Last reviewed
2026-02-07
Workflow pack
Hematuria risk workflow
Workflow for hematuria visits emphasizing bleeding severity, obstruction/infection risk, and rapid urology handoff.
Trust and governance
Use only within this workflow's defined scope and exclusions.
Clinical owner
Family Medicine Editorial Team
Risk tier
Medium
Review cadence
Every 6 months
Next due 2026-08-07
Review status
Current
Scope limits
Initial outpatient hematuria assessment in clinically stable patients without immediate retention or shock.
Exclusions (escalate/redirect)
- Hemodynamic instability, clot retention emergency, or severe sepsis presentations.
- Inpatient procedural and surgical urology management.
References
Escalate-now emphasis (medium-risk workflow)
Treat red-flag findings as urgent. Escalate the care pathway early if concern persists or follow-up reliability is uncertain.
At a glance
Rapid decision framing for in-visit use. Educational only; always apply clinical judgment.
Immediate actions
- Determine gross versus microscopic hematuria and symptom context.
- Screen for obstruction, infection, and renal-risk features.
- Assess whether urgent transfer is required before outpatient workup.
Red flags / escalate now
- Gross bleeding with clots and retention risk.
- Severe flank pain, fever, or instability suggesting complicated cause.
- Rapidly worsening symptoms with declining renal status.
First-line plan
- Use severity-guided initial tests and stabilization steps.
- Document anticoagulation status and key risk factors.
- Define immediate, expedited, or routine referral disposition clearly.
Follow-up and monitoring
- Ensure timely reassessment and trend review.
- Escalate for worsening bleeding, infection, or renal deterioration.
- Confirm referral pathway completion for unresolved cases.
Condition guidance
Referral checklists
Tools and calculators
Return precautions (patient script)
Suggested plain-language wording for safety-net counseling:
If symptoms get worse, new warning signs appear, or you cannot follow the plan from this visit, seek urgent care now.
- Use with the specific red flags listed on this page.
- Confirm follow-up timing and where to go after-hours.
- Document that return precautions were reviewed and understood.
Visit-close checklist
- Document disposition, rationale, and unresolved diagnostic uncertainty.
- Give explicit return precautions and follow-up timeline before ending visit.
- Attach a relevant handout when available to reinforce adherence and safety-netting.