A rapid toxicology screen for emergency and routine care of patients.

I have adapted, for use with a centrifugal analyzer, reagents from 10 different EMIT (Syva Co.) enzyme immunoassay urine drug-detection kits, reagents from another five serum kits, and reagents for determining ethanol. Assays for individual drugs in 100 microL of urine and in 100 microL of serum are performed simultaneously rather than sequentially in less than 15 min, with one-tenth the usual amount of reactants (sample + reagents). These assays, when combined with other easily performed tests, provide a rapid toxicology screen well-suited for evaluating acute emergency patients, and for performing a small number of daily routine screens. The total screen requires 500 microL of urine and 500 microL of serum. I summarize my experience with this procedure in its first year of use, and discuss differences between testing for the care of patients compared with searching for evidence of illegal drug use.