MSLTs and Urine Drug Screens

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MSLTs and Urine Drug Screens

Postby dream police » Fri Mar 06, 2009 12:32 am

The AASM says "Drug screening may be indicated to ensure that the sleepiness on the MSLT is not pharmacologically induced. Drug screening is usually performed on the morning of the MSLT but its timing and the circumstances of the testing may be modified by the clinician."

Just wondering what others do in their neck of the woods.

1) Do you do routine urine drug screens with MSLTs or just if they're ordered?
2) When do you obtain the sample (i.e. between the 2nd and 3rd nap)?
3) Are the results reported on the physician's interpretation?

Thanks for any input.
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Postby Rusty.Sullivan » Fri Mar 06, 2009 1:33 am

1) Do you do routine urine drug screens with MSLTs or just if they're ordered?

We have a protocol that all MSLTs are to be accompanied by a urine drug screen and a standing order to go along with the protocol.

2) When do you obtain the sample (i.e. between the 2nd and 3rd nap)?

The night techs generally collect the urine immediately upon awakening.

3) Are the results reported on the physician's interpretation?

Yes.
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Postby RPSGT88athome » Fri Mar 06, 2009 3:00 am

Why collect urine upon awakening? What if the pt. secretly doses self within 30 minutes before the first nap/trial? Urine should be collected -during- the MSLT/MWT. Not before.

I know prior night NPSGs are not used before MWTs.

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Postby Rusty.Sullivan » Fri Mar 06, 2009 9:12 am

RPSGT88athome wrote:Why collect urine upon awakening? What if the pt. secretly doses self within 30 minutes before the first nap/trial? Urine should be collected -during- the MSLT/MWT. Not before.

I know prior night NPSGs are not used before MWTs.

RPSGT88


You run into the same problem later as well. What if the patient secretly doses self within 30 minutes before the 2nd or 3rd nap? The only thing you can do is try to be vigilant and watch the video monitor as much as possible.
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Postby RPSGT88athome » Fri Mar 06, 2009 11:15 am

Right so collect urine right before the last nap.

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Postby Rocklandish » Fri Mar 06, 2009 9:58 pm

I don't believe my lab does urine screens at all. Unless we are doing some sort of research.
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mslts and urine drug screens

Postby sleepygolfer » Tue Mar 10, 2009 4:52 pm

We test them just before the last nap on all MSLTs and MWTs, especially if they leave the unit to smoke (we'd like to make sure it's just Marlboro's). We include a copy of the screen with our report to the interpreting doc. He has a section where he documents the results in his interpretation. Works well for us.
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Postby Bevelman » Tue Mar 10, 2009 6:30 pm

We are just getting into doing this. It has been discussed before, after, during. I belive we settled on before first nap. Although after reading this i can see why some labs are doing it at the end or just before nap 5. However if the patient is "dosing" him or her self do you really think they are going to stop two weeks before this test? Then after the drug screen start back up?

Just my two cents...

1. yes
2. before first nap
3. yes they are reported on the interp.
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Postby Rocklandish » Tue Mar 10, 2009 9:01 pm

Are the pts told about the drug screen? just curious.
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MSLTs and urine drug screens

Postby sleepygolfer » Thu Mar 12, 2009 2:43 am

Yep, during hookup.
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Postby Rocklandish » Thu Mar 12, 2009 1:54 pm

I asked, and we do screen for all of our mslt pts. it is techs choice as to when it is done.
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Postby Jayhawkhenry » Thu Mar 12, 2009 9:26 pm

We always do the between nap 3 & 4.
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Postby zack » Fri Mar 13, 2009 5:01 am

RPSGT88athome wrote:Right so collect urine right before the last nap.

RPSGT88


That does make sense...
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Postby RayMeece » Tue Mar 17, 2009 10:43 am

RPSGT88athome wrote:Right so collect urine right before the last nap.

RPSGT88


Makes sense to me.

But we do it upon awakening. Thats when the urine is more concentrated, so won't drugs be more apt to appear in the screen?

Our doc has ALWAYS done it upon awakening. It is doen on every MSLT or MWT, though it has to be ordered.

The results are posted on the patients chart when we get them back from the lab.
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Postby somnonaut » Tue Jul 09, 2013 8:21 pm

Just found these 10 drug, instant urine analysis cups.
http://www.origindiagnostics.com/eco-cu ... tests.html
MVAP also offers these and others.

Also found their accompanying PDF of state laws regarding workplace urine drug testing.
http://www.origindiagnostics.com/upload ... g_laws.pdf
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