title: Acute ethanol poisoning in a 6-year-old girl following ingestion of alcohol-based hand sanitizer at school.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Pediatric Emergency Medicine, University of Florida, Department of Emergency Medicine, Jacksonville, Florida, USA (Joseph MM, Reader S)Our Lady of the Lake Regional Medical Center, Pediatric Residency Program, Baton Rouge, Louisiana, USA (Zeretzke C) University of Florida College of Pharmacy and College of Medicine, Department of Emergency Medicine University of Florida Health Science Center-Jacksonville, USA (Sollee DR).
authors.forename: Madeline Matar
authors.initials: MM
authors.lastname: Joseph
authors.affiliation: Division of Pediatric Emergency Medicine, University of Florida, Department of Emergency Medicine, Jacksonville, Florida, USA (Joseph MM, Reader S)Our Lady of the Lake Regional Medical Center, Pediatric Residency Program, Baton Rouge, Louisiana, USA (Zeretzke C) University of Florida College of Pharmacy and College of Medicine, Department of Emergency Medicine University of Florida Health Science Center-Jacksonville, USA (Sollee DR).
authors.forename: Cristina
authors.initials: C
authors.lastname: Zeretzke
authors.affiliation: Division of Pediatric Emergency Medicine, University of Florida, Department of Emergency Medicine, Jacksonville, Florida, USA (Joseph MM, Reader S)Our Lady of the Lake Regional Medical Center, Pediatric Residency Program, Baton Rouge, Louisiana, USA (Zeretzke C) University of Florida College of Pharmacy and College of Medicine, Department of Emergency Medicine University of Florida Health Science Center-Jacksonville, USA (Sollee DR).
authors.forename: Sara
authors.initials: S
authors.lastname: Reader
authors.affiliation: Division of Pediatric Emergency Medicine, University of Florida, Department of Emergency Medicine, Jacksonville, Florida, USA (Joseph MM, Reader S)Our Lady of the Lake Regional Medical Center, Pediatric Residency Program, Baton Rouge, Louisiana, USA (Zeretzke C) University of Florida College of Pharmacy and College of Medicine, Department of Emergency Medicine University of Florida Health Science Center-Jacksonville, USA (Sollee DR).
authors.forename: Dawn R
authors.initials: DR
authors.lastname: Sollee
keywords: Altered mental status; Ethanol; Hand-sanitizer; Pediatrics; Toxicology