August 17, 2015

Welcome to the August 2015 REBEL Cast, where Swami, Matt, and I are going to tackle a couple of topics. First topic: renal colic. Renal colic is a commonly seen condition encountered in emergency departments and the use of medical expulsive therapy (MET) is commonly recommended by our urology colleagues. Proponents of MET in the treatment of ureteric colic advocate for them due to their potential ability to increase stone passage, reduce pain medication use, and reduce urologic interventions. Second topic: pediatric weights. In pediatric resuscitations many of use the Broselow tape to predict weights for dosing of medications.  With the increasing weights in pediatric patients seen in developed countries around the world, does the commonly used Broselow tape accurately predict weights?   So with that introduction today we are going to specifically tackle:

Topic #1: MET for Renal Colic Topic #2: Use of the Broselow Tape to Estimate Pediatric Weights

August 6, 2015

Back in August 2014, we posted an in depth review on medical expulsion therapy (MET) with tamsulosin in patients with renal colic. The summary of that post was:

“Clearly, there is disagreement in the literature. None of the studies are ideal. We continue to lack a large, RDCT done on patients presenting to the Emergency Department with renal colic.

The best evidence we have DOES NOT show a significant benefit to the use of tamsulosin in renal colic.”

Since that post, two well done RDCTs were published so we thought a brief review of each of these articles and updated recommendations were warranted.

August 7, 2014

Renal colic is a common ED presentation. Rarely does a day go by that we don’t see a patient rocking and rolling in acute renal colic. Dan Firestone makes an impassioned argument against the use of CT scanning for diagnosis of renal colic so I won’t address that here. Once we make a diagnosis, our primary goal in the ED is pain relief. Then we turn our attention to disposition planning, follow up and outpatient medications. The majority (90%) of stones will pass spontaneously but it would be nice if we could:
  1. increase the passage rate
  2. shorten the time to passage.
This could potentially reduce ED revisits, reduce the number of invasive procedures and make happy patients. So does the use of tamsulosin in renal colic facilitate stone passage?

REBEL Review 9: Nephrotic vs Nephritic Syndromes

Created October 30, 2013 | Renal and Genitourinary | DOWNLOAD

REBEL Review 7: Urinalysis Findings

Created October 30, 2013 | Renal and Genitourinary | DOWNLOAD

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