Toxicology screening in the emergency department: ethanol, barbiturates, and salicylates

A review of 737 limited toxicological screens performed in a municipal teaching hospital over one calendar year was conducted to determine the value of performing analyses for ethanol, salicylates, and barbiturates. Less than 5% of salicylate determinations and less than 2% of barbiturate tests yielded positive results. On the other hand, ethanol was present in over 70% of cases. The low number of positive results and the cost do not justify analyzing for salicylates or barbiturates unless their presence is suspected. Ethanol determinations should be limited to patients without an obviously consistent clinical presentation. Selective use of these tests in the emergency department is called for.