Laundry detergent pod ingestion: Difference between revisions
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==Background== | ==Background== | ||
* | *Tide pods are laundry detergent pods that contain ethoxylated polymers, ethoxylated alcohols, surfactants, as well as other unknown proprietary ingredients. They are considered a caustic hydrocarbon injury, and contain significantly more concentrated detergent than standard liquid detergents. | ||
*Size and colorful packaging makes pods a risk for pediatric ingestion | *Size and colorful packaging makes pods a risk for pediatric ingestion | ||
Revision as of 12:16, 26 August 2019
Background
- Tide pods are laundry detergent pods that contain ethoxylated polymers, ethoxylated alcohols, surfactants, as well as other unknown proprietary ingredients. They are considered a caustic hydrocarbon injury, and 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][2]
- No effects - 24%
- Vomiting - 66%
- Respiratory complaints - 16%
- altered mental status - 9%
- Eye irritation - 8%
- Skin irritation - 0.5%
- Fever - 0.6%
Differential Diagnosis
Hyperthermia
- Altered Metabolism
- Aspirin (Salicylate) Toxicity
- Benzo or alcohol withdrawal
- Thyroid storm
- dinitrophenols
- Increased Muscle Activity
- Sympathomimetic toxicity, alcohol withdrawal
- MAOI Toxicity
- Phencyclidine, LSD
- Lithium toxicity
- Amoxapine
- Serotonin Syndrome
- Impaired Heat Dissipation
- 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
- botulism
- Mojave rattlesnake, Cobra
Evaluation
- ABCs
- Chem 7
- Chest x-ray for respiratory complaints such as SOB/cough (there may be a delayed pneumonitis)
- Consider 6-hour observation period from time of ingestion, as some symptoms may be delayed
- Assess for co-ingestions if there is sufficient concern
- Red Flag signs: stridor, excessive drooling, persistent vomiting--if 1 of 3 concerning symptoms are present, patient may need endoscopy within 12-24 hours (after 24 hours, greater risk of perforation). Consider toxicology consult.
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.
- ↑ Valdez, A et al. Pediatric Exposure to Laundry Detergent Pods. Pediatrics. 2014. http://media.kshb.com/pdf/Pediatric%20Exposure%20to%20Laundry%20Detergent%20Pods.pdf