Complications of Fleet(R) enema administration and suggested guidelines for use in the pediatric 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 those 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(R) 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.