Urine Trinder spot test: a rapid salicylate screen for the emergency department.

Abstract

To determine whether the urine Trinder spot test, performed by emergency physicians, is a sensitive bedside screen for salicylates. Prospective, blinded human protocol with subjects serving as their own controls. Urban Level I medical center. Ten male and two female volunteers with negative urine toxicologic screen results before the start of the study. Each participant ingested 975 mg of nonenteric coated aspirin. Serum and urine samples were collected before ingestion and 2 and 4 hours after ingestion. Three emergency physicians and a toxicology technician independently performed Trinder spot tests. Results were recorded as positive or negative for salicylate on the basis of color change (a purple reading was considered positive). All postingestion urine specimens were detected by all testers with 100% sensitivity. Two false positives occurred in the preingestion samples. Serum quantitative assays confirmed the presence of salicylates in all postingestion specimens. This pilot study suggests that emergency physicians can use the Trinder spot test as a sensitive bedside salicylate screen, potentially saving time and quantitative assay expense.