The most common toxicity seen in pediatric patients from edibles is lethargy. Other reported effects include ataxia, mydriasis, tachycardia, red eyes, nausea, vomiting, confusion, agitation and respiratory depression, as well as case reports of seizures.
Data from the Children’s Hospital of Colorado indicated that 35% of children presenting to the ED were admitted, 41% of them requiring a pediatric ICU.
The mainstay of treatment is symptomatic and supportive care until patients return to baseline. It is important to do a thorough evaluation for other causes of CNS depression, and comorbidities should be assessed.
Cannabis exposures should be part of the differential in an altered child who presents with sedation and ataxia of unknown cause. Social work evaluation may need to be considered depending on the exposure scenario.
Resources available
Health care professionals play a key role in the management of pediatric marijuana edibles. The Drug and Poison Information Center at Cincinnati Children’s is staffed 24/7 with board-certified medical toxicologists, clinical toxicologists, and pharmacists/nurses who are specialists in poison information.
Call DPIC: 1-800-222-1222
For information on how parents can help keep edibles away from children, visit healthychildren.org.
References
Kathy T. Vo, Howard Horng, Kai Li, Raymond Y. Ho, Alan H. B. Wu, Kara L. Lynch, Craig G. Smollin. Cannabis intoxication case series. Annals of Emergency Medicine 2018; 71(3) 306-313 Cite Unintentional cannabis ingestion in children a systematic review
Grotenhermen, Franjo. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet 2003 42: 327-360
Heizer JW, Borgelt LM, Bashqoy F, Wang GS, Reiter PD. Marijuana Misadventures in Children: Exploration of a Dose-Response Relationship and Summary of Clinical Effects and Outcomes. Pediatr Emerg Care. 2016 Apr 5.
George Sam Wang, MD; Marie-Claire Le Lait, MS; Sara J. Deakyne, MPH; Alvin C. Bronstein, MD; Lalit Bajaj, MD, MPH; Genie Roosevelt, MD, MPH. Unintentional pediatric exposures to marijuana in Colorado, 2009-2015. JAMA Pediatr. 2016; 170 (9)
File:Map of US state cannabis laws.svg – Wikimedia Commons
https://medicalmarijuana.ohio.gov/