Laundry detergent pod ingestion

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Background

Laundry detergent pods
A "Spring Meadow" Tide Pod, a brand of detergent criticized for its candy-like appearance.
  • Laundry detergent pods that contain more concentrated detergent than liquid detergents, and contain ethoxylated polymers, ethoxylated alcohols, surfactants, as well as other unknown proprietary ingredients
  • Considered to cause caustic hydrocarbon injury
  • Size and colorful packaging makes pods a risk for pediatric ingestion

Clinical Features

In a review of 202 cases[1][2]

  • Red flag findings (indicate potential need for endoscopy, risk of perforation)- stridor, excessive drooling, persistent vomiting

Differential Diagnosis

Hyperthermia

Hypothermia

Increased Respiratory Rate

Respiratory Depression

Evaluation


Management

  • ABCs
    • Consider intubation for significant respiratory compromise
  • Decontamination/eye irrigation if external exposure
  • Antiemetics for nausea
  • Correct electrolyte abnormalities if present
  • Contact Poison Control
  • Red Flag signs: stridor, excessive drooling, persistent vomiting- may need endoscopy within 12-24 hours (after 24 hours, greater risk of perforation)

Disposition

  • Monitor in ED in conjunction with Poison Control recommendations
  • Consider 6-hour observation period from time of ingestion, as some symptoms may be delayed
  • Consider admission if respiratory compromise, altered mental status, or GI complaints resistant to symptomatic treatment

See Also

External Links

References

  1. 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.
  2. Valdez, A et al. Pediatric Exposure to Laundry Detergent Pods. Pediatrics. 2014. http://media.kshb.com/pdf/Pediatric%20Exposure%20to%20Laundry%20Detergent%20Pods.pdf
  3. Russell JL1, Wiles DA, Kenney B, Spiller HA. Significant chemical burns associated with dermal exposure to laundry pod detergent. J Med Toxicol. 2014 Sep;10(3):292-4
  4. Schneir AB, Rentmeester L, Clark RF, Cantrell FL. Toxicity following laundry detergent pod ingestion. Pediatric Emergency Care, 2013 Jun 1; 29(6): 741–2.