Pediatric Caffeine Overdose
As the in-service draws closer and the hours to study wind down, I find myself becoming more and more of a caffeine enthusiast. While a No-Doz or Diet Mt. Dew may put a little more pep in my step, the caffeine found in energy drinks, caffeine pills, and diet supplements can quickly result in an dangerous overdose in a young child.
Caffeine Overdose Presentation- Sympathomimetic Toxidrome
- Tachycardia, dysrhythmia, hypertension
- Diaphoresis, piloerection
- Nausea, vomiting
- Hyperthermia
- Dilated pupils
- Agitation, delusions, paranoia
- Seizures, coma
- Sometimes: Metabolic acidosis, hypokalemia
- Rhabdo- muscle breakdown by Ca++ sequestration in the sarcoplasmic reticulum
Available Sources of Caffeine-
- NoDoz- 200mg/tab
- Excedrin 65mg/tab
- Starbuck Double Shot 130mg/6.5oz
- Monster Energy Drink 160mg/16oz
- Caffeine Solution for Neonates with Apnea of Prematurity
- So many more!
Toxic Doses
- 15 mg/L- tachycardia, arrhythmia, HTN, seizure, vomiting, irritable, delusions, hallucinations (approx 1500 mg for an adult)
- >80 mg/L- Coma or Death
Management- treat the symptoms (metabolic, cardiovascular, and neurologic)
- IV Fluids
- Anti-emetics
- Sodium Bicarb if refractory metabolic acidosis
- Benzos for severe agitation or seizure
- PALS protocols for cardiac arrhythmias
Good Luck on the In-Service!
