TEST CATALOG ORDERING & RESULTS SPECIMEN HANDLING CUSTOMER SERVICE EDUCATION & INSIGHTS
Test Catalog

Test ID: VLTBX    
Volatile Screen, Chain of Custody, Blood

Useful For Suggests clinical disorders or settings where the test may be helpful

Detection and quantitation of acetone, methanol, isopropanol, and ethanol in whole blood

 

Quantification of the concentration of ethanol in blood that correlates with the degree of intoxication

 

Evaluation of toxicity to the measured volatile substances

 

Not intended for use in employment-related testing.

 

Providing chain-of-custody for when the results of testing could be used in a court of law. Its purpose is to protect the rights of the individual contributing the specimen by demonstrating that it was under the control of personnel involved with testing the specimen at all times; this control implies that the opportunity for specimen tampering would be limited.

Testing Algorithm Delineates situations when tests are added to the initial order. This includes reflex and additional tests.

This test includes analysis of methanol, ethanol, isopropanol, and acetone.

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Volatile substances in the blood include ethanol, methanol, isopropanol, and acetone. Acetone is generally elevated in metabolic conditions such as diabetic ketoacidosis. Methanol and isopropanol are highly toxic and result from exogenous ingestion.

 

Ethanol is the single most important substance of abuse in the United States. It is the active agent in beer, wine, vodka, whiskey, rum, and other liquors. Ethanol acts on cerebral function as a depressant similar to general anesthetics. This depression causes most of the typical symptoms such as impaired thought, clouded judgment, and changed behavior. As the level of alcohol increases, the degree of impairment progressively increases.

 

In most jurisdictions in the United States, the per se blood level for being under the influence of alcohol (ethanol) for purposes of driving a motor vehicle is 80 mg/dL.

 

Chain of custody is required whenever the results of testing could be used in a court of law. Chain of custody is a record of the disposition of a specimen to document the individuals that collected it, handled it, and performed the analysis. When a specimen is submitted in this manner, analysis will be performed in such a way that it will withstand regular court scrutiny.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

METHANOL

Not detected (Positive results are quantitated.)

Toxic concentration: > or =10 mg/dL

 

ETHANOL

Not detected (Positive results are quantitated.)

Toxic concentration: > or =400 mg/dL

 

ISOPROPANOL

Not detected (Positive results are quantitated.)

Toxic concentration: > or =10 mg/dL

 

ACETONE

Not detected (Positive results are quantitated.)

Toxic concentration: > or =10 mg/dL

Interpretation Provides information to assist in interpretation of the test results

Methanol:

The presence of methanol indicates exposure which may result in intoxication, central nervous system (CNS) depression, and metabolic acidosis. Ingestion of methanol can be fatal if patients do not receive immediate medical treatment.

 

Ethanol:

The presence of ethanol indicates exposure which may result in intoxication, CNS depression, and metabolic acidosis.

 

Isopropanol:

The presence of isopropanol indicates exposure which may result in intoxication and CNS depression. Ingestion of isopropanol can be fatal if patients do not receive immediate medical treatment.

 

Acetone:

The presence of acetone may indicate exposure to acetone; it is also a metabolite of isopropanol and may be detected during ketoacidosis.

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

This test does not detect ethylene glycol.

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Langman LJ, Bechtel LK, Meier BM, Holstege C: Chapter 41: Clinical Toxicology. In: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Edited by N Rifai, AR Horvath, CT Wittwer. Sixth edition. Elsevier; 2018. pp. 832-87

2. Mihic SJ, Koob GF, Mayfield J, Harris RA: Ethanol. In: Goodman & Gilman's: The Pharmacological Basis of Therapeutics, 13th edition. Edited by LL Brunton, R Hilal-Dandan, BC Knollmann. McGraw-Hill Education; 2017

3. Olson KR, Anderson IB, Benowitz NL, et al: Specific Poisons and Drugs: Diagnosis and Treatment. In Poisoning and Drug Overdose, Seventh edition. McGraw-Hill Education; 2017