Use of saliva is a noninvasive, convenient, and rapid way to obtain a sample for ethanol analysis. There is also the advantage that ethanol concentration is 9% higher in saliva (water content 99%) than in whole blood (water content 85% w/v) (10). In one scheme of saliva ethanol testing with the Q.E.D. Saliva Alcohol Test (STC Diagnostics, Bethlehem, PA), sample is obtained by absorbing saliva on a swab, which is then inserted into the test cartridge. Despite the convenience of such a specimen, it is to be noted that for individuals with anticholinergic symptomology, such as dry

Table 1

Proposed Quality Assurance Guidelines for Clinical Breath Alcohol Testing (9)

Guideline Degree of Consensus

1. Clinical breath alcohol testing is point-of-care (POC) and A must meet the same QA/QC requirements as any POC test.

As a part of the laboratory ongoing QA effort, a program must be in place to monitor and evaluate policy, protocols, and the total testing process so that breath alcohol results are accurate and reliable. The clinical laboratory should be involved in the design, implementation, and monitoring of the QA program

2. The laboratory should be involved in the selection, A validation, and deployment of the breath alcohol devices used

3. Alcohol concentrations should be reported in units clearly A defined by the laboratory, with a notation as to the sample matrix that was tested (serum or plasma, urine, whole blood, breath) and methodology mouth associated with tricyclic antidepressant overdose, or alcoholics with impaired salivary flow, a saliva-based alcohol test may not be suitable.

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