Text Version
EXPLORING CANNABIS-ASSOCIATED PRESENTATIONS TO CANADIAN PEDIATRIC EMERGENCY DEPARTMENTS: A CROSS SECTIONAL STUDY
Zina Zaslawski MA 1 , Stevi Golden-Plotnik MD FRCPC 2,3, Jessica Steer BA (Hons) 1, Lynne Warda MD 4, Lauren Kelly PhD 1,5,6
1 George & Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, 2 Department of Pediatrics, University of Alberta, Edmonton, AB, 3 Stollery Children’s Hospital, Edmonton, AB, 4 Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, 5 Department of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, MB, 6 Children's Hospital Research Institute of Manitoba, Winnipeg, MB
Introduction
In Canada recreational use of cannabis for adults was legalized in October 2018.
Since then, the rates of recreational cannabis use in the past 12 months among 16–19-year-olds has increased from 36% in 2018 to 43% in 2023.
Pediatric emergency department (ED) presentations related to cannabis exposures also increased.
Objectives
To understand Canadian pediatric emergency medicine (PEM) providers’ training and knowledge of clinical presentation associated with cannabis exposure in children.
To describe pediatric ED presentations related to cannabis exposure across Canada following legalization in 2018.
Methodology
Survey was adapted with items added based on existing literature and focus groups.
A panel of experts reviewed the survey and provided feedback individually.
Completed a pilot test of the survey with a group of 10 PEM physicians and subspecialty trainees.
Data was collected in 2021.
The survey focused on:
Cannabis knowledge and training
Cannabis-associated pediatric emergencies
Frequency
Diagnosis (investigations ordered)
Management
Results
Response rate: 36.5% (84/230)
91.7% (n=77) reported an average or higher than average level of knowledge on cannabis-associated pediatric emergencies VS. 8.3% (n=7) reported a poor level of knowledge
86% (n=72) received some informal training VS. 35% (n=29) received formal training
Desired training topics:
Clinical presentations and management recommendations
Toxicology/pathophysiology
Utilization of medical cannabis in the pediatric population
69% reported an increase of cannabis-associated ED presentations since legalization.
Main findings
PEM physicians want to learn about when cannabis can be used safely and what to do in cases of unsafe consumption.
Many more tests were ordered when cannabis consumption was unknown at the beginning of the assessment, compared to when the exposure was known, despite management remaining mostly supportive.
The main cannabis-related presentations to the pediatric ED were decreased level of consciousness and vomiting.
Conclusion
There is a gap in formal education opportunities for PEM physicians.
There is a need for evidence based strategies to improve disclosure rates when cannabis products may be in the home, which could reduce unnecessary testing for children.
future studies could compare the efficacy of diagnostic tools and management strategies, as well as long-term outcomes for toddlers and adolescents presenting with cannabis-based emergencies.
For more information, visit www.medcannkids.ca
Produced by Zina Zaslawski in October 2024.
C4T is an academic partnership. Funding details and COI are available on our website.