title: Air enema reduction of intussusception: a registrar-led, protocol-driven service is safe and effective.
abstract: OBJECTIVE
  In the UK, air enema reduction of intussusception is predominantly performed by consultant radiologists. At our institution, it is usually performed by a team involving radiology and surgical registrars. The purpose of this study was to assess who performs air enemas in the UK and the efficacy and safety of our registrar-led service.
  
  
  METHODS
  A telephone survey of paediatric surgical centres in the UK was performed asking who performs air enema in these institutions. Following this, a retrospective review of all air enemas at our institution between January 2005 and 2011 was performed. Cases were identified from radiology databases and reviewed for grade of radiologist, perforation and outcome.
  
  
  RESULTS
  At all 25 centres, consultant radiologists performed air enemas. At our institution 145 enemas were performed in 6 years. 141 were analysed (54 girls, 87 boys). Median age was 9 months (range 3-107 months). 82 % were performed by the registrar-only team. Over 6 years the registrar-led reduction rate was 77.5 % and in the last 3 years 84 %. The perforation rate was 0.9 %.
  
  
  CONCLUSIONS
  A paediatric surgical registrar-led service for air enema reduction can be safe and effective ensuring a team approach is adopted, equipment is efficient and a strict protocol is applied.
authors.affiliation: Department of Paediatric Surgery, St George's Hospital, Tooting, UK.
authors.forename: Edward John
authors.initials: EJ
authors.lastname: Hannon
authors.forename: Rosemary Anne
authors.initials: RA
authors.lastname: Allan
authors.forename: April Samantha
authors.initials: AS
authors.lastname: Negus
authors.forename: Feilim
authors.initials: F
authors.lastname: Murphy
authors.forename: Bruce Obi
authors.initials: BO
authors.lastname: Okoye
mesh_terms: D000388:Air; D002675:Child, Preschool; D002985:Clinical Protocols; D004733:Enema / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007443:Intussusception / Q000628:therapy*; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D006113:United Kingdom