Author(s)

Lea Dikranian¹, Varun Vohra², David Merolla³, Usha Sethuraman^1,4, Nirupama Kannikeswaran^1,4

¹Department of Emergency Medicine, Children’s Hospital of Michigan, Detroit, USA.
²Michigan Poison & Drug Information Center, Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, USA.
³Department of Sociology, Wayne State University School of Medicine, Detroit, USA.
⁴Department of Emergency Medicine, Central Michigan University, Detroit, USA.

Background: Social media platforms are popular among children and often feature challenges that become viral. Notably, the Tide Pod^® and Benadryl^® challenges encouraged viewers to ingest these substances for their visual appeal and hallucinogenic effects, respectively. This study aimed to assess the clinical impact and outcomes of single-use detergent sacs (SUDS) and diphenhydramine challenges on pediatric ingestions reported to United States (U.S.) Poison Control Centers (PCCs). Methods: We conducted a retrospective review of pediatric exposures reported to U.S. PCCs using data from the National Poison Data System (NPDS). The study included intentional single-substance ingestions of both brand-name and generic forms of SUDS and diphenhydramine among children ≤ 19 years. We compared the number of calls, clinical effects, disposition, and management strategies for SUDS (pre: 01/01/17 to 12/31/17 vs. post: 01/01/18 to 12/31/18) and diphenhydramine (pre: 08/01/19 to 07/31/20 vs. post: 08/01/20 to 07/31/21) ingestions 12 months before and after the introduction of the respective social media challenges. Differences in proportions were compared using the Chi-square test. Results: During the study period, 469 ingestions of SUDS and 5,702 ingestions of diphenhydramine were reported. Post-challenge periods saw an increase in both SUDS (pre: 82 vs. post: 387; 372% increase) and diphenhydramine ingestions (pre: 2,672 vs. post: 3,030; 13% increase). While there were no significant changes in moderate or major clinical outcomes, hospitalizations increased post-challenge for both SUDS [pre: 4 (4.9%) vs. post: 33 (8.5%); p = 0.25] and diphenhydramine [pre: n = 904 (33.8%) vs. post: 1,190 (39.3%); p < 0.001]. Conclusion: Pediatric ingestions reported to U.S. PCCs and hospitalizations increased coinciding with the introduction of Tide Pod^® and Benadryl^® challenges. While causality cannot be definitively established, it is essential for pediatricians and parents to be aware of these challenges and educate vulnerable children about the harmful effects of participation in such challenges.

Emergency Medicine, Ingestions, Toxicology, Social Media Challenges, Pediatrics

Dikranian, L. , Vohra, V. , Merolla, D. , Sethuraman, U. and Kannikeswaran, N. (2024) Impact of Social Media Challenges on Pediatric Single-Use Detergent Sacs and Diphenhydramine Ingestions Reported to United States Poison Control Centers. Open Journal of Emergency Medicine, 12, 104-113. doi: 10.4236/ojem.2024.123013.