Emergency Toxicology

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Emergency toxicology focuses on the diagnosis, management, and prevention of poisonings due to drugs, occupational and environmental toxins, and biological agents. Examples of exposures include acute drug overdoses, hazardous exposures to chemical products, and the management of drug withdrawal syndromes.

Indications for Testing

Accidental or intentional poisoning from illicit or licit substances

Decontamination or detoxification

Suspected overdose of licit or illicit substances in patient presenting with altered cognition

Metabolic acidosis of unknown cause

Signs and symptoms of toxicity in event of known or suspected hazardous exposure

Timing of Specimen Collection

In acute emergency, there are no specific timing recommendations – specimens should be collected as soon as possible if toxicity is suspected

For decontamination or detoxification samples (eg, Tylenol poisoning) – intervals for retesting are determined on a case by case basis

Specimen Selection

Blood – used for most testing; provides quantitative and qualitative information

Urine – may be used in select cases when only qualitative information is needed