Acute ethanol poisoning in a 6-year-old girl following ingestion of alcohol-based hand sanitizer at school!

[Srijit]

Hello, a 6-year-old girl 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. How to cure this?

[Amit]

@srijit The wide use of ABHSs for hand hygiene in schools, hospitals, offices, and public buildings leads to an increase in the pediatric exposure of such products, but there are no complications in most cases.[6,7] This is due primarily to ingestion of a less significant amount of the hand sanitizer, which causes no intoxication. Of interest, there are increasingly ABHSs with such flavors as warm vanilla sugar, Japanese cherry blossom, coconut lime verbena, and others that come in very attractive bottles. These products could be enticing to young children to ingest enough of them to cause significant intoxication. Measures taken to decrease potential toxicity of ABHSs in children include installation of hand sanitizer stations in schools, which can be appropriately supervised by the teachers and avoidance of food like labeling of hand sanitizers enticing young children to ingest these products.