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February 2007 Issue

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Resident's Past Training Leads to Unique Case Study

Published February 2007

A UC resident's training in organic chemistry is credited for his swift assessment of a patient at University Hospital-and that quick thinking resulted in an interesting case study appearing in the Feb. 1, 2007, issue of the New England Journal of Medicine.
Ashkan Emadi, MD, PhD, an internal medicine resident with a degree in organic chemistry, discovered that a 43-year-old alcoholic man-with no initial abnormalities on his toxicology screening-was suffering from isopropanol poisoning after drinking the alcohol-based hand sanitizer from the container in his room.
Because many people with alcoholism metabolize alcohol differently from those without the disease, Emadi's patient did not need dialysis treatment and recovered fully.
But, Emadi warns, the concentration of isopropyl alcohol in hand sanitizers can be deadly even if consumed in small doses. 

For that reason, Emadi and coauthor LeAnn Coberly, MD, suggest a labeling change on all hospital hand sanitizer dispensers that may dissuade patients, particularly those with alcoholism, from drinking the dangerous chemical.
But while effecting change like altering the soap-dispenser labeling may be a long way off, the two authors say they hope to increase awareness among physicians of the potential dangers of this form of intoxication.

"Physicians should be aware of the potential for isopropanol intoxication, especially among alcoholics, in the hospital setting," the authors write.
Their case study has already raised awareness among house staff at University Hospital.
"I've had people tell me that since hearing about the case, they've moved these dispensers out of rooms of patients with alcoholism," says Emadi.

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