Taylan Gurgenci. Paediatric Blunt Trauma and Microhaematuria, Don't Forget the Bubbles, 2016. Available at:
Bottom line pearls:
- Gross haematuria must be taken seriously as it raises the likelihood of finding significant renal pathology
- Microhaematuria of any degree is most useful when serial urinalyses are performed. Seeing a downward trend in the degree of microhaematuria is much more useful than the actual number.
- The received wisdom suggesting a microhaematuria of 50RBC/HPF is the dividing line between trivial and significant haematuria is not supported by much evidence.
- Microhaematuria in a child with a possible renal injury is best managed by serial examination, serial FBC, and serial urinalysis. Discharge is safe if the examination remains stable, the FBC is stable, and the microhaematuria resolves.
- There is no role for the urine dipstick in suspected renal injury.
- Adult imaging protocols may be applied to paediatric blunt trauma though with some important provisos.