NHA Certified Phlebotomy Technician (CPT)Collection RoutineHard

A phlebotomy technician is collecting a blood specimen for a blood alcohol content (BAC) test as part of a forensic investigation. Which of the following antiseptics should the technician use?

  1. AChlorhexidine gluconate
  2. BPovidone-iodine (Betadine)
  3. C70% Isopropyl alcohol
  4. DBenzalkonium chloride
Show answer & explanation

Correct answer: D. Benzalkonium chloride

For forensic blood alcohol content (BAC) testing, alcohol-based antiseptics (like isopropyl alcohol or chlorhexidine with alcohol) are contraindicated because they can falsely elevate the patient's BAC. Benzalkonium chloride is an acceptable non-alcohol antiseptic for this purpose.

Why the other options are wrong

  • A. Chlorhexidine gluconate often comes with alcohol, making it unsuitable. Alcohol-free chlorhexidine is an option, but benzalkonium chloride is specifically mentioned as acceptable in many guidelines.
  • B. Povidone-iodine is a suitable non-alcohol antiseptic, but it can stain the skin and some patients are allergic. Benzalkonium chloride is an alternative non-alcohol antiseptic.
  • C. Isopropyl alcohol is an alcohol and would contaminate the specimen, leading to falsely elevated BAC.

Antiseptic for BAC Testing

When collecting blood for a forensic Blood Alcohol Content (BAC) test, an alcohol-free antiseptic such as benzalkonium chloride or povidone-iodine must be used to prevent contamination of the specimen.

  • Alcohol-based antiseptics are contraindicated
  • Prevents false elevation of BAC
  • Benzalkonium chloride is a common non-alcohol choice
  • Povidone-iodine is also acceptable if no allergies

Memory trick: No 'Alcohol' for 'Alcohol' tests – think 'Benz' for 'BAC'.

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