED Pathway for Evaluation and Treatment
of Children with Suspected Nephrolithiasis
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
Low dose, Unenhanced CT Stone Protocol
Pain Control and Hydration
YES
Positive for Nephrolithiasis?
NO
YES
NO
Urology Consult
Admission Criteria
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