Page 281 - ATP-P 11th Ed

ii. For torsion of the right testicle, the procedure is similar except that the testicle
is held using the left thumb and forefinger and the testicle is rotated in a coun-
terclockwise direction.
b. If pain increases, 1 attempt to rotate the opposite direction should be made.
c. Successful detorsion will result in relief of pain.
2. Gradual onset of pain with a normal lying testicle should be treated per Urinary Tract
Infection Protocol.
3. Treat per Pain Management Protocol.
4. Treat per Nausea and Vomiting Protocol.
5. If torsion is not present, treat as presumed STD.
®
a. Ceftraxone (Rocephin ) 250mg IM OR ciprofloxacin (Cipro ) 500mg PO SECTION 2
®
®
b. PLUS azithromycin (Zithromax ) single 1g dose PO
Disposition
1. Urgent evacuation for testicular torsion even if manually relieved with detorsion.
2. For other causes of testicular pain, treat cause and consider evacuation if symp-
toms persist more than 3 days, and if the patient is operationally compromised.

270 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 271