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
Last Revised: October 2024
Authors: M. Zonfrillo, MD; J. Lavelle, MD; J. Piro, RN; S. Kim, MD; K. Darge, MD; S. Back, MD; G. Tasian, MD