Septic Stone Management: A True Urologic Emergency

Credits: 1

Course Description

A 50-year-old mother of three presents to her primary care physician with increasingly severe left flank pain. By the end of the day she will have gone to the emergency room with worsening symptoms, and although effective treatment is begun by the following morning, it is too late to prevent an extensive hospital stay and multiple amputations. How might this patient’s sepsis have been recognized earlier, with better coordination among the physicians involved?
The incidence of sepsis is dramatically increasing, with infection a major source of mortality in stone disease. In this 1-hour webinar course, Dr. Glenn Preminger, Chief of Urology at Duke University, gives you a short checklist to keep “hot stones” on your radar, introduces a treatment algorithm, and demonstrates efficient multi-disciplinary communication.

Learning Objectives

At the conclusion of this webinar, participants will be able to:

  • Cite the signs and symptoms that indicate a ureteral stone patient with potential sepsis
  • Use the SIRS Criteria to identify systemic inflammatory response
  • Incorporate the Safety Checklist for Septic Stone Patients

Faculty Information

Glenn Michael Preminger, MD, has received worldwide recognition for his contributions in Urology. In 2011, he became Chief of Urologic Surgery at Duke University and was named the James F. Glenn Professor of Urologic Surgery.
Dr. Preminger has published more than 350 manuscripts, 100 book chapters, and 9 books. He is a member of 15 professional societies and holds editorial positions with Urology, the Journal of Endourology, and Urological Research.
His clinical interests include the minimally invasive management of urinary tract stones, including shock wave lithotripsy and percutaneous and ureteroscopic stone removal. In addition, he coordinates the comprehensive metabolic evaluation and preventative medical treatment offered at the Duke Comprehensive Kidney Stone Center.


Planning Group

David S. McClellan, MD, Emergency Medicine, Spokane, WA
Timothy Melhorn, MD, MMM, CPE, Internal Medicine, Yakima, WA
Marty Murray, RN, BSN, LNCC, CPHQ, Healthcare Quality/Risk/Legal Nurse Consultant, Seattle, WA
Celia Smith, CCMEP, Director, Continuing Medical Education, Physicians Insurance, Seattle, WA
Ernest Sussman, MD, VP, SCRUBS Risk Retention Group, Stuart, FL, Urology, Las Vegas, NV
Catherine Walberg, JD, Senior Vice President, Physicians Insurance, Seattle, WA

Original release: August 2014
Last reviewed: August 2017
Expiration: August 2018

CME Information
This CME activity was planned and produced in accordance with the ACCME Essentials.
Category 1 credit is applicable throughout the United States.
Estimated time to complete this activity: 1 hour

Physicians in Washington who complete this course will fulfill the risk management education requirement mandated by the Washington Health Services Act of 1993.

Physicians Insurance/Experix is accredited by the Washington State Medical Association to provide continuing medical education for physicians.
Physicians Insurance/Experix designates this internet enduring activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity meets the criteria for up to 1 hour of Category I CME credit to satisfy the relicensure requirements of the Washington State Medical Quality Assurance Commission.


At the time this course was developed and presented, Dr. Preminger disclosed that he has had a consultant role for Mission Pharmacal, a speaker role for Olympus, and a speaker role for Boston Scientific.
Planning group member Dr. McClellan disclosed that he has had a consulting role with Janssen, and a speaking and consultant role with Astra Zeneca.
All other planning and peer-review group members and their spouses/partners certified that they do not have, nor have had within the past year, any financial arrangements or affiliation with any commercial organization involved in health care goods or services consumed by or used on patients, with the exemption of nonprofit or government organizations and non-health-related companies.
The content will not include mention of unapproved or investigational uses of products or devices.

Resolution of Conflicts of Interest
Physicians Insurance/Experix has implemented a process to resolve conflicts of interest for each continuing medical education activity, to help ensure content objectivity, independence, fair balance, and content that is aligned with the interest of the public. Conflicts, if any, are resolved through a peer-review process.
Peer review of this course determined the content to be evidence-based and consistent with generally accepted medical practice.

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