It should be noted that these legal definitions have little or no clinical meaning in the emergency department. A wide variety of technologies are available to quantify alcohol in biological fluids. The laboratory, with advice from the ED, should clearly identify the type of technology used, the specimen of choice, and the report units. The vast majority of clinical alcohol assays is the alcohol dehydrogenase enzymatic assay in serum. An absolute conversion of serum to whole blood alcohol concentration should not be made.
Ethylene glycol also contributes to significant renal tubular necrosis.
Detection of these intoxicants in blood is important for therapeutic management. Clinical laboratories should provide direct measurements for methyl alcohol and ethylene glycol in serum or plasma. The most definitive method for methanol, ethylene glycol and acetone is gas chromatography, while this technique is not widely available in most clinical laboratories, the Committee recommends its use for delivering stat results. Due to the low volume of testing for these analytes, there are no prepackaged commercial reagents for these tests. This assay requires removal of the endogenous triglyceride concentration with the addition of lipase to the reagent.