Ground coffee accidentally ingested by a one year old.
Case: a one year old female seen early in the day for her routine one year exam(normal) presents to the ER having ingested "about 2 tablespoons" of ground coffee. Emesis was induced and produced REAL "coffee ground emesis". She was asymptomatic except for a sinus tachycardia 140-160.
Parents questioned as to "did she really eat that much coffee?" and we were assured that she "was stuffing in her mouth as fast as she could".
The amount of caffeine in this amount of coffee was the question once we found the toxic dose in children to be 35mg/kg. She weighed 10 kg. We could not find the amount of caffeine in ground coffee.
The father of the child (a physician) remembered that one coffee bean contained 35mg of caffeine(not verified). So the number of beans in one tablespoon of ground coffee were counted out. This number was roughly 40. This calculated to between 1400-2800mg of caffeine ingested by this child. In retrospect this was probably high, because the child looked normal. She was admitted to the hospital and observed. She remained asymptomatic but contiuned the tachycardia. The next morning she was fine, heart rate 110-120, and was dismissed home. Follow up she has had no problems.
Comment: I wish I had gotten a serum caffeine level. Induction of emesis probably helped reduce symptoms. This is the first ingestion of this type which I have been involved or heard.
Poison Control had no information, and later called to get permission for this to be an "index case". Certainly would be nice to have a valid source of knowledge about specific amounts of caffeine in ground coffee so we would not have to use the kitchen lab to grind coffee or do the calculus done in the previous post.
