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SYMPOSIUM: CRITICAL POINT OF CARE BIOMARKERS IN EMERGENCY CARE
Year : 2014  |  Volume : 4  |  Issue : 3  |  Page : 257-260

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


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

Correspondence Address:
Ashish Bhalla
Department of Internal Medicine, 4th floor, F block, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh - 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5151.141476

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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.


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