Page 118 - PJ MED OPS Handbook 8th Ed

Flank Pain (Includes Renal Colic, Pyelonephritis, and 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.

Signs and Symptoms:
1. Urinary Tract Infection
a. Dysuria – painful urination
b. Polyuria – large volume of urine
c. Increased frequency of urination
d. Change in urine color or odor
2. Back pain
3. Flank pain
4. Nausea/vomiting
5. Costo-vertebral angle (CVA) tenderness
6. Fever
7. Hematuria

Management:
1. Treat dehydration, pain, nausea/vomiting as indicated.
2. If fever present:
a. Moxifloxacin (Avelox) 400mg PO daily
b. 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.

116 n Pararescue Medical Operations Handbook / 8th Edition