Care of acute renal colic: A survey of emergency medicine physicians

Justin B. Ziemba, Matthew E. Sterling, Phillip Mucksavage

Research output: Contribution to journalArticle

Abstract

Introduction: To determine the contemporary practice patterns of academic emergency department (ED) providers in the United States for an episode of acute renal colic. Materials and methods: A 30-question survey was developed to assess ED providers' clinical decision making for an index patient with acute renal colic. The survey population was all attending and reesident physicians affiliated with an American emergency medicine residency program with an institutional profile available on the Society for Academic Emergency Medicine (156 programs; 95% of programs in the United States). The survey was conducted in October 2014. A response rate of 8.1% (289/3563) was achieved, which represented 29% (46/156) of the programs. Results: Only 17% (53/289) of respondents were aware of the American Urological Association (AUA) guidelines on the management and imaging of ureteral calculi. A clinical care pathway was uncommon amongst institutions (6/46; 13%), but desired by providers (193/289; 67%). A low dose non-contrast computed tomography (CT) would be the most preferred initial diagnostic imaging modality (139/289; 48%). Initial imaging choice was not influenced by respondent role, program, census region, practice environment, ED size, ED volume, presence of a clinical care pathway, or knowledge of the AUA guidelines (all p > 0.05). Conclusions: In this cross-sectional survey of academic emergency medicine providers, we demonstrated a lack of awareness of quality initiatives and uncommon use of clinical care pathways. We observed that diagnostic imaging modalities with reduced radiation were commonly preferred, and that imaging preference was not associated with several demographic or institutional characteristics.

Original languageEnglish (US)
Pages (from-to)8368-8374
Number of pages7
JournalCanadian Journal of Urology
Volume23
Issue number4
StatePublished - 2016

Keywords

  • Emergency care
  • Health care surveys
  • Nephrolithiasis
  • Physician's practice patterns
  • Renal colic

ASJC Scopus subject areas

  • Medicine(all)
  • Urology

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  • Cite this

    Ziemba, J. B., Sterling, M. E., & Mucksavage, P. (2016). Care of acute renal colic: A survey of emergency medicine physicians. Canadian Journal of Urology, 23(4), 8368-8374.