From the Guidelines
Isopropyl alcohol is toxic if ingested and should never be consumed, as it can cause serious poisoning and even death, but it is safe for external use as a disinfectant at concentrations of 70-91%. The liver converts isopropyl alcohol to acetone, which is more toxic than ethanol (drinking alcohol) 1. While isopropyl alcohol is effective in reducing the number of skin micro-organisms, it does not have any residual activity, unlike chlorhexidine, which exerts an antiseptic effect for up to 24 hours 1.
Some key points to consider when using isopropyl alcohol include:
- It should be kept away from children and stored securely to prevent accidental ingestion 1.
- If someone accidentally ingests isopropyl alcohol, seek immediate medical attention or call poison control at 1-800-222-1222 1.
- Do not induce vomiting unless directed by medical professionals 1.
- Isopropyl alcohol is different from ethanol found in alcoholic beverages and should never be substituted for drinking alcohol 1.
- For external use, a preparation that contains 2% chlorhexidine gluconate/70% isopropyl alcohol is the preferred skin-preparation agent for invasive procedures, including placement of central venous catheters, in children 2 months and older 1.
It's also important to note that the use of chlorhexidine in infants younger than two months of age is not recommended due to potential side effects, and alternative antiseptic solutions should be considered 1. Additionally, catheter connectors, ports, and hubs should be disinfected with 2% chlorhexidine solution in 70% isopropyl alcohol before accessing to prevent intraluminal contamination 1.
From the Research
Isopropyl Alcohol Toxicity
- Isopropyl alcohol (isopropanol) is considered a toxic alcohol, which can cause serious health effects if ingested, inhaled, or absorbed through the skin 2, 3, 4.
- The substance is commonly found in household and commercial products, such as rubbing alcohol, cleaners, disinfectants, and cosmetics 3.
- Isopropyl alcohol poisoning can occur accidentally or intentionally, and it is more common in children under 6 years old 3.
Clinical Effects and Diagnosis
- The clinical effects of isopropyl alcohol poisoning include central nervous system (CNS) depression, respiratory depression, shock, and circulatory collapse 3, 5.
- Diagnosis is typically made based on the patient's history, clinical presentation, and laboratory findings, such as an increased osmolal gap, ketonemia, and ketonuria 3, 5.
- The measurement of isopropanol serum concentrations can also be used to diagnose poisoning, but this may not be readily available 3.
Management and Treatment
- Supportive care is the mainstay of management, with primary emphasis on respiratory and cardiovascular support 3, 5.
- Hemodialysis may be considered in severe cases to enhance the elimination of isopropanol and its metabolites 3, 5.
- Treatment with alcohol dehydrogenase blockers, such as fomepizole, may also be used to manage toxic alcohol poisoning 4, 6.