Toxicology screening in adolescent trauma

We sought to define the prevalence of positive drug screens in adolescent victims of major trauma. The records of 125 consecutive adolescent patients presenting with major trauma to an inner-city trauma center during the last nine months of 1990 were reviewed. Eighty-five (68%) received urine toxicology screens for alcohol and illicit drugs. Twenty-one (25%) of screened patients had a positive urine drug screen. The most commonly detected drugs were alcohol, cocaine, and opiates. Gender, race, mechanism of injury, mental status at presentation, injury severity score, and revised trauma score were not associated with a positive drug screen. We conclude that: 1) 25% of screened adolescent victims of major trauma seen at an inner-city trauma center had positive urine toxicology screens for alcohol or illicit drugs. 2) As none of the study variables was associated with a positive drug screen, selective drug screening cannot be supported.