Use the appropriate order set for all "Code" patients!
Physical Exam Findings
1. Most common presenting complaint = abdominal pain; then leg/hip pain; back pain
2. Can have femoral neuropathy, iliopsoas spasm
Zone I - concern for vascular injury - likely OR
Zone II & III - ?pulsatile, ?expanding - determines intervention
Packing vs arterial embolization - majority of traumatic RPH are venous in nature
- RPH is a rare diagnosis with significant mortality - see keep on your differential!
- Undress your adult patients too - look for Fox's sign, etc
- Most common presenting symptom: abdominal pain, then leg or back pain
- Seen more commonly in elderly and those on anticoagulation, but 1/3 of pts who presented with spontaneous RPH were not on anticoagulation
We all know that Flank Pain and Hematuria = Kidney Stone. Right?
First Time Flank Pain
10-30% of patients, when CT scan obtained, had an alternative diagnosis (even with good pre-test probability for kidney stone)
Repeat Renal Stones
-Focal neurologic deficit
-History of spinal instrumentation
-Duration longer than 6 weeks