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 (>12 y/o or 40kg): 4mg slow IVP. (Consider diluting in 10-20cc to aid in administering slowly) or 4mg/2ml deep IM in a large muscle.
  • Pediatric (<40 kg): 0.1mg/kg slow IVP (max of 4mg)
• 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.