ED nurse initiated Rx of the patient presenting with probable biliary colic


  • patients with biliary colic can be initially managed in Fast Track if clinically stable, and if ongoing pain, can be considered for admission to EOU
  • their length of stay in ED could be reduced and their symptoms partly relieved by nurse initiated ED Rx, although it is recognised that these presentations can be complex and warrant timely medical assessment to properly exclude important red flags.
  • the following is a suggested framework for ED's who have nurses accredited to undertake ED nurse initiated treatment including the ordering of pathology tests.

specific history and examination

specific nurse initiated Rx for bilary colic

red flags to escalate medical referral

  • the elderly are particularly susceptible to time critical life threatening sepsis
  • hypotension
  • fever
  • severe pain
  • pregnancy

initial Mx

  • urinalysis with MSU m/c/s
  • if persisting pain, consider admission to EOU as biliary colic:
    • iv access
    • FBE, U&E, glucose, LFTs, lipase
    • iv morphine if not settling with paraectamol, oxycodone
nursing/biliarycolic.txt · Last modified: 2012/07/23 15:52 (external edit)