Approach to the Critical Patient

Immediate stabilization

High risk presentation

Initial monitoring

Access and resuscitation

Time critical causes and triggers

Cannot miss etiologies

Escalation triggers

Key concepts

Framework

History

Presenting features

Symptom characterization

Timing and exposures

Risk factors and comorbidities

Malignancy risk

Bleeding risk

Renal disease risk

Infection and stone risk

Physical Exam

General and hemodynamics

Stability assessment

Bleeding burden clues

Abdominal and genitourinary exam

Abdominal findings

External genital exam

Pelvic exam when indicated

PITFALLS

Common pitfalls

Differential Diagnosis

Life threatening and high consequence

Immediate threats

Common etiologies by pattern

Painful hematuria

Painless hematuria

Glomerular pattern

Mimics and non hematuria causes

Pseudohematuria

Laboratory Tests

Core labs

Initial laboratory panel

Hemostasis and transfusion

Coagulation assessment

Type and screen

Infection and systemic workup

Infection evaluation

Glomerular disease labs when indicated

PITFALLS

Limitations

Diagnostic Tests

Scoring Systems

Hematuria risk stratification

MRI

MRI urography

CT

CT selection by syndrome

Contrast safety

Ultrasound

Point of care ultrasound

Formal ultrasound

Disposition

Admission and level of care

Admission criteria

Transfer criteria

Discharge criteria and follow up

Discharge suitability

Follow up plan

Treatment

Immediate urinary tract management

Clot retention pathway

Hemorrhage and anemia

Transfusion

Hemostatic adjuncts

Infection treatment

Suspected cystitis

Suspected pyelonephritis or urosepsis

Anticoagulant and antiplatelet related bleeding

Warfarin associated major bleeding

Dabigatran associated major bleeding

Factor Xa inhibitor associated major bleeding

Antiplatelet associated major bleeding

Pain and spasm control

Renal colic pattern

Bladder spasm with catheter

Special Populations

Pregnancy

Pregnancy considerations

Geriatric

Older adult considerations

Pediatrics

Pediatric considerations

Background

Epidemiology

Frequency and significance

Pathophysiology

Source categories

Clot formation mechanisms

Therapeutic Considerations

Treatment priorities

Evidence and guideline notes

Patient Discharge Instructions

copy discharge instructions

Discharge instructions

References

Guidelines and key sources

Evidence sources

Coding systems

SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.