| Utility of toxicology screening in a pediatric emergency department. | |
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MedLine Citation:
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PMID: 9220505 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the types of patients who undergo toxicology screen testing (TS) and the clinical utility of the test in a pediatric emergency department. DESIGN: Retrospective chart review. SETTING: Urban pediatric emergency department. PATIENTS OR PARTICIPANTS: All patients, n = 338, less than 18 years of age who had a TS sent from the Kosair Children's Hospital Emergency Department between 1/1/91 and 12/31/91. RESULTS: Three hundred and thirty-eight charts were available for review from 344 patients who had TS testing. Seventy-eight patients (23%) were less than 12 years old; 164 patients (49%) were female. Forty-four patients were tested by serum TS only; 195 patients by serum plus urine TS; 94 patients by urine TS; four patients by serum, urine, and gastric aspirate TS, and one patient by urine and gastric aspirate TS. Chief complaints of patients who had TS sent were as follows: ingestion (211), abnormal behavior (56), seizures (30), trauma (18), syncope/tingling (7), depression/suicide (6), chest pain/palpitations (3), headaches (3), and other (4). While 195 patients (57%) had positive TS for at least one item, only 22 patients (7%) had a positive TS for an unexpected item, including seven patients with ingestions, eight with abnormal behavior, four with seizures, two with syncope, and one with trauma. Only three patients with unexpected positive TS had a change in medical management as a result of the TS findings. All three of these patients had abnormal physical examinations. CONCLUSION: A minority of patients have unexpected TS results. TS results rarely necessitate a change in medical management. Emergency physicians should reevaluate indications for TS testing in pediatric patients. |
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Authors:
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J M Sugarman; G C Rodgers; R I Paul |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatric emergency care Volume: 13 ISSN: 0749-5161 ISO Abbreviation: Pediatr Emerg Care Publication Date: 1997 Jun |
Date Detail:
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Created Date: 1997-08-21 Completed Date: 1997-08-21 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8507560 Medline TA: Pediatr Emerg Care Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 194-7 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, School of Medicine, University of Louisville, KY 40292, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Child Child, Preschool Emergency Service, Hospital Female Humans Infant Infant, Newborn Male Pediatrics* Poisoning / diagnosis*, etiology, therapy Retrospective Studies Toxicology* |
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