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Rational use of toxicology testing in children

R J Hoffman1, L Nelson

  • 1New York City Poison Control Center, New York, New York, USA. rjhoffman@pol.net

Current Opinion in Pediatrics
|April 24, 2001
PubMed

Insights

Laboratory toxicology testing aids in managing poison exposures, but comprehensive screening in children is often costly and ineffective. Focused quantitative assays and careful application of drug of abuse testing are more beneficial.

Area of Science:

  • Clinical Toxicology
  • Laboratory Medicine
  • Pediatric Emergency Medicine

Background:

  • Poison exposures are common, particularly in children, necessitating effective diagnostic tools.
  • Laboratory assays, from basic to specialized, play a role in evaluating poisoned patients.
  • Existing literature on poisoning in pregnant patients and specific pediatric toxicology is reviewed.

Purpose of the Study:

  • To evaluate the utility and limitations of various laboratory toxicology assays in patient management.
  • To assess the cost-effectiveness and clinical impact of comprehensive toxicology screening in pediatrics.
  • To review the application of drug of abuse testing, including hair sampling, and associated pitfalls.

Main Methods:

  • Review of literature on poisoning in pregnant patients and recommendations for pregnancy testing.
  • Analysis of recent studies on pediatric toxicology screening costs and management impact.
  • Evaluation of focused quantitative serum assays and drug of abuse testing methods.

Main Results:

  • Comprehensive toxicology screening in pediatric patients is often expensive and does not alter management for most cases.
  • Focused quantitative serum assays are useful for determining specific poison levels.
  • The capabilities and limitations of drug of abuse testing, including hair sampling, are analyzed.

Conclusions:

  • Indiscriminate or misinterpreted toxicology testing can lead to significant pitfalls.
  • Selective use of quantitative assays and appropriate drug of abuse testing is recommended.
  • Cost-effective laboratory strategies are crucial for managing poison exposures, especially in pediatric populations.

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