For a child presenting with severe abdominal pain and vomiting, which intervention is appropriate prior to any imaging?

Starting intravenous (IV) fluids is a critical intervention for a child presenting with severe abdominal pain and vomiting. This approach achieves several important clinical goals. First, it helps to prevent dehydration, which can quickly become a concern in pediatric patients who experience significant vomiting. Maintaining hydration is crucial for preserving kidney function and promoting overall stability while further evaluation and treatment plans are made.

IV fluids also provide a route for administering medications if necessary, and can be used as a means to begin correcting any electrolyte imbalances that may arise due to the vomiting. The stabilization of the patient through IV hydration allows healthcare providers to perform further diagnostic procedures, such as imaging, safely and effectively while ensuring the child’s physiological needs are being met.

Focusing on the other options, administering analgesics may mask the pain, which could hinder the ability to accurately assess the child’s abdominal condition. Documenting food intake is important, but it does not address the immediate need for stabilization and management of the child’s symptoms. Ordering an ultrasound could be a necessary step for diagnosis, but it should follow the initiation of IV fluids, especially if the child is dehydrated or in distress. IV fluids take precedence in this scenario to ensure the child's safety and readiness for subsequent evaluation.