Alcohol
| Order Code: | ALCH |
| Order Form: | Laboratory Requisition |
Specimen:
Plasma
Collection Medium:
 |
| Plasma Separator Tube |
Alternate
Collection Media:
Call laboratory for additional acceptable specimen collection containers.
Minimum:
3 mL whole blood in light green top tube or TWO microtainers
Rejection Criteria:
Medico-legal specimens are not accepted.
Testing
Schedule:
0700-1530 Monday through Friday.
Analytic Time:
4 hours (upon receipt in laboratory)
Reference Range:
Ethanol intoxication begins in the 50-100 mg/dL range.
Clinical toxicity for methanol and isopropanol can occur at concentrations of 10 mg/dL or greater.
Critical Values:
Methanol 10 mg/dL or greater
Isopropanol 10 mg/dL or greater
Ethanol 300 mg/dL or greater
(NOTE: for patients admitted to the hospital who get multiple alcohol determination by gas chromatography, only the first plasma concentration exceeding the values above are treated as critical values, i.e., follow-up levels are not called as critical values to the ordering clinician).
Clinical toxicity for methanol and isopropanol can occur at concentrations of 10 mg/dL or greater.
Critical Values:
Methanol 10 mg/dL or greater
Isopropanol 10 mg/dL or greater
Ethanol 300 mg/dL or greater
(NOTE: for patients admitted to the hospital who get multiple alcohol determination by gas chromatography, only the first plasma concentration exceeding the values above are treated as critical values, i.e., follow-up levels are not called as critical values to the ordering clinician).
Comments:
This procedure individually quantitates methanol, ethanol, isopropanol
and acetone by gas chromatography. Prior to testing for alcohols by
gas chromatography, the sample will have a preliminary ethanol/
volatiles screen (EVS) performed. An EVS includes plasma ethanol,
plasma osmolality, and a calculated osmolality using plasma sodium,
glucose and urea. See links below for further information concerning
the osmolality gap.
Note: the osmolality gap, which is the difference between measured
osmolality and calculated osmolality, must be >15 before gas
chromatography testing will be initiated. An osmolality gap of
< or 15 will be called to the requesting facility/physician by
Pathology staff to discuss our findings and determine if further
testing is warranted. Glycols (ethylene or propylene) testing by gas
chromatography is also subject to a preliminary EVS screen.
Availability: As needed - subject to the screening procedure described
above.
Test
Limitations:
Sample Integrity Confirmation
References:
(1) Young DS. Effects of Drugs on Clinical Laboratory Tests. 3rd ed.
Washington, DC: AACC Press; 1990.
(2) Young DS. Effects of Preanalytical Variables on Clinical Laboratory
Tests. Washington, DC: AACC Press; 1993: 3-120, 3-121.
Methodology:
Gas Chromatography
Instructions:
Separate plasma from cells asap.
Sample
Processing:
Centrifuge at 3000 RPM for 10 minutes.
Aliquot plasma into labeled container and cap.
Label transport tube with two patient identifiers, date and time of collection.
Aliquot plasma into labeled container and cap.
Label transport tube with two patient identifiers, date and time of collection.
Sample
Storage:
Refrigerate.
Transport
Instructions:
Place specimen into zip-lock type bag, seal bag.
Place requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.
Place requisition into outside pocket of bag.
Transport in cooler with refrigerated coolant packs.
CPT Code:
84600
See also:
Ethanol/Volatiles Screen (EVS), Plasma
Ethylene Glycol, Plasma
Glycols (Ethylene and Propylene), Plasma
Ethanol/Volatiles Screen (EVS), Plasma
Ethylene Glycol, Plasma
Glycols (Ethylene and Propylene), Plasma
See Additional Information:
Chemistry Critical Lab Values
Osmolality Gap - Calculation and Interpretation
Osmolality Gap Calculator
Chemistry Critical Lab Values
Osmolality Gap - Calculation and Interpretation
Osmolality Gap Calculator