Exploring Cannabis-Associated Presentations to Canadian Pediatric Emergency Departments: A Cross-Sectional Study

Recent studies found that recreational legalization of cannabis consumption for Canadian adults has increased presentation to the emergency department (ED) among children. In this descriptive study, our objectives were to (1) understand Canadian pediatric emergency medicine (PEM) providers' training and knowledge of clinical presentations associated with cannabis exposure in children and (2) describe pediatric ED presentations related to cannabis exposure across Canada following legalization in 2018.

In 2021, following ethics board approval, 230 Pediatric Emergency Research Canada (PERC) network pediatric emergency medicine (PEM) physicians were invited to share about their knowledge, training, and experience with patients presenting with cannabis-associated emergencies using an anonymized survey administered through REDCap.

In total, 84/230 (36.5%) invited physicians completed the survey. Almost 70% of the PEM physicians reported an increase in the number of cannabis-associated ED presentations they have seen since legalization, while only 15% reported no increase in presentations. More than 90% of the respondents reported an average or higher level of knowledge of cannabis-associated pediatric emergencies. More than half (n = 48, 57%) were interested in pursuing further training, preferring formal training opportunities. The main presentations to the ED were decreased level of consciousness, known unintentional (accidental) ingestion and vomiting. Significantly more tests were ordered when cannabis consumption was unknown at the beginning of the assessment, compared to when it was known, however, treatment plans were the same (mainly supportive measures).

Most PEM providers are managing an increasing number of cannabis-associated ED presentations. PEM providers should improve communication with caregivers around household cannabis use. When caregivers feel comfortable disclosing cannabis presence at home, it can help prevent unnecessary tests and interventions for their children if they present to the ED.