الفهرس | Only 14 pages are availabe for public view |
Abstract Although toxicological screening has established guidelines in the fields of workplace drug testing and driving under the influence of drugs, there is no consensus on its usefulness in management of ED patients with suspected acute recreational toxicity. In many hospitals, the treatment of those patients is predicated based on the clinical pattern of toxicity along with the patient’s own self-reported drug(s) and the circumstances of presentation, without the use of toxicological tests. However, on many occasions, depending on the patient’s self-reports or the physicians’ interpretation of the clinical presentations may have limitations. The utility of an analytical method in the ED generally depends on many factors including the turnaround time, the screening extent, and the results precision. In this regard, immunoassay (IA) analytical tests, with the advantages of being generally fast, simple to conduct and usually with affordable cost, can be utilized as point-of-care or near-site tests that may give preliminary information on the utilized drug(s)/substance(s), with the results either positive or negative depending on a specified concentration cutoff. However, immunoassays have the limitation of the possibility of false negative (low sensitivity) and false positive results (poor specificity and cross-reactivity). Urine is the traditional sample that is used for toxicological screening for drugs of abuse in many clinical and forensic settings and is the main sample that has been researched in the literature to assess the usefulness of toxicological screening in the emergency department presentations with suspected recreational toxicity. However, as urine can contain drug(s)/ metabolites for a relatively longer time, it has a major limitation that it does. |