In the emergency department, it is important to rapidly identify the toxic substances that have led to acute poisoning because different toxicants or toxins cause poisoning through different mechanisms, requiring disparate therapeutic strategies and precautions against contraindicating actions, and diverse directions of clinical course monitoring and prediction of prognosis. Ambient ionization mass spectrometry, a state-of-the-art technology, has been proved to be a fast, accurate, and user-friendly tool for rapidly identifying toxicants like residual pesticides on fruits and vegetables. In view of this, developing an analytical platform that explores the application of such a cutting-edge technology in a novel direction has been initiated a research program, namely, the rapid identification of toxic substances which might have caused acute poisoning in patients who visit the emergency department and requires an accurate diagnosis for correct clinical decision-making to bring about corresponding data-guided management. This review includes (i) a narrative account of the breakthrough in emergency toxicology brought about by the advent of ambient ionization mass spectrometry and (ii) a thorough discussion about the clinical implications and technical limitations of such a promising innovation for promoting toxicological tests from tier two-level to tier one level.

中文翻译：

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用于紧急毒理学的热解吸环境电离质谱法

在急诊科，快速识别导致急性中毒的有毒物质非常重要，因为不同的毒物或毒素通过不同的机制引起中毒，需要不同的治疗策略和禁忌行为的预防措施，以及临床病程监测和预测的不同方向的预后。环境电离质谱是一种最先进的技术，已被证明是一种快速、准确且用户友好的工具，可用于快速识别水果和蔬菜上残留农药等有毒物质。有鉴于此，开发一个分析平台来探索这种尖端技术在一个新方向的应用已经启动了一项研究计划，即快速识别可能导致就诊患者急性中毒的有毒物质。急诊科需要准确的诊断来做出正确的临床决策，从而实现相应的数据指导管理。这篇综述包括（i）对环境电离质谱的出现所带来的紧急毒理学突破的叙述性描述，以及（ii）对这种有前途的创新的临床意义和技术局限性的彻底讨论，以促进从一级毒理学测试二级到一级。