Trauma Guideline Manual - SUNY Upstate Medical University

Trauma Guideline Manual______________SUNY Upstate Trauma Center119PRACTICE GUIDELINES: EVALUATION OF HEMATURIAOBJECTIVE:Provide guidelines for the diagnosis and management of the trauma patient with hematuria.DEFINITIONS:Gross hematuria: Blood in the urine that can be seen as a change in the urine color.Microhematuria: Urine that appears normal but has tested positive for blood by either a dipsticktechnique or by microscopic examination.GUIDELINES:1. Treat the patient according to ATLS guidelines.2. Determine the presence of blood by either inserting a Foley catheter or having the patientvoid spontaneously.3. If the urine has visible cells or is red or pink, then gross hematuria is present (usually >50RBC/HPF).4. If the urine appears normal but is “dipstick positive” for blood (1+ or greater) and has RBC’son microscopic exam (usually 50 RBC/HPF, then obtain an abdominal CT scan.6. For penetrating trauma:a. If patient is unstable, go to OR for laparotomy. Obtain intraoperative IVP if necessary.This will demonstrate presence of bilateral kidneys.b. If patient is stable and has gross or microhematuria, obtain a “one-shot IVP.”