Suspected Kidney Stone
Section 5 -MEDICAL
5.18 SUSPECTED KIDNEY STONE
INITIAL MEDICAL CARE (2.01) - Provide OXYGEN or assist ventilations as appropriate for patient condition. Use vomiting precautions.
- If age >50, consider Abdominal Aortic Aneurysm etiology
- If hypotension / shock are present, refer to SHOCK PRACTICE PARAMETER (5.13).
- For patients with severe vomiting, obtain detailed history, and then administer ZOFRAN (ONDANSETRON HYDROCHLORIDE):
- Adult: 4mg slow IVP. (Consider diluting in 10-20cc to aid in administering slowly) or 4mg/2ml deep IM in a large muscle.
- Pediatric : Refer to Handtevy System
- Obtain detailed history as to hydration status:
- Dry mucous membranes, tongue
- Sunken eyes
- Urine output
- Multiple episodes of vomiting or diarrhea
If PROPERLY hydrated and no suspected dehydration, consider administration of: TORADOL (KETOLORAC) 30mg slow IVP
For Pain Management: Refer to ANALGESIA/SEDATION PRACTICE PARAMETERS (2.04) MORPHINE 2-20 mg (IV,IO, IN, IM), titrated to effect
If patient presents with:
- Possible dehydration
- History of renal impairment
- Current renal impairment
Fluid Bolus, 200-300cc NS followed by TORADOL (KETOROLAC) 15mg slow IVP. Administer nothing by mouth.