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Test Code VLTUX Volatile Screen, Chain of Custody, Random, Urine

Useful For

Detecting the presence of acetone, methanol, isopropanol, or ethanol in urine with subsequent quantitation

 

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 always under the control of personnel involved with testing the specimen; this control implies that the opportunity for specimen tampering would be limited.

Additional Tests

Test ID Reporting Name Available Separately Always Performed
COCH Chain of Custody Processing No Yes

Testing Algorithm

This test includes analysis of methanol, ethanol, isopropanol, and acetone.

Reporting Name

Volatile Screen, CoC, U

Specimen Type

Urine


Ordering Guidance


For best clinical correlation, the recommended test is VLTBX / Volatile Screen, Chain of Custody, Blood.



Additional Testing Requirements


If urine creatinine is required or adulteration of the sample is suspected, order ADLTX / Adulterants Survey, Chain of Custody, Random, Urine in addition to this test.



Specimen Required


Supplies: Chain-of-Custody Kit (T282)

Container/Tube: Chain-of-Custody Kit containing the specimen containers, seals, and documentation required.

Specimen Volume: 10 mL

Collection Instructions: Collect a random urine specimen using the container provided, seal, and submit with the associated documentation to satisfy the legal requirements for chain of custody testing.


Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 14 days
  Frozen  28 days
  Ambient  24 hours

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

Urine provides a medium for easy screening for methanol, ethanol, isopropanol, and acetone.

 

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.

Reference Values

Methanol

Not detected (Positive results are quantitated.)

Cutoff concentration: 10 mg/dL

Toxic concentration: ≥10 mg/dL

 

Ethanol

Not detected (Positive results are quantitated.)

Cutoff concentration: 10 mg/dL

 

Isopropanol

Not detected (Positive results are quantitated.)

Cutoff concentration: 10 mg/dL

Toxic concentration: ≥10 mg/dL

 

Acetone

Not detected (Positive results are quantitated.)

Cutoff concentration: 10 mg/dL

Toxic concentration: ≥10 mg/dL

Interpretation

Methanol:

The presence of methanol indicates exposure that 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 that may result in intoxication, CNS depression, and metabolic acidosis.

 

Isopropanol:

The presence of isopropanol indicates exposure that 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.

Cautions

Quantitation of acetone, methanol, isopropanol, or ethanol in urine correlates poorly with degree of intoxication.

Clinical Reference

1. Langman LJ, Bechtel LK, Holstege CP. Clinical toxicology. In: Rifai N, Chiu RWK, Young I, Burnham CD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023;chap 43

2. Mayfield J, Mihic SJ. Ethanol. In: Brunton LL, Knollmann BC, eds. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 13th ed. McGraw-Hill Education; 2012:chap 27

3. Olson KR, Anderson IB, Benowitz NL, et al. Specific Poisons and Drugs: Diagnosis and Treatment. In: Poisoning and Drug Overdose. 8th ed. McGraw-Hill; 2022:section II

Method Description

Samples are analyzed and quantified by headspace gas chromatography with flame ionization detection.(Baselt RC. Disposition of Toxic Drugs and Chemicals in Man. 10th ed. Biomedical Publications; 2014:2211)

Day(s) Performed

Monday through Saturday

Report Available

1 to 2 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80320

G0480 (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
VLTUX Volatile Screen, CoC, U 24350-1

 

Result ID Test Result Name Result LOINC Value
36247 Volatile Scrn, U 12983-3
36248 Methanol, U 5695-2
36249 Ethanol, U 5645-7
36250 Acetone, U 5570-7
36251 Isopropanol, U 9434-2
36252 Chain of Custody 77202-0

Method Name

Headspace Gas Chromatography Flame Ionization Detector (HSGC-FID)

Secondary ID

62746

Forms

1. Chain of Custody Request is included in the Chain-of-Custody Kit (T282).

2. If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Specimen Retention Time

2 weeks