Can use air or water soluble contrast—peds rads usually start with air, unless abd film shows so much air that it may be hard to tell
If using water soluble contrast, can use Cystoconray or Hypaque
The seal is the name of the game—use a Foley catheter that is big enough, so it will give you the best seal (usually 24-28 French in kids >12 months)
Inflate balloon under fluoro, then pull to snug and tape well with foam tape
Inflate air until you confidently see air reflux into the small bowel (it’s “bubbly”)
Sustained pressure shouldn’t be higher than 120 mmHg
Give it 3 tries to try and reduce—in general, if making progress, keep going
If using water soluble contrast, elevate bag approximately 3 feet above table, to get a good pressure head
Image capture multiple spots as you go—it can be helpful if trying to convince yourself that you are in fact in the small bowel to go back and look at the spots as you progress.
Consent for the procedure should include risk of perforation necessitating surgery and risk of being unable to reduce intussusception thus necessitating surgery.