Initial Emergency Management of Intussusception
Intussusception requires prompt recognition and structured emergency management to stabilise the child before definitive intervention. Timely circulatory support, pain control, and bowel decompression are central to the initial approach.
Clinical Approach
Initial management focuses on securing IV access early — before diagnostic imaging — followed by circulatory resuscitation and analgesia. Where bowel obstruction or perforation is identified on imaging, or when air transfer is planned, additional airway and bowel precautions apply.
The full protocol specifies resuscitation volumes, analgesic selection, and transfer preparation steps — see the structured regimen for complete guidance.
References
- Secure IV access for all children suspected to have intussusception before diagnostic imaging
- Treat hypovolaemic shock with IV boluses of 0.9% saline
- Start IV fluids to optimise circulatory volume
- Ensure adequate analgesia, usually intranasal fentanyl or IV morphine, see Acute pain management
- Keep nil orally. Pass nasogastric tube if bowel obstruction or perforation on AXR, or if planning transfer by air
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