# Implementation of a Standardized Management Algorithm for Cannabis Hyperemesis Syndrome in a Pediatric Emergency Department.

> **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637)
> **Publisher:** CED Clinic (https://cedclinic.com)
> **Canonical URL:** https://cedclinic.com/implementation-of-a-standardized-management-algorithm-for-cannabis-hypereme/
> **Published:** 2026-04-28T22:02:43-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T16:05:26-04:00
> **Clinical Summary:** Cannabis hyperemesis syndrome (CHS) is an increasingly common cause of pediatric emergency department (ED) visits, yet management pathways remain understudie...

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CED Clinical Relevance  #56Monitored Relevance  Early-stage or contextual signal requiring further evidence before action.
🔬 Evidence Watch  |  CED Clinic

Journal
Pediatric emergency care

Study Type
[Clinical Study](https://cedclinic.com/cannabis-hyperemesis-syndrome-psychiatric-risk/)

Population
Human participants

Why This Matters

This item covers developments relevant to [cannabis medicine](https://cedclinic.com/essential-oils-industrial-hemp-antimicrobial-benefits/) and [clinical practice](https://cedclinic.com/cannabis-reproductive-health-women-clinical-evidence/). Clinicians monitoring evidence in this area should review the source material.

Clinical Summary
[Cannabis hyperemesis syndrome](https://cedclinic.com/remediated-cannabis-mold-contamination-risks/) (CHS) is an increasingly common cause of pediatric emergency department (ED) visits, yet management pathways remain understudied. We evaluated clinical outcomes following the implementation of a CHS management algorithm in a pediatric ED. We conducted a retrospective study of encounters by adolescents before and after implementation of a CHS management algorithm in an academic pediatric ED from July 2020 to July 2024. We examined medications administered, length of stay, disposition, and return visits before and after implementation using chi-square, Fisher exact, or Mann-Whitney U tests as appropriate. We used mixed-effects models to examine the association of time period and admission rates, adjusting for age, sex, and emergency severity index level. A similar model examined the association of time period and ED length of stay that was also adjusted for total daily ED arrivals. Of 533 screened encounters, 128 met inclusion criteria, representing 44 uniqu

Dr. Caplan’s Take

“This is a development worth tracking. The clinical implications will become clearer as more evidence accumulates.”

Clinical Perspective
🧠 Clinicians should review this item in the context of their current practice and patient population.

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📰 Source: [https://pubmed.ncbi.nlm.nih.gov/42003265/](https://pubmed.ncbi.nlm.nih.gov/42003265/)

Table of Contents

- [FAQ](#FAQ)[Why study a CHS management algorithm in a pediatric emergency department?](#Why_study_a_CHS_management_algorithm_in_a_pediatric_emergency_department)
- [How was the pediatric CHS algorithm study designed?](#How_was_the_pediatric_CHS_algorithm_study_designed)
- [What outcomes were compared before and after the CHS algorithm?](#What_outcomes_were_compared_before_and_after_the_CHS_algorithm)
- [Related](#Related)

## FAQ

### Why study a CHS management algorithm in a pediatric emergency department?

[Cannabis hyperemesis syndrome](https://cedclinic.com/remediated-cannabis-mold-contamination-risks/) is an increasingly common cause of pediatric emergency department visits, yet management pathways remain understudied. To address this, the researchers evaluated clinical outcomes after a standardized CHS management algorithm was implemented in a pediatric emergency department.

### How was the pediatric CHS algorithm study designed?

It was a retrospective study of encounters by adolescents at an academic pediatric emergency department from July 2020 to July 2024. Researchers compared encounters before and after the CHS management algorithm was implemented. Of 533 screened encounters, 128 met the study’s inclusion criteria.

### What outcomes were compared before and after the CHS algorithm?

Researchers examined medications administered, length of stay, disposition, and return visits. Mixed-effects models assessed admission rates while adjusting for age, sex, and emergency severity index level, and a similar model of emergency department length of stay was also adjusted for total daily emergency department arrivals.

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### Related

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### Verification & Medical Governance

- **Lead Clinical Author:** Benjamin Caplan, MD
- **Credentials:** Board Certified in Family Medicine (ABFM), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House).
- **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`).
- **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/).
- **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637).
- **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).