Emergency casebook
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We report 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 conscious level was reduced. Supportive measures were sufficient to allow the patient’s blood pressure and temperature to recover 24 h post-ingestion. The clinical manifestations of ethanol toxicity are often confounded by co- existent drug ingestion, and variable periods of unconsciousness prior to 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 to 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 are normally abstinent from alcohol.
Wilson E,
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