And since 99.99% of our headbangers have been drinking in the pub, the
debate about methanol & ethylene glycol is rather esoteric [since very few
of our locals sell Austrian wine].
TIM
****************************************************************************
*********
Prof. Tim Reynolds,
Clinical Chemistry Department,
Queens Hospital,
Belvedere Rd.,
Burton-on-Trent,
STAFFORDSHIRE,
DE13 0RB,
UK.
tel: 01283 511511 ext. 4035
fax: 01283 593064
email: [log in to unmask]
alternative email for the all too frequent occasions when the NHS email
connection doesn't work:
[log in to unmask]
****************************************************************************
**********
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> -----Original Message-----
> From: Simpson Elliott (MK) Top Grade Biochemist, Laboratory
> Directorate
> [mailto:[log in to unmask]]
> Sent: 06 June 2003 10:32
> To: 'Reynolds Tim'; [log in to unmask]
> Subject: RE: 'Screening' test for alcohol
>
>
> So do we, and being in the West of Scotland, we include
> ethanol as a test
> for every A&E head injury case.
>
> Elliott
>
> -----Original Message-----
> From: Reynolds Tim
> [mailto:[log in to unmask]]
> Sent: 06 June 2003 09:58
> To: [log in to unmask]
> Subject: Re: 'Screening' test for alcohol
>
>
> We simply have an ethanol method permanently on the main
> analyser and run
> the A&E ethanol request at the same time as the inevitable U&E
>
> TIM
>
> **************************************************************
> **************
> *********
> Prof. Tim Reynolds,
> Clinical Chemistry Department,
> Queens Hospital,
> Belvedere Rd.,
> Burton-on-Trent,
> STAFFORDSHIRE,
> DE13 0RB,
> UK.
> tel: 01283 511511 ext. 4035
> fax: 01283 593064
> email: [log in to unmask]
> alternative email for the all too frequent occasions when the
> NHS email
> connection doesn't work:
> [log in to unmask]
>
> **************************************************************
> **************
> **********
> IMPORTANT: This email is intended for the use of the individual
> addressee(s)named above and may contain information that is
> confidential
> privileged or unsuitable for overly sensitive persons with
> low self-esteem,
> no sense of humour or irrational religious beliefs. If you are not the
> intended recipient, any dissemination, distribution or
> copying of this email
> is not authorized (either explicitly or implicitly) and constitutes an
> irritating social faux pas. Unless the word absquatulation
> has been used in
> its correct context somewhere other than in this warning, it
> does not have
> any legal or grammatical use and may be ignored. No animals
> were harmed in
> the transmission of this email, though the kelpie next door
> is living on
> borrowed time, let me tell you. Those of you with an
> overwhelming fear of
> the unknown will be gratified to learn there is no hidden
> message revealed
> by reading this backwards, so just ignore that Alert Notice
> from Macroshaft.
> However, by pouring a complete circle of salt around yourself and your
> computer you can ensure that no harm befalls you and your
> pets. If you have
> received this eMail in error, please add some nutmeg and egg
> whites, whisk,
> and place in a warm oven for 40 minutes.
>
>
>
> > -----Original Message-----
> > From: David Brown [mailto:[log in to unmask]]
> > Sent: 05 June 2003 21:52
> > To: [log in to unmask]
> > Subject: Re: 'Screening' test for alcohol
> >
> >
> > Can someone put me straight on the formula for
> > measuring/calculating osmolar gap? Is it the
> > difference between the "calculated" and measured
> > osmolality? Is there now a reference/standard for
> > calculating osmolality?
> > It think it might be OK to "suggest" the probability
> > of an alcohol ingestion in the light of a significant
> > "osmolar gap", but.............
> >
> > David Brown
> >
> >
> > --- Jonathan Kay <[log in to unmask]> wrote:
> > > Seems to work OK for us. In practice clinicians
> > > request "ethanol" and
> > > we measure the osmolar gap... they don't request
> > > "osmolar gap".
> > >
> > > We refer requests for individual alcohols to a
> > > toxicology unit.
> > > Occasionally we have to remind clinicians that it
> > > may be necessary to
> > > treat before the results of assaying individual
> > > alcohols are available
> > >
> > > A and E handbooks should have guidance on ethanol,
> > > methanol and
> > > ethylene glycol poisoining, written in collaboration
> > > with the lab... I
> > > think it is important the timing aspects are in the
> > > protocol.
> > >
> > > Methanol poisoning is very rare in the UK compared
> > > to the USA...
> > >
> > > Was this point covered in the Annals review of
> > > toxicology requirements?
> > >
> > > Jonathan
> > >
> > >
> > > On Thursday, Jun 5, 2003, at 10:30 Europe/London,
> > > Borland, Bill wrote:
> > >
> > > > I would be interested to hear any views on the use
> > > of the Osmolal Gap
> > > > as a screening test for Ethanol. (Coakley at al,
> > > Pathology, 1983,15,
> > > > 321)
> > > >
> > > > One of the A&E departments within our Trust uses
> > > the Osmolal Gap as a
> > > > 'screening' test for alcohol and in only a few
> > > clinical situations do
> > > > they require a more specific assay for ethanol.
> > > They have used the Gap
> > > > in this way for many years and I suspect were
> > > encouraged to do this by
> > > > the lab in the days when it was easier to measure
> > > serum osmolality
> > > > than ethanol, especially out of hours.
> > > >
> > > > The danger is that junior medical staff may not be
> > > aware of the
> > > > limitations of this approach and delay
> > > identification of a possible
> > > > methanol or ethylene glycol poisoning. Should we
> > > be discouraging them?
> > > >
> > > > It would be useful to find out the practice in
> > > other centres.
> > > >
> > > > William Borland
> > > > Principal Biochemist (Toxicology)
> > > > Biochemistry Department
> > > > North Glasgow NHS Trust
> > > > Gartnavel General Hospital
> > > > Glasgow G12 0YN
> > > > Tel 0141 211 3343
> > > > Fax 0141 211 3452
> > > > Email bill.borland.wg@northglasgow .scot.nhs.uk
> > > >
> > > >
> > >
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