Emergency Department Clinical Pathway for Evaluation/ Treatment of Children with Suspected Nephrolithiasis

  • Related Order Set
  • ED Urolithiasis
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
Urology Consult
YES
Ureteral
Stone?
YES
NO
Outpatient
Referral
to Urology
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, July 2020
Authors: M. Zonfrillo, MD; J. Lavelle, MD; J. Piro, RN; S. Kim, MD; K. Darge, MD; S. Back, MD; G. Tasian, MD