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Safety warning for Victorian hospitals after patients drink, ignite hand sanitiser
Victorian hospitals are being urged to restrict access to hand sanitiser after a patient drank half a bottle of the substance in an emergency department and was admitted to intensive care.
In another recent case, a patient used hand sanitiser as an accelerant and set fire to their bed and blanket. They also threw the sanitiser at a health worker’s face, causing an eye injury.
Two recent incidents involving hand sanitiser misuse in Victorian health services have prompted WorkSafe to issue new guidance.Credit: Getty Images
The two incidents have prompted WorkSafe to issue a safety alert to healthcare services about the risks of hand sanitiser misuse. It recommends that health services remove bottles from areas where vulnerable people may be present.
The health and safety regulator has also recommended that health services make hand sanitiser containers more difficult to open by using brackets, dispensers or tamper-proof lids. It also advised using smaller bottles or different forms of sanitiser – such as thick gel or wipes – that are more difficult to ingest or ignite.
“The easy accessibility of alcohol-based hand sanitiser can pose risks where vulnerable people are present – for example, patients with clinical conditions such as alcohol dependence or other behaviours of concern,” it said.
New data obtained by The Age reveals that the Victorian Poisons Information Centre has received 5060 calls about hand sanitiser exposure over the past five years. While these inquiries peaked during the pandemic, they remained high last year, with 791 calls.
These exposures may include adults who consumed the product or children who accidentally got the substance in their eye or licked the lid of a container, according to a spokeswoman from Austin Health, which manages the information centre.
While hand sanitiser boomed in popularity during the pandemic, its misuse has been a long-running issue for health services.
Australian Medical Association Victorian president Simon Judkins treated a patient about a decade ago who had ingested a bottle of hand sanitiser that he found in the emergency department of a Melbourne hospital. The patient ended up in intensive care.
“The patient had a mental health background and was in the middle of being assessed,” Judkins recalled.
Emergency medicine physician Simon Judkins.Credit: Jason South
“It didn’t take long for him to take the top off the bottle and drink it. It was 30 seconds.”
Fortunately, the patient survived, but Judkins said the high concentration of alcohol made him incredibly unwell.
He said that as well as leading to intoxication, drinking hand sanitiser could cause neurological issues, seizures and cardiovascular issues.
But he said restricting hand sanitisers in health facilities could cause more harm than good. He said the antiseptic reduced hospital infections and the spread of disease.
“If you remove hand sanitiser, things will go backwards,” he said.
“It has to be there on the end of every bed and in nursing stations. If you don’t have that visual reminder, [hand hygiene] is going to slip. It is all about risk versus benefits.”
Associate Professor Mark Putland, the Victorian faculty chair of the Australasian College for Emergency Medicine, said hand sanitiser was widely available in emergency departments because it was essential – along with hand-washing – for stopping the spread of infections.
He said many hospitals routinely stocked a foam or gel-based sanitiser, instead of a liquid, to minimise the risk of misuse.
The Royal Children’s Hospital.Credit: Simon Schluter
“Ultimately, any risk posed by the misuse of hand sanitiser in hospital settings is one that cannot be entirely eliminated, but instead reduced and managed as much as possible,” he said.
One emergency doctor, who wanted to remain anonymous as he was not authorised to speak publicly, said hand sanitiser misuse was an issue in many emergency departments across the country.
“It has become an issue post-COVID,” he said. “Some people do enjoy drinking it.”
In the first case highlighted by WorkSafe, a patient with a history of alcohol intoxication consumed about 300 millilitres of liquid sanitiser (from a 600-millilitre bottle) that contained more than 70 per cent alcohol. The bottle was easily accessible to members of the public in an emergency department, according to WorkSafe.
The second incident involved a patient setting fire to their bed and blanket in a four-bed room. “The alcohol-based sanitiser was used as an accelerant,” WorkSafe said. “The patient also threw the sanitiser at an employee’s face causing an eye injury and contaminating their clothing.”
In 2015, a three-year-old Victorian girl suffered severe alcohol poisoning after playing with a bottle at home and ingesting the substance.
She was treated at the Royal Children’s Hospital, where doctors found she had a level of alcohol in her blood that was equivalent to five times the legal driving limit.
She was admitted to the intensive care unit and recovered over 24 hours.
And in 2011, doctors at The Alfred hospital reported a 45-year-old patient with an alcohol dependency consumed six bottles of hand sanitiser, equivalent to about 20 bottles of beer.
A Department of Health spokeswoman said that while the recent incidents were concerning, they were rare. “Our health services are taking the issue seriously,” she said.
She said individual health services made their own decisions about the placement of hand sanitiser based on clinical need and patient safety.
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