Bedside Intussusception Diagnosis and Reduction: A Comprehensive Emergency Department Process for Bedside...

Area of Science:

• Pediatric Emergency Medicine
• Pediatric Radiology
• Gastrointestinal Disorders

Background:

• Ileocolic intussusception is a common cause of intestinal obstruction in young children.
• Current diagnosis via ultrasound and treatment with enema often occur outside the pediatric emergency department (PED), lacking adequate sedation.
• This necessitates a more integrated and patient-centered approach within the PED.

Purpose of the Study:

• To evaluate the efficacy and safety of a comprehensive bedside approach for diagnosing and reducing ileocolic intussusception.
• To assess the feasibility of performing ultrasound-guided hydrostatic reduction within the PED.
• To determine the impact of this approach on patient outcomes and resource utilization.

Main Methods:

• A retrospective cohort study of children diagnosed with ileocolic intussusception between January 2021 and July 2024.
• Point-of-care ultrasound for diagnosis and ultrasound-guided hydrostatic reduction performed bedside by pediatric radiologists.
• Sedation administered by pediatric emergency medicine physicians.

Main Results:

• Twenty-eight children underwent bedside diagnosis and reduction.
• An 86% success rate for bedside reduction was achieved, with an average time from admission to reduction of 126 minutes.
• No adverse events were reported, though 7% experienced early recurrence within 48 hours.

Conclusions:

• A comprehensive bedside approach for ileocolic intussusception in the PED is effective and safe.
• This integrated model enhances sedation/analgesia administration and reduces interdepartmental transfers.
• Further prospective studies are warranted to validate these findings.