To best understand the utility (or possible lack thereof) of the UDS, it is important to analyze how the test is actually performed.Īlthough hair, fingernails, toenails, and saliva can be used to detect the presence of drugs, hospitals most commonly employ the use of blood or urine assays. For example, the UDS may play a role in determining if a chest pain patient is suffering from an acute occlusive myocardial infarction or amphetamine-induced vasospasm, or if an unresponsive patient may have a substance-related cause for their obtundation.ĭespite the ubiquitous nature of these tests - which are widely used as screening and diagnostic tools within medicine as well as in the sports industry and business sectors - many healthcare providers are skeptical to trust the results for a variety of reasons. In the ED, the UDS allows the emergency physician to ascertain the nature of a patient’s current or recent toxicity, which can assist in the narrowing of a differential diagnosis. In non-emergency medicine settings, these drug screens can be used to evaluate pharmacologic diversion, medication compliance, and the possibility of recent or current intoxicants. Nearly 30 million ED visits per year are associated with some form of drug use. The UDS is a frequently ordered test in the emergency department as well as in inpatient services, psychiatry, pain medicine, and outpatient clinics. You decide to order a head CT, CBC, CMP, TSH with reflex T4, EKG, aspirin and acetaminophen levels, Flu/COVID/RSV swab, and a urine drug screen (UDS). Differential diagnosis includes a polypharmacy overdose such as acetaminophen or diphenhydramine, illicit drug intoxication, viral encephalopathy, and electrolyte abnormality. The patient has a history of asthma and frequent marijuana use. Her friend at bedside notes the patient has been taking acetaminophen cold and flu, pseudoephedrine, diphenhydramine, ibuprofen, and dextromethorphan to treat her current acute symptoms. Her vitals are: BP 104/62 pulse 120 respiratory rate 28 SpO2 96% on room air and temperature 100.5☏. A 36-year-old woman presents to the ED with chief complaints of altered mental status, cough, fever, and runny nose.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |