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
This test is 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 always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.
Additional Tests
Lists tests that are always performed, at an additional charge, with the initial tests.
| Test Id | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| COCH | Chain of Custody Processing | No | Yes |
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.
Method Name
A short description of the method used to perform the test
Headspace Gas Chromatography Flame Ionization Detector (HSGC-FID)
NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.
Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test
Aliases
Lists additional common names for a test, as an aid in searching
Acetone
Alcohol
Ethanol
Ethyl Alcohol
ETOH (Ethanol)
Isopropanol
Methanol
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.
Specimen Type
Describes the specimen type validated for testing
Whole blood
Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing
Supplies: Chain-of-Custody Kit (T282)
Container/Tube: Chain-of-Custody Kit containing the specimen container seals and documentation required.
Preferred: Gray top (potassium oxalate/sodium fluoride)
Acceptable: Lavender top (EDTA) or green top (sodium heparin)
Specimen Volume: 2 mL
Collection Instructions:
1. Do not use alcohol to clean arm. Use alternative such as Betadine to cleanse arm before collecting any specimen for volatile testing.
2. Specimen must be sent in original tube. Collect specimen, seal, and submit with the associated documentation to satisfy the legal requirements for chain of custody testing.
Forms
Chain of Custody Request is included in the Chain-of-Custody Kit (T282)
Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.
0.5 mL or amount to fill 1 tube
Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected
| Gross hemolysis | OK |
| Gross lipemia | Reject |
| Gross icterus | OK |
Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole blood | Refrigerated (preferred) | 14 days | |
| Ambient | 24 hours | ||
| Frozen | 28 days |
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
This test is 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 always under the control of personnel involved with testing the specimen; 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 one of the most widely abused legal substances 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 (0.08%).
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 that 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 that may result in intoxication, CNS depression, and metabolic acidosis.
Isopropanol:
The presence of isopropanol indicates exposure that 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, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 43
2. Mayfield J, Mihic SJ. Ethanol. In: Brunton LL, Knollmann BC. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 13th ed. McGraw-Hill Education; 2022:chap 27
3. Olson KR, Anderson IB, Benowitz NL, et al. Specific Poisons and Drugs: Diagnosis and Treatment. In: Poisoning and Drug Overdose. 8th ed. McGraw-Hill; 2022:section II
Method Description
Describes how the test is performed and provides a method-specific reference
Samples are analyzed and quantified by headspace gas chromatography with flame ionization detection.(Baselt RC. Disposition of Toxic Drugs and Chemicals in Man. 10th ed. Biomedical Publications; 2014:2211)
PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information
Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.
Monday through Saturday
Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.
Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location
Indicates the location of the laboratory that performs the test
Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
- Authorized users can sign in to Test Prices for detailed fee information.
- Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
- Prospective clients should contact their account representative. For assistance, contact Customer Service.
Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
CPT codes are provided by the performing laboratory.
CPT codes are provided by the performing laboratory.
80320
G0480 (if appropriate)
LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.
| Test Id | Test Order Name | Order LOINC Value |
|---|---|---|
| VLTBX | Volatile Screen, CoC, B | 41266-8 |
| Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
|---|---|---|
| 36241 | Volatile Scrn, B | 41266-8 |
| 36242 | Methanol, B | 9334-4 |
| 36243 | Ethanol, B | 5640-8 |
| 36244 | Acetone, B | 9425-0 |
| 36245 | Isopropanol, B | 5667-1 |
| 36246 | Chain of Custody | 77202-0 |