Hand Sanitizer Intoxication in the Emergency Department

Hand hygiene has always been an area of emphasis within the hospital setting, never more so than during the coronavirus disease 2019 (COVID-19) pandemic. The consumption of alcohol-containing hand sanitizer products, whether intentional or accidental, often garners attention, particularly since these products may contain methanol. This report describes a case of surreptitious theft and intentional ingestion of the emergency department's (ED) ethanol-based hand sanitizer by a patient who presented to the ED clinically intoxicated with a high ethanol level. When the patient remained clinically intoxicated for more than 18 hours and had a rising serum ethanol level in the ED, clinicians searched his belongings and found several purloined bottles of the ED's hand sanitizer. When confronted, the patient admitted to ingesting hand sanitizer during his ED stay. This case highlights the need for clinicians to be suspicious of intentional ingestion of ethanol-containing products for at-risk patients. Additionally, it demonstrates that measures and protocols should be put in place that minimize the ability for the inappropriate use of these widely accessible products within the hospital.