Page 236 - ATP-P 11th Ed

FLANK PAIN PROTOCOL
(INCLUDES RENAL COLIC, PYELONEPHRITIS, KIDNEY STONES)

SPECIAL CONSIDERATIONS
1. May proceed to life-threatening systemic infection.
2. May be associated with testicular torsion. Ensure normal external GU exam first.

SECTION 2 Signs and Symptoms
1. Urinary Tract Infection
a. Dysuria
b. Polyuria
2. Back pain
3. Flank pain
4. Nausea/vomiting
5. Costovertebral angle tenderness
6. Fever
7. Hematuria
Management
1. Treat per Pain Management Protocol.
2. Treat per Nausea and Vomiting Protocol.
3. Treat per Dehydration Protocol.
4. If fever present:
®
a. Moxifloxacin (Avelox ) 400mg PO daily OR amoxicillin/clavulanic acid
®
(Augmentin ) 875mg PO bid
®
®
b. Ceftriaxone (Rocephin ) 1g bid IV/IM OR ertapenem (Invanz ) 1g IV/IM if
unable to tolerate PO or unresponsive to oral treatment.
Disposition
1. Priority evacuation for persistent flank pain and/or fever.

226 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 227