Implementation of a Standardized Management Algorithm for Cannabis Hyperemesis Syndrome in a Pediatric Emergency...

Area of Science:

• Pediatric Emergency Medicine
• Clinical Toxicology
• Cannabinoid Research

Background:

• Cannabis hyperemesis syndrome (CHS) is a growing cause of pediatric emergency department (ED) visits.
• Standardized management protocols for CHS in pediatric populations are lacking.
• This study addresses the need for evidence-based CHS treatment strategies in adolescents.

Purpose of the Study:

• To evaluate the clinical outcomes of implementing a CHS management algorithm in a pediatric ED.
• To assess the impact of the algorithm on medication administration, length of stay, and disposition.
• To analyze changes in patient management before and after the algorithm's introduction.

Main Methods:

• Retrospective study of adolescent encounters in a pediatric ED (July 2020-July 2024).
• Comparison of patient management before and after CHS algorithm implementation.
• Statistical analysis included chi-square, Fisher exact, Mann-Whitney U tests, and mixed-effects models.

Main Results:

• Algorithm implementation led to increased use of capsaicin (2.7% to 22.2%) and metoclopramide (6.8% to 42.6%).
• Haloperidol administration frequency did not change significantly, but the mean dose decreased.
• No significant differences were observed in the adjusted odds of hospital admission or ED length of stay.

Conclusions:

• The CHS management algorithm increased the use of specific medications like capsaicin and metoclopramide.
• The algorithm did not significantly impact hospital admission rates or ED length of stay.
• Prospective studies are essential to determine optimal CHS management strategies for pediatric patients.