Do you know what products contain alcohol (ethanol) in your home? Many products used on a daily basis contain ethanol as part of their normal constituents. Increasing patient awareness of these products educates and prevents accidental poisoning. Normally we think of beer, wine, whiskey and other “drinking” alcohol as containing ethanol. Typical ethanol concentrations in these products are 4-6% for beer, 10-20% wine, and “hard liquors” 20-50%.
Because concentrations in home products are quite high, ingestion of relatively small amounts may cause symptoms. Typical household items include mouthwash (15-27%), cough and cold preparations (25%), perfume and colognes (50%), aftershaves (50-90%), hairspray (25-80%). The volume needed to be ingested to cause inebriation (blood alcohol level ~100mg/dL) in a “typical” 15 kg, two year old child would be 50 mL of mouthwash (20%), 40 mL of a cough/cold preparation (25%), 20 mL of a perfume/cologne (50%), 20 mL of aftershave (50%), and 15 mL of hairspray (70%) Remember that the “average” volume of a swallow for a child between 2-4 years of age is about 4.5 mL.
Significant amounts of these products cause CNS depression along with its complications of aspiration and possibly trauma. A more common problem in young children is hypoglycemia, which may be associated with seizures, coma and death. Although hypoglycemia is more common in young children, it may also occur in older children and adults. There are reports of hypoglycemia following chronic ethanol ingestion.
If ethanol has been ingested, watch for development of CNS depression and support the patient as appropriate. Consider the potential for hypoglycemia and give glucose supplementation as indicated.
Question prepared by: John Benitez, M.D., MPH Medical Toxicologist
I am interested in any questions you would like answered in the Question of the Week. Please email me with any suggestion at firstname.lastname@example.org
Donna Seger, M.D.
Tennessee Poison Center
Poison Help Hotline: 1-800-222-1222
NATIONAL POISON PREVENTION WEEK, MARCH 15-21, 2009