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Complications of Fleet enema administration and suggested guidelines for use in the pediatric emergency department
1Department of Pediatrics, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Insights
Hypertonic sodium phosphate enemas can cause severe issues in children, especially those with underlying health problems. New guidelines aim to ensure the safe use of these enemas in pediatric emergency departments.
Area of Science:
- Pediatric Emergency Medicine
- Gastroenterology
- Pharmacology
Background:
- Hypertonic sodium phosphate enemas are frequently used for acute constipation in pediatric emergency settings.
- Literature indicates a risk of severe metabolic derangement and death in children, even those without known gastrointestinal or renal abnormalities.
Purpose of the Study:
- To establish guidelines for the safe and effective administration of hypertonic sodium phosphate enemas.
- To mitigate risks associated with enema use in pediatric emergency departments.
Main Methods:
- A comprehensive literature review was performed using the MEDLINE database from 1966 to September 1995.
- Internal resources from the Hospital for Sick Children, Toronto, were also consulted.
Main Results:
- The literature review identified potential risks associated with hypertonic sodium phosphate enemas.
- The study synthesized information to inform guideline development.
Conclusions:
- The developed guidelines are intended to promote the safe use of hypertonic sodium phosphate enemas.
- These guidelines will aid clinicians in managing acute constipation in children presenting to the emergency department.
Introduction:
Hypertonic sodium phosphate enema solutions are commonly used for the treatment of acute constipation in the pediatric emergency department. The potential for severe metabolic derangement and death in children with gastrointestinal and/or renal abnormalities and these reported as normal has been documented in the literature.
Objective:
To develop guidelines for the safe and effective use of hypertonic sodium phosphate enema solutions such as Fleet enema, in the pediatric emergency department setting.
Resources:
A comprehensive review of the literature was conducted using the MEDLINE database for the time period 1966 to September 1995. Resources used within our institution, the Hospital for Sick Children, Toronto, Ontario, included Staff of the Emergency and General Surgery Departments.
Summary:
The guidelines provided will promote safe use of hypertonic sodium phosphate enema solutions for the treatment of acute constipation in children presenting to the emergency department.