Severe ethanol poisoning: a case report and brief review

A case of severe ethanol toxicity is described where a patient was admitted pulseless, apnoeic and deeply unconscious after ingesting a full bottle (1 litre) of 'methylated spirits' The initial blood ethanol level was 1.127 g/dL. The patient was rapidly intubated and resuscitated with fluids and inotropic agents. Renal replacement therapy was initiated and a rapid reduction in the initial blood ethanol level occurred. Twenty-one hours after her admission she was conscious and cooperative and was discharged from the intensive care unit without any clinical evidence of brain injury. Ethanol toxicity is common although ethanol poisoning leading to death is rare. Nevertheless, severe toxicity can cause medullary paralysis with respiratory failure and death. Rapid resuscitation and, in severe cases, renal replacement therapy may be warranted as the outlook for patients who recover is excellent.