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Adjunct Hospital Emergency Toxicology Service: Title and subTitle BreakA Model for a Metropolitan Area FREE

Jerome P. Horwitz, PhD; Elliott B. Hills, PhD; Denis Andrzejewski, MS; Walter Brukwinski; James Penkala; Sam Albert, MD, PhD
[+] Author Affiliations

Reprint requests to the Department of Experimental Therapeutics, Michigan Cancer Foundation, 110 E Warren, Detroit, MI 48201 (Dr Horwitz).


JAMA. 1976;235(16):1708-1712. doi:10.1001/jama.1976.03260420024020
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A feasibility demonstration with a gas chromatograph/mass spectrometer/computer system (GC/MS) was initiated to provide a 24-hour (seven days/week) adjunct emergency toxicology service to the hospitals in the tricounty area comprising Metropolitan Detroit. During June 1, 1974, to April 1, 1975, more than 85 different drugs and other agents were identified in the body fluids of approximately 1,000 victims of accidental or deliberate poisonings. At least one toxic substance was identified in 57% of the cases, and the presence of two or more drugs was established in one of five (19%) of the victims. This study indicates that a centrally located GC/MS/computer system can provide an effective adjunct emergency toxicology service for an entire metropolitan community and thereby provide guidelines for a prompt and rational therapy.

(JAMA 235:1708-1712, 1976)

REFERENCES

Christison, cited by  Curry AS: Outline of a systematic search for an unknown poison , in Toxicology, Mechanisms and Analytical Methods . New York, Academic Press, 1960;, vol 1, p 257.
Goldstein A, Aronow L, Kalman SM:  Drug toxicity , in Principles of Drug Action: The Basis of Pharmacology , ed 2. New York, John Wiley & Sons, 1974;, p 359.
Costello CE, Hertz HS, Sakai T, et al:  Routine use of a flexible gas chromatograph-mass spectrometer-computer system to identify drugs and their metabolites in body fluids of overdose victims . Clin Chem 20:255-265, 1974;.
Biemann K (ed): Mass Spectra of Drugs . Cambridge, Mass, MIT Department of Chemistry, 1971;.
Heller SR, Koniver DA, Fales HM, et al:  Conversational mass spectral search system . Anal Chem 46:947, 1974;.
Simon NM, Krumlovsky FA:  The role of dialysis in the treatment of poisoning . Pharmacol Physicians 5:1-7, 1971;.
Domino EF:  Neurobiology of phencyclidine (Sernyl), a drug with an unusual spectrum of pharmacological activity . Int Rev Neurobiol 6:303-347, 1964;.
Rainey J, Crowder M:  Prevalence of phencyclidine in street drug preparations . N Engl J Med 290:467, 1974;.
Eastman JW, Cohen SN:  Hypertensive crisis and death associated with phencyclidine poisoning . JAMA 231:1270-1271, 1975;.
Fauman B, Baker F, Coppleson LW, et al:  Psychosis induced by phencyclidine . J Am Coll Emergency Physicians 4:223-225, 1975;.
Vale AJ, Widdop B, Goulding R:  Use of charcoal hemoperfusion in the management of severely poisoned patients . Br Med J 4:5-9, 1975;.
Walberg CB, Lundberg GD, Pantlik VA:  Emergency hospital toxicology . J Chromatogr Sci 12:225-227, 1974;.
Done AD:  The toxic emergency: On being prepared . Emergency Med , (November) 1973;, pp 284-291.

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Christison, cited by  Curry AS: Outline of a systematic search for an unknown poison , in Toxicology, Mechanisms and Analytical Methods . New York, Academic Press, 1960;, vol 1, p 257.
Goldstein A, Aronow L, Kalman SM:  Drug toxicity , in Principles of Drug Action: The Basis of Pharmacology , ed 2. New York, John Wiley & Sons, 1974;, p 359.
Costello CE, Hertz HS, Sakai T, et al:  Routine use of a flexible gas chromatograph-mass spectrometer-computer system to identify drugs and their metabolites in body fluids of overdose victims . Clin Chem 20:255-265, 1974;.
Biemann K (ed): Mass Spectra of Drugs . Cambridge, Mass, MIT Department of Chemistry, 1971;.
Heller SR, Koniver DA, Fales HM, et al:  Conversational mass spectral search system . Anal Chem 46:947, 1974;.
Simon NM, Krumlovsky FA:  The role of dialysis in the treatment of poisoning . Pharmacol Physicians 5:1-7, 1971;.
Domino EF:  Neurobiology of phencyclidine (Sernyl), a drug with an unusual spectrum of pharmacological activity . Int Rev Neurobiol 6:303-347, 1964;.
Rainey J, Crowder M:  Prevalence of phencyclidine in street drug preparations . N Engl J Med 290:467, 1974;.
Eastman JW, Cohen SN:  Hypertensive crisis and death associated with phencyclidine poisoning . JAMA 231:1270-1271, 1975;.
Fauman B, Baker F, Coppleson LW, et al:  Psychosis induced by phencyclidine . J Am Coll Emergency Physicians 4:223-225, 1975;.
Vale AJ, Widdop B, Goulding R:  Use of charcoal hemoperfusion in the management of severely poisoned patients . Br Med J 4:5-9, 1975;.
Walberg CB, Lundberg GD, Pantlik VA:  Emergency hospital toxicology . J Chromatogr Sci 12:225-227, 1974;.
Done AD:  The toxic emergency: On being prepared . Emergency Med , (November) 1973;, pp 284-291.
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