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HelpTest ID: 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, USpecimen Type
UrineOrdering 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 |
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.
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
Day(s) Performed
Monday through Saturday
Report Available
1 to 2 daysTest 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)
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.
| mml-custody, mml-substancemonitoring |