Analytical toxicology service model at the subregional center level for severe acute poisoning
AbstractAcute poisoning may necessitate identification of the toxic agent; however, several acutely poisoned patients are treated with minimal laboratory assistance. We investigated whether focused reference to laboratory toxicology tests conducted during a pilot project for a subregional analytical...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2021-11-01
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| Series: | Toxicology Communications |
| Online Access: | https://www.tandfonline.com/doi/10.1080/24734306.2021.1913913 |
| _version_ | 1797300126683758592 |
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| author | Mi Jin Lee Jae Wan Cho Haewon Jung Jungbae Park Yun Jeong Kim Jun Seok Seo Hanseok Chang Sinae Won |
| author_facet | Mi Jin Lee Jae Wan Cho Haewon Jung Jungbae Park Yun Jeong Kim Jun Seok Seo Hanseok Chang Sinae Won |
| author_sort | Mi Jin Lee |
| collection | DOAJ |
| description | AbstractAcute poisoning may necessitate identification of the toxic agent; however, several acutely poisoned patients are treated with minimal laboratory assistance. We investigated whether focused reference to laboratory toxicology tests conducted during a pilot project for a subregional analytical toxicology service influences treatment decisions. Patients with acute poisoning presented to the level 1 regional emergency medical center from May 2018 to April 2019 were initially reviewed. Poison samples were referred to the subregional toxicological analytical service. In total, 253 substance samples were tested among 111 patients during the study. According to the reported drug levels, 3 (1.2%) samples contained lethal doses, 49 (19%) had toxic levels, and 28 (11%) contained detectable levels of a lethal toxin or pesticide. Disagreement between the clinical assessment and laboratory analyses was found for 62 patients (fair kappa = 0.24, 56%), and they often had lower Glasgow Coma Scale, higher severity scores, older age, and less likelihood of receiving gastrointestinal decontamination. The regional analytical toxicology services were helpful for diagnostic planning and therapeutic management of acute poisoning. For seriously poisoned patients with inconsistent histories, it is necessary to reevaluate the classic therapeutic process based on the medical history. |
| first_indexed | 2024-03-07T23:02:46Z |
| format | Article |
| id | doaj.art-035eb84b62d44bfe86c6437d640c9a66 |
| institution | Directory Open Access Journal |
| issn | 2473-4306 |
| language | English |
| last_indexed | 2024-03-07T23:02:46Z |
| publishDate | 2021-11-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Toxicology Communications |
| spelling | doaj.art-035eb84b62d44bfe86c6437d640c9a662024-02-22T09:16:09ZengTaylor & Francis GroupToxicology Communications2473-43062021-11-015110210810.1080/24734306.2021.1913913Analytical toxicology service model at the subregional center level for severe acute poisoningMi Jin Lee0Jae Wan Cho1Haewon Jung2Jungbae Park3Yun Jeong Kim4Jun Seok Seo5Hanseok Chang6Sinae Won7Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaDepartment of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaDepartment of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaDepartment of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaDepartment of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of KoreaDepartment of Emergency Medicine, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Seoul, Republic of KoreaNational Emergency Medical Center, National Medical Center, Seoul, Republic of KoreaNational Emergency Medical Center, National Medical Center, Seoul, Republic of KoreaAbstractAcute poisoning may necessitate identification of the toxic agent; however, several acutely poisoned patients are treated with minimal laboratory assistance. We investigated whether focused reference to laboratory toxicology tests conducted during a pilot project for a subregional analytical toxicology service influences treatment decisions. Patients with acute poisoning presented to the level 1 regional emergency medical center from May 2018 to April 2019 were initially reviewed. Poison samples were referred to the subregional toxicological analytical service. In total, 253 substance samples were tested among 111 patients during the study. According to the reported drug levels, 3 (1.2%) samples contained lethal doses, 49 (19%) had toxic levels, and 28 (11%) contained detectable levels of a lethal toxin or pesticide. Disagreement between the clinical assessment and laboratory analyses was found for 62 patients (fair kappa = 0.24, 56%), and they often had lower Glasgow Coma Scale, higher severity scores, older age, and less likelihood of receiving gastrointestinal decontamination. The regional analytical toxicology services were helpful for diagnostic planning and therapeutic management of acute poisoning. For seriously poisoned patients with inconsistent histories, it is necessary to reevaluate the classic therapeutic process based on the medical history.https://www.tandfonline.com/doi/10.1080/24734306.2021.1913913 |
| spellingShingle | Mi Jin Lee Jae Wan Cho Haewon Jung Jungbae Park Yun Jeong Kim Jun Seok Seo Hanseok Chang Sinae Won Analytical toxicology service model at the subregional center level for severe acute poisoning Toxicology Communications |
| title | Analytical toxicology service model at the subregional center level for severe acute poisoning |
| title_full | Analytical toxicology service model at the subregional center level for severe acute poisoning |
| title_fullStr | Analytical toxicology service model at the subregional center level for severe acute poisoning |
| title_full_unstemmed | Analytical toxicology service model at the subregional center level for severe acute poisoning |
| title_short | Analytical toxicology service model at the subregional center level for severe acute poisoning |
| title_sort | analytical toxicology service model at the subregional center level for severe acute poisoning |
| url | https://www.tandfonline.com/doi/10.1080/24734306.2021.1913913 |
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