[The toxicological testing in the emergency room in the era of choosing wisely]

The emergency physician is frequently called upon to take care of intoxicated patients. The identification of the culprit is a diagnostic challenge when the clinical picture is discordant, or the poisoning uncertain. Toxicological screening is of limited usefulness to the ED physician. Results from indiscriminate use can be misleading. The « all-out » search for toxins is expensive and rarely influences the treatment strategy. In the era of the « choosing wisely » campaign, a pragmatic and thoughtful use of toxicological testing is justified.