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    Diagnosing and imaging renal calculi: what can be done in the pre-hospital environment?

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    Author
    McPherson, Melinda (Dolly)
    Keyword
    Emergency Medical Services
    X-ray Computed Tomography (CT)
    Kidney Stones
    Renal
    STONE Score
    Journal title
    Journal of Paramedic Practice
    
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    URI
    http://hdl.handle.net/20.500.12417/391
    DOI
    10.12968/jpar.2016.8.2.80
    Abstract
    Abstract published with permission. Renal colic is a common pre-hospital presentation that is often conveyed to hospital due to diagnostic uncertainty. The use of the STONE score and a greater understanding of computerised tomography (CT) requirement in the diagnostic process can aid the pre-hospital clinician in making an informed decision about the management of these patients. Case: A 48-year-old female presenting with symptoms of renal colic who was assessed, managed and treated at home. Methods: A literature search was carried out on Medline, Cinahl, BNI and Embase. In addition, searches of the NHS evidence database (www.evidence.nhs.uk) and the Cochrane Database of Systematic Reviews (www.cochrane.org) were completed. Results: The search yielded 536 results, each of which were browsed for relevance, duplicates removed and their references reviewed. 16 articles were relevant to the use of CT to diagnose renal calculi and four addressed the derivation and validation of the STONE score. These were critically reviewed and conclusions drawn about their applicability to the pre-hospital environment. Conclusions: The STONE score, when combined with clinical judgement and if applied to the right patient group, is an appropriate clinical decision tool to identify uncomplicated renal calculi. CT imaging of this low-risk patient group is not required to confirm diagnosis; however, delayed CT scanning is required to form a management plan.
    ae974a485f413a2113503eed53cd6c53
    10.12968/jpar.2016.8.2.80
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    Publications - South Central Ambulance Service

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