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February 1988

Role of the Laboratory in Treatment of the Poisoned Patient

Arch Intern Med. 1988;148(2):279-280. doi:10.1001/archinte.1988.00380020023004

Contemporary clinical toxicology involves the study and treatment of poisonings due to a variety of chemicals, including household and industrial products, plants, poisonous and venomous animals, environmental agents, pharmaceutical products, and illegal drugs.1 Potential indications for analytical (laboratory) toxicologic assistance (recalled using the mnemonic promise) include the following: (1) determination of prognosis; (2) collection of research data; (3) response to order of court, medical examiner, or law enforcement official; (4) monitoring of treatment; (5) identification of a substance to establish a diagnosis; (6) assessment of severity of poisoning; and (7) exclusion (or confirmation) of toxic exposure.2 The clinician's interest in analytical toxicology focuses on identification and/or quantitation of xenobiotics in biological specimens for purposes of patient care. In this issue of the Archives, Brett3 rekindles the controversy concerning the role of comprehensive toxicology testing in acute poisoning evaluations. In addition,