Bedside point of care toxicology screens in the ED: Utility and pitfalls.
Bedside point of care toxicology screens in the ED: Utility and pitfalls.
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DOI：
10.4103/2229-5151.141476
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发表时间：
2014-07-01
影响因子：
--
通讯作者：
Bhalla, Ashish
中科院分区：
文献类型：
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作者：
Bhalla, Ashish
暴露于药物和毒素是患者到急诊科（艾德）就诊的主要原因。对于大多数药物滥用中毒，艾德医生怀疑依赖尿液药物检测结果的紧急管理决策。这部分是因为免疫测定法虽然快速，但在灵敏度和特异性方面具有局限性，而色谱测定法更明确，劳动强度更大。需要对有毒酒精进行检测，但没有快速的商业检测方法。艾德医生需要对对乙酰氨基酚、水杨酸盐、一氧化碳血氧测定法、胆碱酯酶、铁和一些可能用作自我伤害剂的治疗药物进行统计分析。在这篇综述中，我们着眼于这些筛查试验的潜在局限性，并提出了更好的临床应用所需的改进和创新。应寻找新的滥用药物，并应开发分析方法，以适应不断变化的滥用模式。
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.