Laundry detergent pod ingestion: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
===Hyperthermia=== | ===Hyperthermia=== | ||
*Altered Metabolism | *Altered Metabolism | ||
**[[Aspirin (Salicylate) Toxicity]] | **[[Aspirin (Salicylate) Toxicity]] | ||
**withdrawal | **Benzo or [[alcohol withdrawal]] | ||
** | **[[Thyroid storm]] | ||
**dinitrophenols | **dinitrophenols | ||
*Increased Muscle Activity | *Increased Muscle Activity | ||
**withdrawal | **[[Sympathomimetic toxicity]], alcohol withdrawal | ||
**[[MAOI Toxicity]] | **[[MAOI Toxicity]] | ||
**[[ | **[[Phencyclidine]], LSD | ||
**[[Lithium]] | **[[Lithium toxicity]] | ||
**Amoxapine | **Amoxapine | ||
**[[Serotonin Syndrome]] | **[[Serotonin Syndrome]] | ||
*Impaired Heat Dissipation | *Impaired Heat Dissipation | ||
** | **[[Anticholinergic toxicity]] | ||
** | **[[Antihistamines]] | ||
** | **[[TCA toxicity]] | ||
*[[Malignant Hyperthermia]] | *[[Malignant Hyperthermia]] | ||
**anesthestics | **anesthestics | ||
| Line 50: | Line 49: | ||
**[[Metabolic Acidosis]] | **[[Metabolic Acidosis]] | ||
**dintirophenol, pentachlorophenol | **dintirophenol, pentachlorophenol | ||
** | **Hepatorenal failure | ||
**CNS stimulants (cocaine, amphet, theophylline) | **CNS stimulants (cocaine, amphet, theophylline) | ||
*Tissue [[Hypoxia]] | *Tissue [[Hypoxia]] | ||
| Line 70: | Line 69: | ||
**[[Nicotine Poisoning|Nicotine]] | **[[Nicotine Poisoning|Nicotine]] | ||
**strychnine | **strychnine | ||
** | **botulism | ||
**Mojave rattlesnake, Cobra | **Mojave rattlesnake, Cobra | ||
Revision as of 01:17, 11 September 2016
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
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
- 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.