Acute toxicology of ethanol ingestion. Role of the clinical laboratory.

Information from the clinical laboratory can contribute in several ways to the evaluation and management of the acute consequences of alcohol ingestion. If a blood alcohol analysis is not available, measurement of serum osmolality can be helpful. An elevated ethanol level can explain central nervous system depression. Evidence of acute or chronic alcohol use can explain atypical responses to various drugs. Severe acidosis in association with an increased anion gap may suggest ingestion of other toxic volatiles, such as methanol or ethylene glycol. Alcoholic ketoacidosis, also associated with a large anion gap, may occur in the absence of measureable alcohol or positive test for ketones.