Key investigations

Vonghia, 2008

Laboratory investigations are usually unnecessary in patients with clinical features of mild ethanol intoxication. However, all children who have ingested ethanol must have a serum glucose concentration.

For patients with clinical features of moderate to severe ethanol intoxication, key investigations include:

  • serum ethanol concentration1
  • blood glucose concentration
  • serum electrolyte, urea and creatinine concentrations
  • blood gas analysis, including lactate concentration (severe intoxication).

Additional investigations may be required depending on patient-specific factors (eg if trauma has occurred as a result of ethanol intoxication, specific imaging may be required).

For patients with clinical features of life-threatening ethanol intoxication, seek advice from a clinical toxicologist on the appropriate investigations.

In patients presenting with coma and a serum ethanol concentration less than 65 mmol/L (0.30%), consider the possibility of co-ingestants or other causes of CNS depression (eg head injury or infectionMorgan, 2015). Regardless of the initial serum ethanol concentration, in patients showing no improvement in conscious state over the 2 to 4 hours following assessment, investigate for other causes of CNS depression.

1 A breathalyser can be used to measure the breath ethanol concentration, which correlates with the whole blood ethanol concentration. Serum ethanol concentrations are roughly 10% higher than the whole blood ethanol concentration approximated from the breathalyser result, but this difference is not clinically significant.Return