Renal colic

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1. Treatment

    1. Pain control: the most important part

        1. Supp diclofenac 100 mg rectal

        2. amp ketorolac 30mg IV (up to 60mg IV, up to 90mg IM)

        3. amp hyoscine 10 mg IV or IM

        4. for severe pain

            1. Amp pethidine 25-50mg IM

                1. or Amp MS 4mg IM

                    1. repeat every 10-15 mins up to 2-3 times

                2. or Amp aminophylline 250mg + 200cc DW5% infusion in 20 mins

                3. or Visceral nerve block with Intradermal Tap water injection over pain site 0.5-1cc

    2. check

        1. CBC, K, Na, BUN, Cr, U/A

        2. Sonography

    3. If stone seen in sono:

        1. ≤5mm ⇒ easily passed

        2. >5mm ⇒ less likely to pass

    4. Herbals for stone passage:

        1. Drop Sankol #1 30cc tds

            1. or Tab Cystone #60 tds

            2. or Tab Lithorex. B #60 tds

    5. Refer to urologist with

        1. Tab ibuprofen 400mg #30 PRN

            1. or supp indomethacin #10 PRN

2. do not discharge if

    1. Obstruction

    2. Febrile