Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/96082
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Type: Journal article
Title: Assessment of the breath alcohol concentration in emergency care patients with different level of consciousness
Author: Kaisdotter Andersson, A.
Kron, J.
Castren, M.
Muntlin Athlin, A.
Hok, B.
Wiklund, L.
Citation: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 2015; 23(11):1-9
Publisher: BioMed Central
Issue Date: 2015
ISSN: 1757-7241
1757-7241
Statement of
Responsibility: 
Annika Kaisdotter Andersson, Josefine Kron, Maaret Castren, Asa Muntlin Athlin, Bertil Hok, and Lars Wiklund
Abstract: BACKGROUND: Many patients seeking emergency care are under the influence of alcohol, which in many cases implies a differential diagnostic problem. For this reason early objective alcohol screening is of importance not to falsely assign the medical condition to intake of alcohol and thus secure a correct medical assessment. OBJECTIVE: At two emergency departments, demonstrate the feasibility of accurate breath alcohol testing in emergency patients with different levels of cooperation. METHOD: Assessment of the correlation and ratio between the venous blood alcohol concentration (BAC) and the breath alcohol concentration (BrAC) measured in adult emergency care patients. The BrAC was measured with a breathalyzer prototype based on infrared spectroscopy, which uses the partial pressure of carbon dioxide (pCO₂) in the exhaled air as a quality indicator. RESULT: Eighty-eight patients enrolled (mean 45 years, 53 men, 35 women) performed 201 breath tests in total. For 51% of the patients intoxication from alcohol or tablets was considered to be the main reason for seeking medical care. Twenty-seven percent of the patients were found to have a BAC of <0.04 mg/g. With use of a common conversion factor of 2100:1 between BAC and BrAC an increased agreement with BAC was found when the level of pCO₂ was used to estimate the end-expiratory BrAC (underestimation of 6%, r = 0.94), as compared to the BrAC measured in the expired breath (underestimation of 26%, r = 0.94). Performance of a forced or a non-forced expiration was not found to have a significant effect (p = 0.09) on the bias between the BAC and the BrAC estimated with use of the level of CO₂. A variation corresponding to a BAC of 0.3 mg/g was found between two sequential breath tests, which is not considered to be of clinical significance. CONCLUSION: With use of the expired pCO₂ as a quality marker the BrAC can be reliably assessed in emergency care patients regardless of their cooperation, and type and length of the expiration.
Keywords: Blood alcohol concentration; breath alcohol concentration; patient cooperation; emergency care patients
Rights: © 2015 Kaisdotter Andersson et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
RMID: 0030027812
DOI: 10.1186/s13049-014-0082-y
Appears in Collections:Nursing publications

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