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Bhalla A. Bedside point of care toxicology screens in the ED: Utility and pitfalls. Int J Crit Illn Inj Sci. 2014;4(3):257-60doi: 10.4103/2229-5151.141476.
Bhalla, A. (2014). Bedside point of care toxicology screens in the ED: Utility and pitfalls. International journal of critical illness and injury science, 4(3), 257-60. https://doi.org/10.4103/2229-5151.141476
Bhalla, Ashish. "Bedside point of care toxicology screens in the ED: Utility and pitfalls." International journal of critical illness and injury science vol. 4,3 (2014): 257-60. doi: https://doi.org/10.4103/2229-5151.141476
Bhalla A. Bedside point of care toxicology screens in the ED: Utility and pitfalls. Int J Crit Illn Inj Sci. 2014 Jul;4(3):257-60. doi: 10.4103/2229-5151.141476. PMID: 25337490; PMCID: PMC4200554.
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Int J Crit Illn Inj Sci. 2014 Jul;4(3):257-60. doi: 10.4103/2229-5151.141476.

Bedside point of care toxicology screens in the ED: Utility and pitfalls.

International journal of critical illness and injury science

Ashish Bhalla

Affiliations

  1. Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

PMID: 25337490 PMCID: PMC4200554 DOI: 10.4103/2229-5151.141476

Abstract

Exposure to drugs and toxins is a major cause for patients' visits to the emergency department (ED). For most drugs-of-abuse intoxication, ED physicians are skeptical to rely on results of urine drug testing for emergent management decisions. This is partially because immunoassays, although rapid, have limitations in sensitivity and specificity and chromatographic assays, which are more definitive, are more labor intensive. Testing for toxic alcohols is needed, but rapid commercial assays are not available. ED physicians need stat assays for acetaminophen, salicylates, co-oximetry, cholinesterase, iron, and some therapeutic drugs that could be used as agents of self-harm. In this review, we look at the potential limitations of these screening tests and suggest improvements and innovations needed for better clinical utilization. New drugs of abuse should be sought and assays should be developed to meet changing abuse patterns.

Keywords: Poisoning; point of care testing; self harm; toxicology screening

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