Emerg Med J 24:e7 doi:10.1136/emj.2006.041590
  • Emergency casebook

Severe hypotension and hypothermia caused by acute ethanol toxicity

  1. E Wilson,
  2. W S Waring
  1. Scottish Poisons Information Bureau, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. 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}
  • Accepted 30 August 2006


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.


  • Competing interests: None declared.

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