Drugs detected in suspected pediatric ingestions: a three-year review

Comprehensive toxicology testing can be a valuable resource when pediatric patients are suspected of having ingested unknown chemicals. In a recent 36-month period (January 2000-December 2002), the Analytical Toxicology Laboratory at the University of Mississippi Medical Center, Jackson, MS, tested 190 urine samples referred from the hospital's Pediatric Emergency Department for STAT toxicology testing. All samples were tested in parallel using an immunoassay technique for drugs of abuse and a comprehensive technique using gas chromatography/mass spectroscopy (GC/MS). With immunoassay, sixteen percent of the samples were positive for a drug of abuse. In comparison, drugs were detected in 85% of the samples using comprehensive GC/MS analysis. A total of 86 different pharmaceuticals were identified by GC/MS. This review shows that comprehensive toxicology testing provides the clinician significantly more information regarding the exposure of the pediatric patient presenting with an unknown chemical ingestion.