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Interpretive Handbook

Test 8632 :
Volatile Screen, Serum

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:

-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.

-Methanol and isopropanol are highly toxic; toxicity results from ingestion (exogenous).

-Acetone is generally elevated in metabolic conditions such as diabetic ketoacidosis (endogenous). It also is a metabolite of isopropanol.


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.


On average, the serum or plasma concentration of the alcohols is 1.2-fold higher than blood concentration. For example, the serum or plasma would contain approximately 0.10 g/dL of ethanol in a blood specimen that contains 0.08 g/dL ethanol. Due to potential variations in the serum to whole blood ratio, serum should not be used in a medico-legal context. However, in the context of medical/clinical assessment, serum or plasma may be submitted for analysis.

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

Detection and quantitation of acetone, methanol, isopropanol, and ethanol in serum


Quantification of the concentration of ethanol in serum correlates with degree of intoxication


Evaluation of toxicity to the measured volatile substances

Interpretation Provides information to assist in interpretation of the test results

Toxic concentrations:

-Methanol: > or =10 mg/dL

-Ethanol: > or =400 mg/dL

-Isopropanol: > or =10 mg/dL

-Acetone: > or =10 mg/dL

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

No significant cautionary statements

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.


Not detected (Positive results are quantitated.)

Toxic concentration: > or =10 mg/dL



Not detected (Positive results are quantitated.)

Toxic concentration: > or =400 mg/dL



Not detected (Positive results are quantitated.)

Toxic concentration: > or =10 mg/dL



Not detected (Positive results are quantitated.)

Toxic concentration: > or =10 mg/dL

Clinical References Provides recommendations for further in-depth reading of a clinical nature

1. Caplan YH: Forensic Science Handbook. Vol 1. Edited by R Saferstein. Englewood Cliffs, Prentice Hall, 1982

2. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. Seventh edition. Edited by TW Rall, F Murad. New York, McMillan Publishing, 1985

3. Porter WF, Moyer TP: Clinical toxicology. In Tietz Textbook of Clinical Chemistry. Fourth edition. Edited by CA Burtis, ER Ashwood. Philadelphia, WB Saunders Company, 1993, pp 1155-1235

4. Principles of Forensic Toxicology. Edited by B Levine. Washington DC, American Association of Clinical Chemistry, 1999