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Nephrolithiasis, Suspected — Discharge with Outpatient Follow-up — Clinical Pathway: Emergency

Nephrolithiasis Clinical Pathway — Emergency Department

Discharge with Urology Follow-up in 3-4 Weeks

  • Send child home with a urine strainer and instructions and provide prescription for tamsulosin
    • For age < 4 years: tamsulosin 0.2 mg/day
    • For age > 4 years: tamsulosin 0.4 mg/day
  • Children should take pills for 4 weeks or until stone is passed
  • SE: Orthostatic hypotension, dizziness
  • Helps the ureter relax and stones pass
  • Review importance of hydration
  • Treat pain, provide prescriptions for:
    • Ibuprofen 10 mg/kg PO every 6 hours (maximum dose 600 mg)
    • Oxycodone 0.1-0.15 mg/kg PO (maximum dose 5 mg) every 4 hours for 3 days
  • Urology within 3-4 weeks with a follow-up RBUS
    • Complete web-based CHOP Referral Form
    • Family may call the following business day for an appointment

 

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