The Poison Review

Pediatric Ingestions of Hand Sanitizers: Debunking the Myth.  Mrvos R, Krenzelok EP.  Pediatr Emerg Care Oct 2009;25:665-666.

Abstract

Since alcohol-based hand sanitizers are 124 proof (62% ethanol), they pose a potential threat to small children who may ingest the product.  To measure the gravity of this threat, the authors retrospectively reviewed exposures to these products in children less than 6 years old reported to a regional poison center from January 1, 2000 to March 30, 2007.  They identified 647 cases. There were a handful of children with minor or minimal effects, but none with moderate or major clinical effects attributed to the exposure, and no fatalities.

I did not give this article a skull rating because it is not available online through our university database, and the library no longer subscribes to a hard copy.  This is, I think, becoming a major problem for some very good — but somewhat specialized — journals.  Access to a significant part of the medical literature is becoming impossible unless one subscribes to a specific journal, is willing to pay an exorbitant fee to download a single article online, or has access to a university library and can wait until the article can be special ordered.  Certainly everything that’s available readily online makes researching many topics much easier than it used to be (don’t even get me started on the Index Medicus). But some journals risk becoming marginalized and irrelevant unless they can maintain reasonable access to their content.

By the way, a 2007 letter in Mayo Clinic Proceedings describes at 53-year-old male patient with alcoholism who was found unresponsive in bed on his second day of hospitalization for intoxication.  He had been seen 45 minutes previously with normal mental status.  Laboratory testing showed a serum alcohol level of almost 400 mg/dL.  When the patient sobered up he reported ingesting 450 cc of an ethanol-based hand sanitizer attached to the wall of his room. When he sobered up, he commented: “It had a horrible taste, but I was drunk pretty quick.”