Renal colic

Question 1

Airway, Breathing, Circulation

Answer 1

Breathing: Look,listen,feel, RR, O2, ABG, XCR

Circulation: Look, listen feel, HR, BP, ecg, cannula

• acute abdomen bloods (FBC, UEs, LFTs, CRP, calcium, amylase, glucose, blood cultures)
• surgical bloods: G&S, clotting

Question 2

D&E

Answer 2

abdo exam
urine dipstick (haematuria)
catheter
calves

Investigations:
* Non contrast CT / USS

Question 3

Management of suspected renal stone

Answer 3

Acute abdomen protocol plus:
1. IV fluids 500-1000ml NaCl
2. diclofenac 75mg IV/ IM or 100 mg PR
3. Antibiotics: pipperacillin / tazobactam

Stone < 5mm: pass spontaneously, increase fluid intake

Stone > 5mm:
1. Medical explolsive therapy: a blockers (tamsulsine 0.4 mg OD) or nifedipine 10mg / 8 hours PO
2. extracorporeal shock wave lithotripsy ESWK
3. ureteroscopy
4. Percutaneous nephrolithotomy (keyhole surgery when large stone)