Exploring Cannabis-Associated Presentations to Canadian Pediatric Emergency Departments: A Cross-Sectional Study
Bibliographic record
Abstract
Objective: Recent studies found that recreational legalization of cannabis consumption for Canadian adults has increased presentation to the emergency department (ED) among children. In this descriptive study, our objectives were to (1) understand Canadian pediatric emergency medicine (PEM) providers’ training and knowledge of clinical presentations associated with cannabis exposure in children and (2) describe pediatric ED presentations related to cannabis exposure across Canada following legalization in 2018. Method: In 2021, following ethics board approval, 230 Pediatric Emergency Research Canada (PERC) network pediatric emergency medicine (PEM) physicians were invited to share about their knowledge, training, and experience with patients presenting with cannabis-associated emergencies using an anonymized survey administered through REDCap. Results: In total, 84/230 (36.5%) invited physicians completed the survey. Almost 70% of the PEM physicians reported an increase in the number of cannabis-associated ED presentations they have seen since legalization, while only 15% reported no increase in presentations. More than 90% of the respondents reported an average or higher level of knowledge of cannabis-associated pediatric emergencies. More than half (n = 48, 57%) were interested in pursuing further training, preferring formal training opportunities. The main presentations to the ED were decreased level of consciousness, known unintentional (accidental) ingestion and vomiting. Significantly more tests were ordered when cannabis consumption was unknown at the beginning of the assessment, compared to when it was known, however, treatment plans were the same (mainly supportive measures). Conclusions: Most PEM providers are managing an increasing number of cannabis-associated ED presentations. PEM providers should improve communication with caregivers around household cannabis use. When caregivers feel comfortable disclosing cannabis presence at home, it can help prevent unnecessary tests and interventions for their children if they present to the ED.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".