The approach of emergency physicians to patients with acute renal colic

Abstract

Objective: This study was conducted to describe the current diagnosis and treatment strategies of patients admitted to the emergency department and diagnosed with acute renal colic.
Material and Methods: In this study, an internet-based cross-sectional survey was administered to emergency medicine physicians. In addition to the participants’ demographic data, such as age and gender, years of experience in the emergency medicine department, and whether they were a specialist or resident, the survey also inquired about their choices of imaging methods, laboratory tests, analgesic medications, and intravenous fluids, and tendency to refer patients to a urologist for a consultation.
Results: The median age of the 108 volunteers participating in the study was calculated as 31 (27 - 34.8) years and their years of experience as 4 (2-8) years. More than half (60.2%, n=65) of the participants were emergency medicine residents, while the remaining 39.8% (n=43) were emergency medicine specialists. The emergency medicine specialists and residents were compared in terms of the variables related to their approaches to patients presenting to the emergency department with a preliminary diagnosis of renal colic. The first choice of analgesic drugs was dichotomised as diclofenac and other non-steroidal anti-inflammatory drugs, with 34 (79.1%) of the specialists and 60 (92.3%) of the residents reporting diclofenac as their first choice, and there was a statistically significant difference between the two groups.
Conclusion: In this study, the emergency medicine residents preferred diclofenac more than the emergency medicine specialists in primary care, although they had similar renal colic imaging methods preferences.

Keywords

• acute renal colic
• emergency department
• kidney stone

Acil servis doktorlarının akut renal kolikli hastaya yaklaşımı

Abstract

Amaç: Çalışmamızda acil servise başvuran ve akut renal kolik tanısı alan hastalarda acil tıp uzmanı ve asistanların tanı ve tedavi stratejilerini belirlemeyi amaçladık.
Gereç ve Yöntemler: Bu çalışmada acil tıp doktorlarına internet tabanlı kesitsel bir anket yapıldı. Ankette katılımcılara ait demografik verileri, acil serviste çalışma süreleri ve acil tıp uzmanı veya asistanı oldukları soruldu. Katılımcılara acil servise başvuran akut renal kolik hastalarında ilk tercih görüntüleme yöntemleri, tetkikler, hangi durumlarda üroloji konsültasyonu istedikleri, analjezik ve tedavi tercihleri soruldu.
Bulgular: Çalışmaya katılan 108 gönüllünün yaş ortancası 31 (27 – 34,8) yıl olarak hesaplandı. Katılımcıların %60,2’i (n=65) acil tıp asistanı, %39,8’i (n=43) acil tıp uzmanı olan çalışma grubunun acil serviste çalıştığı sürenin yıl cinsinden ortancası 4 (2-8) yıl olarak hesaplandı. Acil tıp uzmanı ve asistanlarının renal kolik ön tanısı ile acil servise başvuran hastalardaki yaklaşımları ile ilgili değişkenler açısından farkları incelendi. Non-steroidal antienflamatuvar ilaç (NSAID) verilmesi planlanan hastalarda seçilecek ilk ilaç, diklofenak ve diğer NSAID olarak dikotomize edildiğinde, uzmanların 34 (%79,1)’nün, asistanların ise 60 (%92,3)’ının ilk tercih olarak diklofenak seçtiği görülmüş ve gruplar arasında istatistiksel anlamlı fark saptandı.
Sonuç: Çalışmamızda acil tıp uzmanı ve asistanı arasında renal kolik görüntüleme yöntemi açısından benzer tercihler yapmasına rağmen birinci basamak tedavide acil tıp asistanları, acil tıp uzmanlarına kıyasla daha çok Diklofenak’ı tercih etmiştir.

Keywords

• akut renal kolik
• acil servis
• böbrek taşı

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