Neonatal ethanol exposure from sanitizers in isolettes: a bench study.

BACKGROUND: Ethanol-based hand sanitizer (EBHS) is used repeatedly in neonatology. Inadequately dried hands can increase ambient ethanol concentrations in air, especially in a small, enclosed space as isolette. We sought to better document the potential exposure to alcohol vapors on a newborn placed in an isolette, by mimicking common neonatal situations. METHODS: EBHS were rubbed on hands for 10 or 30 seconds, before inserting hands in the isolette of 1 or 2 experimenters for 6 minutes. Ethanol concentrations were measured every 30 seconds with photoionization detector. RESULTS: Twenty-six trials were made, with 286 measurements. With four hands, the concentration peak was in mean about 700 (±900) ppm and with two hands about 300 ppm. With 10-second rubbing time, the concentrations peak was in mean about 850 ppm, and with 30-second rubbing time, mean concentrations were about 100 pm. When respecting normal use (rubbing time 30 seconds), observed ethanol concentrations were low, always below 200 ppm with 2 or 4 hands. CONCLUSIONS: Concentrations of ethanol are very high when drying of EHBS is incomplete. The exposure is of short duration, but ethanol inhalation may be negatively experienced by the child during procedures, especially since they may be frequent and repeated. To minimize the child's exposure to ethanol, we suggest the hands should be completely dried before being inserted into the isolette.

Pulmonary contusion after bumper car collision: Case report and review of the literature.

Thoracic trauma is a major source of morbi-mortality in injured children. Their pliable chest wall makes pulmonary contusion the most common chest injury. It is most often secondary to blunt trauma caused by traffic accidents. We report a case of severe chest trauma caused by a bumper car collision in an 8-years old girl. She sustained right lung contusion that led to complete atelectasis. After a week of supportive therapy, bronchoscopy removed a mucous plug from the main bronchus, resulting in significant clinical improvement. We aim to raise awareness of the risk of severe chest injuries during bumper car collisions.

Coexistence of Subdural Hematoma and a Rare Cardiopathy in an Infant: Etiological and French Medicolegal Discussion.

During legal proceedings following the unexpected death of an infant, the magistrate calls on an expert to clarify the causes of death and to decide on the course to be taken. A report was made following the death of a 7-month-old baby girl after recovery from cardiac arrest when investigations of the cause revealed a subdural hematoma (SDH). We discuss the interconnection of these two entities and their role in the lethal process. In this infant, two distinct lesions with medicolegal implications were simultaneously present: on the one hand histiocytoid cardiopathy, and on the other hand SDH, which could result from ill-treatment. The case of this infant reminds us that the role of the pediatrician is to report the suspicion, whereas the role of the medical expert is to inform the magistrate as to the reality of abuse and its implication in the lethal process.