{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T09:23:21Z","timestamp":1761989001748,"version":"build-2065373602"},"reference-count":0,"publisher":"SMW Supporting Association","issue":"5152","license":[{"start":{"date-parts":[[2015,12,13]],"date-time":"2015-12-13T00:00:00Z","timestamp":1449964800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Swiss Med Wkly"],"abstract":"<jats:p>Drug poisoning is a common cause for attendance in the emergency department. Several toxicology centres suggest performing urinary drug screens, even though they rarely influence patient management.\n        STUDY OBJECTIVES: Measuring the impact on patient management, in a University Emergency Department with approximately 40\u00a0000 admissions annually, of a rapid urinary drug screening test using specifically focused indications. Drug screening was restricted to patients having a first psychotic episode or cases demonstrating respiratory failure, coma, seizures, a sympathomimetic toxidrome, severe opiate overdose necessitating naloxone, hypotension, ventricular arrhythmia, acquired long QT or QRS &gt;100 ms, and high-degree heart block.\n        METHODS: Retrospective analysis of Triage\u00ae TOX drug screen tests performed between September 2009 and November 2011, and between January 2013 and March 2014.\n        RESULTS: A total of 262 patients were included, mean age 35 \u00b1 14.6 (standard deviation) years, 63%\u00a0men; 29% poisoning with alcohol, and 2.3% deaths. Indications for testing were as follows: 34% were first psychotic episodes; 20% had acute respiratory failure; 16% coma; 8% seizures; 8% sympathomimetic toxidromes; 7% severe opioid toxidromes; 4% hypotension; 3% ventricular arrhythmias or acquired long QT intervals on electrocardiogram. A total of 78% of the tests were positive (median two substances, maximum five). The test resulted in drug-specific therapy in 6.1%, drug specific diagnostic tests in 13.3 %, prolonged monitoring in 10.7% of methadone-positive tests, and psychiatric admission in 4.2%. Overall, 34.3% tests influenced patient management.\n        CONCLUSIONS: In contrast to previous studies showing modest effects of toxicological testing, restricted use of rapid urinary drug testing increases the impact on management of suspected overdose patients in the ED.<\/jats:p>","DOI":"10.4414\/smw.2015.14242","type":"journal-article","created":{"date-parts":[[2016,1,29]],"date-time":"2016-01-29T10:03:57Z","timestamp":1454061837000},"page":"w14242","source":"Crossref","is-referenced-by-count":4,"title":["Focused use of drug screening in overdose patients increases impact on management"],"prefix":"10.57187","volume":"145","author":[{"given":"Andreas","family":"Erdmann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominique","family":"Werner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Hugli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bertrand","family":"Yersin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"36756","published-online":{"date-parts":[[2015,12,13]]},"container-title":["Swiss Medical Weekly"],"original-title":[],"link":[{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/2117\/3112","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/2117\/3113","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/download\/2117\/3112","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T06:45:28Z","timestamp":1755240328000},"score":1,"resource":{"primary":{"URL":"https:\/\/smw.ch\/index.php\/smw\/article\/view\/2117"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12,13]]},"references-count":0,"journal-issue":{"issue":"5152","published-online":{"date-parts":[[2015,12,14]]}},"URL":"https:\/\/doi.org\/10.4414\/smw.2015.14242","relation":{},"ISSN":["1424-3997"],"issn-type":[{"type":"electronic","value":"1424-3997"}],"subject":[],"published":{"date-parts":[[2015,12,13]]}}}