The rising incidence of intentional ingestion of ethanol-containing hand sanitizers
The rising incidence of intentional ingestion of ethanol-containing hand sanitizers
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DOI：
10.1097/ccm.0b013e31822f09c0
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发表时间：
2012-01-01
影响因子：
8.8
通讯作者：
Suffredini, Anthony F.
中科院分区：
文献类型：
--
作者：
Gormley, Nicole J.;Bronstein, Alvin C.;Suffredini, Anthony F.
目的：描述我院一例故意摄入洗手液的病例，并回顾已发表的病例和美国毒物控制中心协会国家毒物数据系统报告的病例。设计：病例报告，已发表病例的文献综述，以及国家毒物数据系统的查询。设置：医疗重症监护室。患者：17岁男性，体重37公斤，故意将洗手液产品摄入胃造瘘管。干预措施：插管、通气和血液透析。测量和主要结果：2005年至2009年美国报告的无意和有意摄入含乙醇洗手液病例的发生率和结局一项文献检索发现了14例故意使用含酒精洗手液的详细病例报告，其中1例死亡。从2005年到2009年，国家毒物数据系统收到了68,712份接触96种乙醇洗手液的报告。新病例数平均每年增加1，894例（95%置信区间[CI] 1266-2521）（p = .002）。2005年，每百万美国人每年的暴露率。S.居民死亡率为33.7（95% CI 28.4-39.1）;从2005年到2009年，这一比率平均每年增加5.87（95% CI 3.70-8.04; p = 0.003）。在2005年，故意暴露率，每年，每百万美元。S.居民，为0.68（95%CI 0.17-1.20）;从2005年到2009年，这一比率平均每年增加0.32（95%CI 0.11-0.53; p = 0.02）。结论：在这5年期间，每年故意摄入洗手液的新病例数显著增加。虽然大多数情况下，洗手液摄入有一个良好的结果，288中度和12个主要的医疗结果报告在这个国家毒物数据系统队列。提高对故意摄入相关风险的认识是必要的，特别是在照顾有药物滥用史，冒险行为或自杀意念的人的医疗保健提供者中。(Crit Care Med 2012; 40：290-294）
Objective: To describe a case of intentional ingestion of hand sanitizer in our hospital and to review published cases and those reported to the American Association of Poison Control Centers' National Poison Data System.Design: A case report, a literature review of published cases, and a query of the National Poison Data System.Setting: Medical intensive care unit.Patient: Seventeen-yr-old male 37-kg with an intentional ingestion of a hand sanitizer product into his gastrostomy tube.Interventions: Intubation, ventilation, and hemodialysis.Measurements and Main Results: Incidence and outcome of reported cases of unintentional and intentional ethanol containing-hand sanitizer ingestion in the United States from 2005 through 2009. A literature search found 14 detailed case reports of intentional alcohol-based hand sanitizer ingestions with one death. From 2005 to 2009, the National Poison Data System received reports of 68,712 exposures to 96 ethanol-based hand sanitizers. The number of new cases increased by an average of 1,894 (95% confidence interval [CI] 1266-2521) cases per year (p = .002). In 2005, the rate of exposures, per year, per million U. S. residents was 33.7 (95% CI 28.4-39.1); from 2005 to 2009, this rate increased on average by 5.87 per year (95% CI 3.70-8.04; p = .003). In 2005, the rate of intentional exposures, per year, per million U. S. residents, was 0.68 (95% CI 0.17-1.20); from 2005 to 2009, this rate increased on average by 0.32 per year (95% CI 0.11-0.53; p = .02).Conclusions: The number of new cases per year of intentional hand sanitizer ingestion significantly increased during this 5-yr period. Although the majority of cases of hand sanitizer ingestion have a favorable outcome, 288 moderate and 12 major medical outcomes were reported in this National Poison Data System cohort. Increased awareness of the risks associated with intentional ingestion is warranted, particularly among healthcare providers caring for persons with a history of substance abuse, risk-taking behavior, or suicidal ideation. (Crit Care Med 2012; 40: 290-294)