II. Definitions
- Blood Alcohol Content (BAC, Blood Alcohol Concentration)
- Measure of Alcohol content (and Intoxication) in blood
- Measured in grams of Alcohol per 100 ml of blood (expressed as percent)
- Example: 0.10% = 0.10 g Alcohol per 100 ml blood = 100 mg/dl = 22 mmol/L
- Alcohol Breath Test (Breathalyzer)
- Measured as grams Alcohol per 210 Liters of breath
III. Labs: Blood Alcohol Level
- Blood Alcohol Effects in non-habitual drinkers
- Blood Alcohol Content 0.02% to 0.05% (20 to 50 mg/dl, 4.4 to 11 mmol/L)
- Decreased fine motor coordination
- Blood Alcohol Content 0.05% to 0.10% (50 to 100 mg/dl, 11 to 22 mmol/L)
- Impaired judgement
- Impaired concentration
- Blood Alcohol Content 0.10% to 0.15% (100 to 150 mg/dl, 22 to 33 mmol/L)
- Altered gait and balance
- Blood Alcohol Content 0.15% to 0.25% (150 to 250 mg/dl, 33 to 55 mmol/L)
- Lethargy
- May need assistance to sit upright
- Blood Alcohol Content 0.30% (300 mg/dl, 66 mmol/L)
- Blood Alcohol Content 0.40% (400 mg/dl, 88 mmol/L)
- Respiratory Depression
- References
- Marx (2002) Rosen Emergency Medicine, Elsevier, p. 2513
- (2022) Clinical Effects of Blood Alcohol Concentration, UpToDate, accessed 4/21/2022
- Blood Alcohol Content 0.02% to 0.05% (20 to 50 mg/dl, 4.4 to 11 mmol/L)
- Blood Alcohol Metabolism
IV. Labs: Biomarkers of Alcohol Use
- Ethyl Glucuronide
- Urine Alcohol biomarker
- Positive if Alcohol use in last 3 days (longer if Renal Insufficiency)
- Detects ingestions of as little as 5 g of Alcohol
- Test Sensitivity: 76%
- Test Specificity: 93%
- Urine Alcohol biomarker
- Ethyl Sulfate
- Urine Alcohol biomarker
- Positive if Alcohol use in last 3 days (longer if Renal Insufficiency)
- Test Sensitivity: 82%
- Test Specificity: 86%
- Urine Alcohol biomarker
- Phospatidylethanol
- Blood Alcohol biomarker
- Positive if Alcohol use in last 2 to 3 weeks
- No major confounding factors (e.g. age, BMI, gender, renal or liver disease)
- More expensive than the urine biomarkers
- Test Sensitivity: 100%
- Test Specificity: 96%
- Blood Alcohol biomarker