What should I do with my cocaine-positive patient?

Almost two fifths of your patients with major trauma will arrive in the trauma bay with a positive toxicology screen for cocaine.  Is that a problem?  Should the presence of cocaine metabolites in the urine delay urgent or elective procedures?  Dr. Tiffany Moon summarizes some of the existing literature related to the subject.  Dr. Moon is currently practicing at UT Southwestern Medical Center.  She is heavily involved with the residency program, specifically in the areas of recruitment and research.  She is also involved with the Trauma Anesthesiology Society and the American Society of Anesthesiologists.  Her editorial summary of the existing knowledge of cocaine use perioperatively, which affects the traumatically injured disproportionately, highlights the need for further research in this area.

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