[Laboratory investigations in acute intoxications--what makes sense?]

Clinical symptoms in acute intoxications are often nondescript and unspecific for a definite diagnosis. This makes laboratory investigations necessary in order to initiate supportive measures and to confirm or discard the diagnosis of an acute intoxication. For toxicological analyses immunoassays as well as chromatographic methods are applied. Unfortunately, not all potential toxic compounds can be detected by these methods, e.g. ethanol and metals (including lithium) cannot be seen. The sample materials for toxicological analyses are on one hand blood for the quantitative determination of a distinct compound and on the other hand urine for toxicological screening procedures. Whenever the clinical situation does not exclude intoxication, a toxicological screening should be carried out. The comprehensiveness of the toxicological screening is dependent on the anamnesis and the clinical symptoms of the patient and should also depend on the therapeutic options for the various differential diagnoses. A specific quantitative determination of the toxic compound is recommended for acetaminophen, lithium, amanitine (intoxications with death cap), colchicine, alcohols and glycols, carbon monoxide and cyanide.