Most cases of hypothermia during winter months in urban settings are associated with ethanol use. Many homeless persons are heavy users of ethanol and on cold nights may employ ethanol to inure themselves to the effects of low temperature. While the sedative effects of ethanol may result in exposure predisposing to hypothermia, ethanol also directly contributes to body cooling by depressing central thermoregulatory mechanisms, decreasing shivering, and enhancing heat loss through vasodilatation. Management of the hypothermic intoxicated patient is similar to that of hypothermia in other patients. Prognosis is related to severity of hypothermia and the presence of underlying diseases, but does not appear to be adversely affected by ethanol intoxication.
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