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Ingestion of cannabis: a cause of coma in children
A Macnab1, E Anderson, L Susak
1Pediatric Intensive Care Unit, British Columbia's Children's Hospital, Vancouver, Canada.
Insights
Accidental cannabis ingestion in children can lead to severe toxicity, including coma. Increased physician awareness and parent education are crucial for prevention and prompt management of pediatric cannabis exposure.
Area of Science:
- Pediatric Toxicology
- Emergency Medicine
- Cannabinoid Research
Background:
- Accidental pediatric cannabis ingestion is infrequently reported.
- Previous cases did not involve coma, though stupor requiring ventilation has been documented.
Observation:
- Six pediatric cases of cannabis toxicity managed over four years.
- Three children presented in coma; one experienced airway obstruction.
- Key symptoms included drowsiness, mydriasis, hypotonia, and oral cannabis traces.
Findings:
- Cannabis toxicity in children can present with severe neurological impairment, including coma.
- Urine cannabinoid screening confirmed exposure.
- Diagnostic signs include rapid onset of altered consciousness and specific physical findings.
Implications:
- Highlights the potential severity of pediatric cannabis intoxication.
- Emphasizes the need for emergency physicians to recognize diagnostic criteria.
- Underscores the importance of preventative measures through parent education regarding cannabis safety.
Abstract:
Previous reports of accidental ingestion of cannabis by children are rare. None has reported coma, although one described a stuporous state that required assisted ventilation. Over the past four years, the staff of British Columbia's Children's Hospital has managed six children with cannabis toxicity, three of whom presented in coma, including one with airway obstruction. Recurring diagnostic features included rapid onset of drowsiness, moderate pupil dilation, hypotonia, lid lag, and the presence of small granules or leaves in the mouth. Confirmation was obtained by positive urine screening for cannabinoids. The six cases described emphasize the need for emergency physician awareness of possible diagnostic criteria, the potential severity of intoxication, and the need for prevention through parent education.