Hospital Guidelines for the Collection of Blood to Test for Alcohol Content

Tests to determine alcohol levels in the blood are performed frequently in a hospital facility. They are also done in other settings to test for the presence of alcohol in a person's bloodstream. For example, if there is any possibility that a person who was involved in a car accident may have been drinking, a test is ordered. This test is a quantitative test, meaning results show not only whether alcohol is present, but also the exact amount in the bloodstream.

Ethanol

• Alcohol, or ethanol, is found in beer, wine and hard liquor such as whiskey and vodka. It is rapidly absorbed into the bloodstream. There is a large difference in levels depending upon the subject's food intake and size, as well as the amount of time that has passed since the alcohol was consumed.

Patient Preparation

• The patient's arm needs to be prepared for phlebotomy differently for an alcohol test than for routine blood work. Typically, an alcohol swab is used to cleanse the area of the needle stick. Since that alcohol swab could influence the test results, iodine or another alcohol free cleanser, such as soap and water, should be used.

Proper Specimen Collection

• Correct specimen collection is absolutely essential for blood alcohol levels since these tests are frequently used in legal cases. There should be a written policy for all employees regarding collection. The proper tube to draw in the specimen may vary by state or institution, although the most frequently used are tubes with gray stoppers or the red-topped tubes. These tubes do not have additives that could skew the results.

Labeling the Specimen

• Each tube of blood that is drawn must be properly labeled. Again, this may vary according to the institution or the state, but all tubes should have at a minimum the patient's name and medical record number; the date and time of the draw; and the signature of the person who drew the specimen.

Chain of Custody

• The chain of custody for a blood alcohol level is frequently very important. If this test will be used in a legal case, it is necessary to prove that it was not tampered with at any point. The phlebotomist who drew the blood begins the custody form. These forms, while different for each institution, list exactly who had contact with the specimen. The custody form must be filled out with the date and time, as well as the name and signature of the person who is accepting the tube.

Important

• It is important for blood alcohol tests to be transported to the lab immediately. This establishes chain of custody and eliminates the possibility of tampering. Never leave a blood alcohol level sample without obtaining the signature of the next person and make sure the chain of custody form is filled out properly.