From the Guidelines
Management of tetrahydrocannabinol (THC) ingestion in a 3-year-old requires immediate medical attention at an emergency department. Treatment is primarily supportive care, focusing on monitoring vital signs, ensuring adequate hydration, and addressing specific symptoms. Activated charcoal may be administered if the ingestion occurred within 1-2 hours. For severe symptoms, benzodiazepines such as lorazepam (0.05-0.1 mg/kg IV) or diazepam (0.1-0.3 mg/kg IV) can be used to manage agitation or seizures 1. IV fluids should be provided to maintain hydration. Continuous cardiac monitoring is necessary due to potential cardiovascular effects, as noted in studies on the health effects of cannabis and cannabinoids 1. Respiratory support may be required in severe cases. THC toxicity in children can cause significant central nervous system depression, so airway protection is crucial. The clinical course typically resolves within 24-48 hours as THC is metabolized, though hospitalization for observation is often warranted. Child protective services should be notified as this represents an accidental poisoning requiring investigation of the home environment to prevent future exposures, especially given the rising incidence of pediatric cases of edible cannabis exposure 1. Key considerations include:
- Monitoring for potential long-term effects of cannabis exposure on adolescent brain development and well-being 1
- Awareness of the potential for cannabis use disorder (CUD) and its symptoms 1 Given the potential risks and the need for immediate medical attention, prompt action is essential in managing THC ingestion in a 3-year-old.
From the Research
Management of THC Ingestion in a 3-Year-Old
- The management of tetrahydrocannabinol (THC) ingestion in a 3-year-old typically involves supportive care, as there is no specific antidote for THC toxicity 2, 3.
- Symptoms of THC ingestion in children can range from mild to severe and may include drowsiness, hypotonia, seizures, and decreased level of consciousness 2, 4.
- In cases of suspected THC ingestion, a urine test can be performed to confirm the presence of THC, although blood screening may not always be positive 3.
- Treatment may involve administration of activated charcoal to help absorb the toxin, although this is not always necessary 3.
- Children who ingest THC may require hospitalization for observation and supportive care, including monitoring of vital signs and management of any symptoms that may arise 3, 5.
- In severe cases, children may require admission to a pediatric intensive care unit for closer monitoring and management of complications such as seizures or respiratory depression 2.
Reporting to Child Protective Services
- Accidental THC ingestion in children should be reported to child protective services (CPS) to assess for potential neglect or risk to the child 3, 6.
- However, some studies suggest that not all cases of accidental THC ingestion require CPS reporting, and that a more nuanced approach may be necessary to avoid wasting resources and harming families 6.
- Clinicians should use their judgment when deciding whether to report a case of THC ingestion to CPS, taking into account the circumstances of the ingestion and the family's situation 6.
Prevention and Education
- Prevention of accidental THC ingestion in children is crucial, and parents and caregivers should be educated on the risks of THC exposure and the importance of keeping THC-containing products out of reach of children 2, 3.
- Clinicians should also be aware of the potential for THC ingestion in children and be able to recognize the symptoms and provide appropriate management 2, 4.