Laundry detergent pod ingestion
Revision as of 02:30, 31 July 2016 by Rossdonaldson1 (talk | contribs) (Text replacement - "AMS" to "altered mental status")
Background
- Pods contain significantly more concentrated detergent than standard liquid detergents
- Size and colorful packaging makes pods a risk for pediatric ingestion
Clinical Features
In a review of 202 cases[1]:
- No effects - 24%
- Vomiting - 66%
- Respiratory complaints - 16%
- altered mental status - 9%
- Eye irritation - 8%
- Skin irritation - 0.5%
Differential Diagnosis
Differential Diagnosis for Specific Signs
Hyperthermia
- Altered Metabolism
- Aspirin (Salicylate) Toxicity
- withdrawal states
- thyroid hormones
- dinitrophenols
- Increased Muscle Activity
- withdrawal, sympathomimetics
- MAOI Toxicity
- PCP, LSD
- Lithium
- Amoxapine
- Serotonin Syndrome
- Impaired Heat Dissipation
- anticholinergics
- antihistamines
- antipsychotics (TCAs)
- Malignant Hyperthermia
- anesthestics
- Neuroleptic Malignant Syndrome
- phenothiazines, Lithium, LevoDopa
Hypothermia
- Exposure
- Ethanol Toxicity
- Sedative hypnotics
- Opioids
- TCAs
- Phenothiazines
- Insulin (Hypoglycemia)
Increased Respiratory Rate
- Direct Stimulation
- Aspirin (Salicylate) Toxicity
- Metabolic Acidosis
- dintirophenol, pentachlorophenol
- hepatorenal failure
- CNS stimulants (cocaine, amphet, theophylline)
- Tissue Hypoxia
Respiratory Depression
- Central Depression
- antipsychotics
- Chlorinated hydrocarbons
- Sedative/Hypnotics (Ethanol Toxicity, glycols)
- Tricyclic (TCA) Toxicity
- Lomitil
- Muscle Failure
- Organophosphates
- Marine Toxins
- Nicotine
- strychnine
- botulinis
- Mojave rattlesnake, Cobra
Evaluation
- ABCs
- Chem 7
- Chest x-ray for respiratory complaints
- Assess for coingestions if there is sufficient concern
Management
- ABCs
- Consider intubation for significant respiratory compromise
- Decontamination/eye irrigation if external exposure
- Ondansetron for nausea
- Correct electrolyte abnomralities if present
- Contact Poison Control
Disposition
- Monitor in ED in conjunction with Poison Control recommendations
- Consider admission if respiratory compromise, altered mental status, or GI complaints resistant to symptomatic treatment
See Also
External Links
References
- ↑ Beuhler MC, Gala PK, Wolfe HA, et al. Laundry detergent “pod” ingestions: a case series and discussion of recent literature. Pediatr Emerg Care. 2013; 29(6):743–747.