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.
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
COCH | Chain of Custody Processing | No | Yes |
Headspace Gas Chromatography-Flame Ionization Detector (HSGC-FID)
Acetone
Alcohol
Ethanol
Ethyl Alcohol
ETOH (Ethanol)
Isopropanol
Methanol
Whole blood
Supplies: Chain-of-Custody Kit (T282)
Container/Tube: Chain-of-Custody Kit containing the specimen container seals and documentation required.
Preferred: Grey top (potassium oxalate/sodium fluoride)
Acceptable: Any anticoagulant
Specimen Volume: 1 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.
Chain of Custody Request is included in the Chain-of-Custody Kit (T282).
0.5 mL or amount to fill 1 tube
Gross hemolysis | OK |
Gross lipemia | Reject |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole blood | Refrigerated (preferred) | 14 days | |
Frozen | 28 days | ||
Ambient | 24 hours |
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.
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.
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
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.
This test does not detect ethylene glycol.
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
Specimens are analyzed and quantified by headspace gas chromatography- flame ionization detection.(Baselt RC. Disposition of Toxic Drugs and Chemicals in Man, 10th edition, Biomedical Publications; 2014. pp 2211)
Monday through Saturday
This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.
80320
G0480 (if appropriate)
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 |