Overall, the “Guidelines on Urological Trauma” from the European Association of Urology offer a nice review and interpretation of the current literature. The key take-home points are:
Explore This IssueACEP Now: Vol 34 – No 11 – November 2015
- Suspect renal injury in the presence of blunt trauma or evidence of injury near the patient’s flank along with gross or microscopic hematuria.
- CT is recommended as the initial imaging modality if kidney injury is suspected.
An initial creatinine elevation is more likely to represent preexisting renal function impairment rather than indicate acute kidney injury caused by the accident.
Dr. Pierce is a new attending at St. Thomas Rutherford Hospital in Murfreesboro, Tennessee. He wrote this article as the 2014–2015 EMRA representative to the ACEP Clinical Policies Committee while finishing residency at the University of Virginia.
- Summerton DJ, Djakovic N, Kitrey N, et al. Guidelines on urological trauma. European Association of Urology; Arnhem, The Netherlands: 2014. Accessed Aug. 5, 2015.