EP372 - Initial assessment and management of patients presenting with renal colic

Abstract Aims Abdominal colic secondary to nephrolithiasis is a common presentation to the A & E. Aim of our study is to evaluate the assessment and management of these patients in the first 24 hours of presentation and compare it to standards. Methods Patients admitted to a single surgical unit in a tertiary care hospital with renal or ureteric colic were included in the study. British association of urological surgeon’s guidelines were used as standard. Guidelines were as follows,NSAIDs for analgesia.CT KUB should be performed within 14 hours of admission.Urine dipstick, culture, serum creatinine, electrolyte, calcium, urate, FBC, CRP, clotting screen if per cutaneous intervention is planned. Blood culture if patient is pyrexial or has signs of SIRS. Results Out of 41 patients, 10 (24.3%) were given NSAIDS for pain relief, 16 (39 %) had CT KUB in 14 hours of admission, while 24 (58.5%) had ultrasound abdomen as the first investigation. All patients had FBC, urea, electrolytes, creatinine, urine routine and culture sent. Serum Calcium was sent for only 9 (21.9%) patients. CRP was sent for 8 (19.5%) patients. Out of 4 pyrexial patients, blood culture was sent for 2(50%) patients. Conclusion NSAIDs unless contraindicated, should be used for management of pain instead of antispasmodics. Serum calcium should be sent for all patients with renal colic. Pyrexial patients with urolithiasis should have blood cultures performed. CR KUB plain should be done for all patients of urolithiasis unless a clear contraindication like pregnancy, young age exists. Reference- https://www.baus.org.uk/professionals/baus_business/publications/133/guidelines_for_the_management_of_acute_ureteric_colic/