Red Flags & When to Go In Person for Kidney Stone (Suspected) - Pediatric Triage

Audience: pediatric

Kidney stones in children can cause sudden and severe pain, often in the side or back, and may be accompanied by nausea or changes in urination. While some kidney stones pass on their own, it is important to watch for signs that need urgent medical care. This guide helps parents and caregivers understand when to seek in-person medical evaluation for a child suspected of having a kidney stone. Telemedicine can assist with initial assessment and advice but cannot replace hands-on exams or urgent treatments when serious symptoms appear. Recognizing red flags like high fever, inability to urinate, or severe pain that does not improve is key to ensuring timely care. This information supports safe triage and helps families know when to go to the emergency room or see a healthcare provider in person.

Red flags — go in person / ER

• High fever (above 38°C or 100.4°F) with pain — seek emergency care immediately.
• Inability to urinate or severe difficulty urinating — go to urgent care or emergency room.
• Severe pain not relieved by home treatment or medications — seek in-person evaluation promptly.

What telemedicine can do

• Initial symptom assessment and advice.
• Guidance on hydration and pain management.
• Determining urgency and need for in-person care.
• Providing education about kidney stones and prevention.

What telemedicine cannot do

• Physical examination and palpation.
• Imaging tests such as ultrasound or CT scans.
• Procedures to remove or break up stones.
• Treatment of severe complications like infection or urinary blockage.

What Are Kidney Stones in Children?

Kidney stones are hard deposits made of minerals and salts that form inside the kidneys. In children, these stones can block urine flow and cause pain. Symptoms often include sharp pain in the side or lower back, blood in the urine, and sometimes nausea or vomiting. Kidney stones may pass naturally, but some require medical treatment.

Common Symptoms to Watch For

Children with kidney stones may experience:

If your child shows these symptoms, telemedicine can help assess the situation initially.

Red Flags That Require In-Person Care

Some signs mean your child needs urgent medical attention in person:

If you notice any of these, go to the emergency room or urgent care immediately.

How Telemedicine Can Help

Telemedicine can provide:

However, telemedicine cannot perform physical exams, imaging tests, or urgent procedures needed for some kidney stone cases.

Preparing for a Telemedicine Visit

Before your tele-visit, prepare:

This helps the healthcare provider give the best advice.

After the Telemedicine Visit

Follow the healthcare provider’s instructions carefully. This may include:

If symptoms worsen or red flags appear, seek in-person care promptly.

How to prepare for your tele-visit

• Note the exact symptoms and when they began.
• Gather information on any past kidney or urinary issues.
• List current medications and allergies.
• Prepare to describe urine color and any visible blood.
• Ensure a quiet and private space for the telemedicine visit.
• Have a thermometer ready to check for fever if possible.

After your tele-visit

• Follow all medication instructions given by the provider.
• Encourage your child to drink plenty of fluids unless advised otherwise.
• Watch for any worsening symptoms or new red flags.
• Schedule any recommended follow-up tests or visits.
• Keep a symptom diary to share with healthcare providers if needed.

FAQs

Can kidney stones in children be treated at home?

Small kidney stones often pass on their own with plenty of fluids and pain relief. However, children should be monitored closely, and medical advice should be sought to ensure safe care.

When should I take my child to the emergency room for kidney stones?

Go to the emergency room if your child has a high fever with pain, cannot urinate, has severe pain that does not improve, or is vomiting and unable to keep fluids down.

Can telemedicine diagnose kidney stones?

Telemedicine can help assess symptoms and guide you on next steps but cannot confirm a diagnosis without physical exams and imaging tests done in person.

What can I do to prevent kidney stones in my child?

Encourage your child to drink enough water daily, maintain a balanced diet, and follow any specific advice from your healthcare provider based on your child’s health history.

Sources

1. Kidney Stones in Children — MedlinePlus, U.S. National Library of Medicine.
2. Kidney Stones: Symptoms and Causes — Mayo Clinic.
3. Kidney Stones in Children and Adolescents — American Academy of Pediatrics.
4. Kidney Stones — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational and triage purposes only. It is not a substitute for in-person medical evaluation, diagnosis, or treatment. If your child has severe symptoms or red flags, seek immediate medical care.