Lec 16: PADIS Assessment

Question 1

What are the 10 P’s of poison hx taking?

1) Check ______
2) Ask ______
3) Ask
__________
4) ____ personnel
5) P____
6) Ped_____
(Probably Low yield)
7) Po_____
8) Personal ____
9) Past _____
10) Ph________

Answer 1

1) Check Pockets
2) Ask the Patient
(Duh!)
3) Ask
Parents/Partners/Pals
4) Prehospital
personnel (EMS)
5) PADIS
6) Pedestrians
(Probably Low yield)
7) Police
8) Personal MD
9) Past History (old
chart)
10) Pharmacy

Question 2

What are the 2 types of “drug screens”

Answer 2

Immunoassay screening test and Comprehensive Intensive (aka Tox Labs).

Question 3

Immunoassay screening test vs Comprehensive Intensive:
- which one is more like an OTC pregnancy test?
- what is the biggest cons with immunoassay tests?
- Comprehensive intensive tests are usually done via what meethod?
- how long does it take to get results?

Answer 3

Immunoassay:
- Otc pregnancy test.
High risk false positives.
- UDS: useless test. Avoid.

Comprehensive Intensive:
- usually done with Liquid chromatography, mass spec.
- takes days- weeks and is more intensive.

Question 4

Why are Urine Drug Screens basically useless?

cuz they rarely make a _____, _____ from lab to lab, not all toxins can be _____, and ______ can be an isseu (i.e. dextromethorphan testing postiive for amphetamineS?)

Answer 4

cuz they rarely make a clinical difference, differs from lab to lab, not all toxins can be screened, and cross sensitivity can be an isseu (i.e. dextromethorphan testing postiive for amphetamineS?)

Question 5

Why are Comprehensive Urine Drug Screens not frequently used either?

Answer 5

they’re labour intensive, lengthy to perform, and rarely contribute to the management of the poisoned pt in an acute situation.

–> used most often for academic or medical-LEGAL purposes (lance armstrong).

Question 6

Under what situations, might you consider getting a fanccy COMPREHENSIVE LC/MS TEST?

if any suspicion of what?

• in some pts with waht type of damage?
• if there’s a recent ___________.
• in pts with what type of status?

Answer 6

• if any suspicion of child abuse, homicide or sexual assault.
• in some pts with brain death [Some drugs mimick brain death (baclofen) –> make sure brain death is not drug related and that they’re atually dead].
• if there’s a recent public health outbreak.
• in pts with delirium/altered mental status that can’t be explained by any other cause. (at this point, trying everything).

Question 7

What are some toxins that have CLINICALLY RELEVANT drug levels, that you MAY consider ordering a drug level for?

Answer 7

• Acetaminophen
• salicylates
• lithium
• heayv metals
• iron
• digoxin
• anticonvulsants (phenytoin)
• methanol
• ethylene glycol
• isopropyl alcohol
• Co2.