Severe Alcohol Hand Rub Overdose Inducing Coma, Watch After H1N1 Pandemic

From Neurocritical Care:

Alcoholic hand rubs (AHRs) have been proven effective in preventing nosocomial infections, and healthcare authorities include AHRs use among quality-of-care criteria. Since the onset of the influenza A (H1N1) pandemic, AHRs have gained considerable popularity among the general public.

We report a case of intentional AHRs self-poisoning inducing rapid coma with hyperlactatemia, and a full recovery. The relevant literature was reviewed. To our knowledge, this is the third reported case of intentional AHRs poisoning. 3 patients presented with a picture of acute alcohol intoxication, of variable severity depending on the amount ingested and speed of ingestion.

The blood alcohol level was 414 mg/dl and tests for other drugs were performed 30 min after admission. The blood lactate level increased briefly to 4.8 mmol/l, without renal or hepatic function disturbances. She regained consciousness after 6 h then achieved a full recovery allowing extubation and readmission to the psychiatric ward after 24 h. She reported gulping down the entire contents of the Aniosgel® bottle.

Whereas overdrinking in social settings (wine and liquor) leads to a gradual increase in blood alcohol levels, AHRs poisoning is usually characterized by a sudden massive alcohol load. The unusual nature of the alcohol source may lead to diagnostic wanderings. AHRs are currently available in bottles that facilitate the ingestion of large amounts. Unit-dose packaging or dispensing might decrease the risk of AHRs poisoning.

Cleveland EMS Rejects Minor Calls to Save Money

From JEMS:

At 7 a.m. today, Cleveland Emergency Medical Services will no longer serve as a hospital taxi for problems such as toothaches, boils and similar illnesses.

Callers with the most serious ailments, such as chest pains and trouble breathing, will still be treated before paramedics are dispatched on low-priority runs. Those lesser calls will not be dispatched until 10 ambulances become available and all life-threatening calls are finished.

County, hospitals team up to reduce seniors’ ER visits

From the Sacramento Bee:

The case management team is an outgrowth of the Sacramento County Board of Supervisors’ 2005 strategic plan for dealing with a looming demographic tidal wave of seniors. The team intervenes in the lives of vulnerable elderly people and dependent adults with a history of largely unnecessary emergency room visits and avoidable hospitalizations.

The program helps keep seniors living in their own homes, said APS program manager Elizabeth Foster-Ward, and has provided significant savings in health care costs.

Although Kaiser Permanente figures were not available, the program saved $1.1 million in hospital costs and emergency services at Sutter Medical Center, said Sutter spokesman Gary Zavoral.

Heroes All


OTTAWA — As Ottawa police officer Eric Czapnik lay dying from a mortal knife wound to the throat, he spoke two final and poignant words to his paramedic rescuers, thanking them.

The patrolman had moments earlier been sitting alone early Dec. 29, writing case notes inside his cruiser parked outside the emergency department of the Ottawa Hospital’s civic campus when a man approached and attacked with a knife.

Four paramedics, none yet publicly identified, ran from the emergency room to help. It wasn’t until a male paramedic grabbed the man in headlock from behind, they realized the assailant had a knife.

As the attacker tried to reach around and stab the male paramedic, a female paramedic wrestled the weapon from his hand. A second female paramedic kicked him in the groin, and all three wrestled him to the ground. Another female paramedic attended to Czapnik.

As he lay dying from the random attack, Czapnik, 51, uttered his last words to the paramedics, according to police sources.

“Thank you,” he said.