Bedside tipple?

Alcohol hand‐gel is now provided at all patient–staff contact points throughout the National Health Service as part of the Department of Health's ”clean your hands” campaign. This potentially could adversely influence patient care as we found out in our hospital. A 53‐year‐old patient admitted with alcoholic liver disease and acute renal failure consumed about 350 ml of spirigel from the container at his bedside. Gastric lavage was not considered safe and he was monitored closely over the next two days. He did not manifest any signs of ethanol intoxication and was discharged in due course. Spirigel contains 70% ethanol and small quantities of glycerol, bitrex and triethanolamine. The features of toxicity are entirely due to the ethanol. The estimated fatal dose for this gentleman was about 600 ml. The presence of bitrex and the consistency of this product discourage ingestion. However, the easy availability of this rather rich source of alcohol could prove tempting to patients known to misuse alcohol. It is perhaps prudent to put in place measures to limit access to alcohol‐containing products for this type of patients.