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Emergency Medicine Journal 2007;24:e7; doi:10.1136/emj.2006.041590
© 2007 BMJ Publishing Group Ltd and the College of Emergency Medicine.

EMERGENCY CASEBOOK

Severe hypotension and hypothermia caused by acute ethanol toxicity

E Wilson, W S Waring

Scottish Poisons Information Bureau, Royal Infirmary of Edinburgh, Edinburgh, UK

Correspondence to:
Correspondence to:
Dr W S Waring
Scottish Poisons Information Bureau, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, Scotland, UK; s.waring{at}ed.ac.uk

ABSTRACT

This article reports the time course and clinical features of acute ethanol poisoning in an elderly man who had previously abstained from alcohol. Several hours after ingestion, severe hypotension and hypothermia developed, and the consciousness level was reduced. Supportive measures were sufficient to allow the patient’s blood pressure and temperature to recover by 24 h post ingestion. The clinical manifestations of ethanol toxicity are often confounded by coexistent drug ingestion and variable periods of unconsciousness before arrival at hospital. This case highlights that hypotension and hypothermia may be explained on the basis of severe ethanol poisoning alone, in the absence of any other contributing factors. Clinical features of poisoning may be delayed by several hours and, therefore, patients presenting at the hospital should be considered for observation for at least 4 h after consumption of potentially toxic quantities. More severe toxicity should be anticipated in patients who normally abstain from alcohol.


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This article has been cited by other articles:

  • Headdon, W G, Wilson, P M, Dalton, H. R (2009). The management of accidental hypothermia. BMJ 338: b2085-b2085 [Full Text]  

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