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Interpretive Handbook

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Test 89190:
Volatile Screen, Blood

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.

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 which correlates with the 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

This test does not detect ethylene glycol.

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

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

1. Caplan YH: In 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