SF General Hospital Toxicology Center | BIE
As part of emergency medicine, the toxicology and poison centers at San Francisco General Hospital analyze human lab specimens such as blood and urine to diagnose what the toxins are in their patient’s bodies. Whether it is a foodborne, prescription drug, non-prescribed drug or biologic compound, the toxicology group diagnoses and manages the conditions.
The BIE blue team had the pleasure of meeting Dr. Alan Wu, PhD., a clinical chemist who has a passion for accurate mass spectroscopy and other laboratory tests for diagnosis. Dr. Wu began by describing some of the major challenges in the department, such as patients taking street drugs that have not been observed before. Toxicology is very experiential field since safe human tests cannot be performed with potentially toxic compounds. Thus, new modified drugs are hard to identify since they are not in the documentation previously. In addition, the original compounds may not be present due to patient metabolism.
Afterwards, Dr. Wu guided the cohort through the various facilities such as the 24-hour poison center and the microbiology labs. Dr. Wu also brought the group to a toxicology grand rounds, where a fellow was describing an unusual toxicology cases involving rat lungworm and sulfur dioxide. The team learned about the various forms of mass spectrometry in the facility like Gas Chromatography Mass Spectrometry (GCMS), Liquid Chromatography Mass Spectrometry (LCMS), and High-Resolution Liquid Chromatography Mass Spectrometry (HRLCMS). With machines like HRLCMS, compounds can be identified to the nearest thousandth atomic mass. Using search tools like Google, the number of possible compounds with a particular atomic mass is reduced tremendously, making diagnosis for the clinical toxicologist much easier and faster.
Later in the day, the cohort reviewed and presented on current papers pertaining to toxicology and mass spectroscopy in front of a group of Dr. Wu’s colleagues. Next, Dr. Wu showcased some recent diagnostic devices the hospital tested over the years for the group to discuss their shortcomings and successes. This demonstrated the importance of needs finding, in terms of consulting physicians and field experts, before developing a medical device. The team wrapped up the visit with a tour of the emergency room and the new hospital.
