Emergency Rooms & Required Urine Drug Tests

Drug overdoses can be transferred by an ambulance.

Every minute is critical when a patient is in the emergency room. There may be several people waiting for help and not enough medical personnel. Emergency room doctors must make quick decisions. Certain diagnostic tests are common in the emergency room including blood tests, X-rays, electrocardiograms, CT or computer tomography scans, and MRI or magnetic resonance images. Most emergency rooms require urine drug tests, otherwise known as toxicology tests, of all patients.

Why Test Urine?

Urine test strip.

Many drugs show up in the urine and remain in it longer than those in blood. More than 30 different drugs can be checked for from one specimen. Urine tests are also easier to do. No needles or painful pokes are necessary to obtain a urine sample. A toxicology text (tox screen) can be done if someone is unconscious, has odd or bizarre behavior, or appears to have life-threatening symptoms. Drug overdose can also be determined by a urine sample.

Valuable Information

Medications.

If a urine test is requested, a nurse or doctor will ask several questions of the patient or the family which may affect the results. If the patient is already on any prescription or nonprescription drugs, it is important that this information be shared. Any herbal supplements, vitamins or other substances taken within the last four days should be reported.

Obtain Specimen

Urine samples are taken in a restroom.

A catheter can be used to obtain urine if the patient is unable to do it themselves. This will be done by a nurse or doctor. If the patient is lucid and able, they will be given a small container to collect the urine in. The patient should wash their hands to make sure they are clean before collecting the urine. The patient should also clean the area around their genitals. A clean catch specimen is one that is caught midstream. The container is sterile and has a lid. After collecting, it should be given to the emergency room personnel.

Security Measures

Medical form.

At times another person of the same sex may have to watch the patient take the sample to be sure that the sample is truly theirs. The temperature of the urine is also checked to make sure that it is a fresh sample. Some individuals use drugs to enhance their ability as an athlete, which may be illegal. Emergency room patients will also be asked to sign a consent form before they take a urine specimen that confirms their understanding of the risks of toxicology testing.

Results

Patient's urine.

A normal toxicology test will show levels of prescription or nonprescription medicines, which are within the effective or therapeutic range. An abnormal result would be one that shows levels of prescription or nonprescription medicines in the urine, which are too low or too high or potentially toxic. If a person is supposed to be taking prescription medication, it would show a low level of that drug in their urine. It may mean that they are not taking their medicine as they should. If the levels are very high for certain drugs, it could be accidental or intentional.

Controversy

Poppies may lead to test problems.

Some drugs can be mistaken for others. Cough medicines sometimes are mistakenly identified as narcotics. Certain foods can affect the results such as poppy seeds. Salt tablets, bicarbonates, and detergents and blood in the urine can also affect the results of the test.

References

• Hospital: Common tests in the emergency room

Resources

• WebMD