Accidental ingestion occurred in the very young, elderly and where patients were confused, while intentional ingestion only occurred in those with alcohol dependency.
Due to the wide variation of individual response and tolerance to ethanol a toxic dose of alcohol hand rub is difficult to establish, say the authors.
In our experience, they say, the more serious effects are seen in those who ingest more than 500ml of hand-rub and this is most likely to occur in the confused (e.g. mistaking it for water) and those with alcohol dependency seeking the desired effect.
They stress that poisoning due to alcohol hand rub remains relatively uncommon, but appears to have increased since their widespread introduction in the UK.
They suggest that in areas that are easily accessible by high risk patients, the larger hand rub dispensers (500ml or more) could be placed within locked secured holders preventing accidental or intentional withdrawal of the container and ingestion.
They conclude that to tackle the relative risks associated with alcohol hand rub ingestion, balanced against the benefits and importance of them in reducing healthcare acquired infection, there needs to be a multidisciplinary and coordinated approach from risk managers, toxicologists and infection control specialists.
Source-BMJ
KAR/P