EDITOR—A 3 year old boy was found collapsed and unresponsive at home by his mother. While waiting for the ambulance his mother discovered that a bottle of mouthwash was not in its usual place and she feared that her son had ingested some.

On arrival at the accident and emergency department, the child was comatose (Glasgow coma scale score 3) but breathing on his own, and his oxygen saturation was good. He was hypothermic (core temperature 34.2°C), and capillary refill time was 3 seconds. A minty odour was detectable on his breath.

Initial blood glucose estimation was 2.1 mmol/l, and he received 3 ml/kg of 10% dextrose and 20 ml/kg of colloid. At 10 …