Calculate osmolality with optional ethanol and osmolal gap.
Calculated Osm—
Osmolal Gap—
Osmolality
Calc Osm = 2×Na + Glucose/18 + BUN/2.8 + EtOH/4.6. Normal 275–295. Gap = Measured − Calculated. Normal gap ≤10. Elevated gap suggests toxic alcohols (methanol, ethylene glycol).