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Many thanks to those who responded - some very rapidly - one in fact beat the out of office replies! Reference was drawn to a similar topic in June 2007 which, shame on me, I overlooked. Of the responses received, there was a majority suggesting anti-freeze or car windscreen wash and a suggestion to check Ethylene Glycol. Blue coloured tablets were also suggested as was the possibility of an indigo blue indicator plus one other suggestion (more later!) When first contacted, we were asked by the team about the possibility of some drugs having been ingested. On a subsequent visit to the ward, the team were getting excited as they thought they had discovered the answer having seen green / blue coloured cleaning fluid on the cleaners trolly. A sample was taken for comparative analysis. When gastric contents were examined, they were sweet smelling -a fruity, berry-like smell and were light blue coloured. pH was 3.8. On screening for drugs none were found. Alcohol was measured and a level of 22 mg/dl obtained. Eth Glycol was not measure but a serum sample showed no osmolal gap and she was quite well after the acute episode. As a hospital inpatient, there was no obvious access to the suggested fluids (though this of course is not an absolute). The analyst, considering the alcohol and fruity smell, considered that perhaps she had taken one of these alco-pop type drinks and consulted the oracle (his teenage son) who immediately advised that the WKD blue vodka drink was the one that smelt of berries. Meanwhile, the contents of the cleaning fluid were checked on the manufacturer's website and confirmed with the company. It contained no alcohol, had small amounts of caustic soda, had a pH of 13.0 and was described as a mild irritant. It was suggested that if she had consumed this, and brought it back up, there should be evidence of inflammation / burning, which were not present. So, some WKD vodka was obtained (purely for scientific purposes!) and we ran spectral scans of the vodka, the stomach contents and the stomach contents - this was not the most helpful as all showed a broad absorption peak in the 660-670 region. In view of the fruity smell we ran sugar chromatography - this showed fructose and sucrose in the vodka, glucose and galactose in the stomach contents so not a direct comparison. What results we have do point towards the blue vodka option - interestingly, when first confronted she did comment, without suggestion, that we would think she was drink WKD - she was otherwise in denial. My colleague is to talk to her again to see if anything further can be learned. But for the moment we think it was WKD or similar so points would appear to go to the person who made that "other suggestion" Joe Dr JP Begley, Clinical Biochemistry Department, Poole Hospital NHS Foundation Trust Longfleet Road Poole BH15 2JB Tel: 01202 442155 Fax: 01202 448454 ________________________________ From: Begley, Joe Sent: Tue 12/02/2008 13:36 To: [log in to unmask] Subject: RE: POCT Audit A young woman with a long history of recurrent abdominal pain was admitted, again with an episode of abdominal pain. While on the ward she vomited - gastric contents were pale blue and sweet smelling! The suspicison is she has taken something and this is being investigated. Any suggestions as to what might be the cause, especially if anything other than the patient's own actions, would be appreciated. Joe Dr JP Begley, Clinical Biochemistry Department, Poole & Royal Bournemouth Hospitals, Dorset ________________________________ From: Clinical biochemistry discussion list on behalf of Annette Thomas Sent: Mon 11/02/2008 12:08 To: [log in to unmask] Subject: Re: POCT Audit Dear Michael, Not a template but a suggested checklist and cross reference to 22870. Kind Regards Annette Annette Thomas Consultant Clinical Biochemist Cardiff and Vale NHS Trust Quality Laboratory Quadrant Centre Cardiff Business park Llanishen Cardiff CF14 5WF Tel 02920 748332 Fax 02920 748336 www.weqas.com ________________________________ From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Colley, Michael Sent: 06 February 2008 16:48 To: [log in to unmask] Subject: POCT Audit Our Quality Lead is about to do a POCT Audit. Does anyone have a good template for this which we could acquire? Michael ________________________________ Swindon & Marlborough NHS Trust Great Western Hospital Marlborough Road Swindon SN3 6BB Tel 01793 60 40 20 http://www.swindon-marlborough.nhs.uk This message and any files transmitted with it are confidential and intended solely for the individual(s) addressed. If you believe you have received this e-mail in error, disclosing, copying, distributing or retaining this message, or any part of it, is strictly prohibited; please notify the sender immediately and delete it from your system. Any views or opinions presented are solely those of the author and do not necessarily represent those of Swindon & Marlborough NHS Trust. All messages sent by the Trust are checked for viruses but this does not, and cannot, guarantee that a virus has not been transmitted. 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