1033 Renal Colic Emergency Management - an Audit Cycle

Aim

This audit aims to assess whether the management of renal colic diagnosed in an emergency department setting is adhering to the current recommendations by the British Association of Urological Surgeons and National Institute for Health and Care Excellence.

Method

Two audit cycles were completed. Patients were retrospectively identified using the online clerking system in use by the emergency department. Patients were excluded if returning to hospital in the last 3 months, if the patient had a complex urological history, or if the CT scan was negative. Outcomes assessed were CT imaging within 14 hours of assessment, inpatient referral criteria being met, and NSAIDs being prescribed. Interventions included updated NSAID dosing and an updated renal colic pathway for the health board.

Results

The first cycle conducted identified 15 patients post exclusion, 9 were excluded. 87% of patients had NSAIDs prescribed, 93% of patients had a CT within 14 hours of assessment, 100% of patients meeting referral criteria were referred, 67% of patients meeting no referral criteria were referred.

The second cycle identified 6 patients post exclusion, 10 were excluded. 50% of patients had NSAIDs prescribed, 100% of patients had a CT within 14 hours of assessment, 50% of patients meeting no referral criteria were referred.

Conclusions

This audit despite the low patient numbers highlighted a need to update the renal colic pathway for emergency clinicians in keeping with national guidance. In addition, for future audits it has shown a better identifier for renal colic would be all patients receiving CT kidneys, ureters, and bladder.