Ultrasound abdomen

You explain to Charlie’s mother that the CT scan is not going to happen, but that you will arrange an ultrasound instead. She is pleased that you will be able find out soon what is the cause of the vomiting.

After 30 minutes she is taken to the ultrasound department. It is the end of your shift and you go home.

The following morning you go to the ward to find out what happened with Charlie. The consultant takes you aside and asks you to describe your involvement with Charlie.

After sending her to ultrasound, the radiologists rapidly identified an intussusception in her right hypochondrium. However, she also became unresponsive and stopped breathing. The arrest team were called, and the radiologists started CPR. The arrest team identified an asystolic arrest and gave adrenaline and fluid. She had a return of spontaneous cardiac output after 10 minutes. She was intubated and taken to the paediatric intensive care unit.

After 6 hours of stabilization she was taken to theatre and the ileo-colic intussusception reduced and resected. Because a section of the bowel was infarcted some bowel contents were spilt into the abdomen, and she is now on antibiotics.

The ICU team also noticed some abnormalities of her blood tests at admission and ask if you have investigated this further and what your plan will be.