Acute ethanol poisoning in a 6—year—old girl following ingestion of alcohol—based hand sanitizer at school.doc

Acute ethanol poisoning in a 6—year—old girl following ingestion of alcohol—based hand sanitizer at school BACKGROUND： Alcohol-based hand sanitizers （ABHSs） have been widely used in homes， workplaces and schools to prevent the spread of infectious diseases. We report a young child unintentionally ingested ABHS at a school， resulting in intoxication. METHODS： The child was a 6-year-old girl who had been brought to the emergency department （ED） for hypothermia， altered mental status （AMS）， periods of hypoventilation， hypothermia and vomiting. Computed tomography of her head revealed nothing abnormal in intracranial pathology. Urine drug screening was negative. Alcohol level was 205 mg/dL on admission. Other abnormal values included potassium of 2.8 mEq/L， osmolality of 340 mOsm/kg and no hypoglycemia. Further investigation revealed that the patient had gone frequently to the class restroom for ingestion of unknown quantities of ABHSs during the day. The patient was admitted for one day for intravenous fluid hydration and close observation of her mental status. RESULTS： The patient was discharged from the hospital the next day without any complications. CONCLUSION： Despite the large safety margin of ABHSs， emergency physicians need to be aware of the potential risk of ingestion of a large amount of such products in children and consider it in the assessment and management of school-age children with acute AMS. KEY WORDS： Pediatrics； Toxicology； Ethanol； Hand-sanitizer； Altered mental status World J Emerg Med 2011；2（3）：232-233 DOI： 10.5847/ wjem.j.1920-8642.2011.03.014 INTRODUCTION ABHSs have been widely used in recent years in hospitals， households and schools for its ability to reduce transmission of gastrointestinal and respiratory illnesses， making it an essential part of the infection control programs at schools.[1，2] Common ABHSs use ethyl alcohol and/or isopropanol with their concentrations ranging from 60% to 65%. Intentional ingestion