title: Breath analyzer screening of emergency department patients suspected of alcohol intoxication.
abstract: BACKGROUND
  Acute alcohol intoxication is a frequent cause of emergency department (ED) visits. Evaluating a patient's alcohol intoxication is commonly based on both a physical examination and determination of blood alcohol concentration (BAC).
  
  
  OBJECTIVE
  To demonstrate the feasibility and usefulness of using a last-generation infrared breath analyzer as a non-invasive and rapid screening tool for alcohol intoxication in the ED.
  
  
  METHODS
  Adult patients suspected of acute alcohol intoxication were prospectively enrolled over 10 days. Breath alcohol concentrations (BrAC) were measured using a handheld infrared breath analyzer. BAC was determined simultaneously by automated enzymatic analysis of a venous blood sample. The relationship between BAC and BrAC values was examined by both linear regression and Bland-Altman analysis.
  
  
  RESULTS
  The study included 54 patients (mean age 40±14 years, sex ratio M/F of 3/1). Breath and blood alcohol concentrations ranged from 0 to 1.44 mg/L and from 0 to 4.40 g/L (0-440 mg/dL), respectively. The mean individual BAC/BrAC ratio was 2615±387, 95% confidence interval 2509-2714, which is 30% higher than the legal ratio in France (2000). The correlation between both measurements was excellent: r=0.95 (0.92-0.97). Linear regression revealed BAC=0.026+1.29 (BrAC×2000) and BAC=0.026+0.99 (BrAC×2615). Mean BAC-BrAC differences and limits of agreement were 0.49 g/L [-0.35, 1.34] (or 49 mg/dL [-35, 134] and 0.01 g/L [-0.68, 0.71] (or 1 mg/dL [-68, 71]), for the 2000 and 2615 ratios, respectively.
  
  
  CONCLUSIONS
  The calculated conversion coefficient provided a satisfactory determination of blood alcohol concentration. Breath alcohol testing, using appropriate BAC/BrAC conversion, different from the legal BAC/BrAC, could be a reliable alternative for routine screening and management of alcohol intoxication in the ED.
authors.affiliation: Département des urgences, Centre Hospitalier Régional Universitaire Lapeyronie, Montpellier, France.
authors.forename: Mustapha
authors.initials: M
authors.lastname: Sebbane
authors.forename: Pierre-Géraud
authors.initials: PG
authors.lastname: Claret
authors.forename: Riad
authors.initials: R
authors.lastname: Jreige
authors.forename: Richard
authors.initials: R
authors.lastname: Dumont
authors.forename: Sophie
authors.initials: S
authors.lastname: Lefebvre
authors.forename: Josh
authors.initials: J
authors.lastname: Rubenovitch
authors.forename: Grégoire
authors.initials: G
authors.lastname: Mercier
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Eledjam
authors.forename: Jean-Emmanuel
authors.initials: JE
authors.lastname: de la Coussaye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000435:Alcoholic Intoxication / Q000175:diagnosis*; D001944:Breath Tests / Q000295:instrumentation; D004636:Emergency Service, Hospital; D000431:Ethanol / Q000097:blood*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000431:Ethanol