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Test Code 76479994 Volatiles Screen, Serum

Performing Laboratory

Barnes-Jewish Hospital Laboratory

Methodology

Profile Information:

Acetone

Ethanol

Isopropanol

Methanol

Reflex Information:

Quantitation of positive analytes is performed at an additional charge.

Methadology:

Headspace gas chromatography with flame ionization detection (GC-FID)

Literature References:

Clarke’s Analysis of Drugs and Poisons (Moffat A, Osselton M, Widdop B, eds.), Pharmaceutical Press, Grayslake, IL, 2004.

 

Specimen Requirements

Specimen Type: Serum

Container/Tube: Plain red top

Specimen Volume: Full tube

 

Collection Procedure:

A non-alcohol germicide must be used to cleanse skin. Do not use alcohol wipes for venipuncture.

 

 

Day(s) Test Set Up

Monday through Sunday

Turn Around Time:

Stat: 1 hour after receipt in laboratory

Routine: 1 hour after receipt in laboratory

Reference Values

Methanol:  None detected.  Toxic:  ≥ 20 mg/dL

Ethanol:  None detected.  Toxic:  ≥ 300 mg/dL

Isopropanol:  None detected.  Toxic:  ≥ 50 mg/dL

Acetone: None detected.  Toxic:  ≥ 100 mg/dL

 

Administration of fomepizole or ethanol has been recommended when methanol levels exceed 20 mg/dL and initiation of hemodialysis when levels exceed 50 mg/dL.  Acetone may be observed in diabetic ketoacidosis, alcoholic ketoacidosis, starvation ketosis, or isopropanol intoxication. Isopropanol is metabolized to acetone.

 

If ethanol is the only drug taken, the blood level can be roughly correlated with the clinical findings:

0-100 mg/dL (subclinical)
100-200 mg/dL (emotional instability)
150-300 mg/dL (confusion)
250-400 mg/dL (stupor)
350-500 mg/dL (coma)

≥500 mg/dL (possible death)

Test Classification and CPT Coding

80320 (volatiles screen), (84600)

80320 (ethanol quantitation, if appropriate) (G0480)

80320 (isopropanol quantitation, if appropriate) (84600)

80320 (methanol quantitation, if appropriate) (84600)

80320 (acetone quantitation, if appropriate) (84600)

Additional Information

For BJH Laboratory Use Only

Alternate Tubes:

1 dark green-top (lithium heparin) tube

1 mint green-top (lithium heparin) tube

1 full, grey-top (potassium oxalate/sodium fluoride) tube

1 grey/red top (SST) tube

1 full, lavender-top (EDTA) tube

Analyte Stability:

The specimen may be stored refrigerated at 2° C to 8° C up to 3 days. Freeze specimen for longer storage and avoid repeated freeze-thaw cycles. Specimen is run upon receipt.

Laboratory Processing Instructions:

Test performed in BJH Chemistry.  Log in and deliver immediately to the toxicology area for processing.

Specimen Transport Temperature

Ambient

LOINC Code Information

Name LOINC Code
Methanol 5693-7
Ethanol 5643-2
Isopropanol 5669-7
Acetone 5568-1