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In the ED setting, the diagnosis of ketamine intoxication is a clinical one. Ketamine is not routinely detected by urine toxicology tests, although it can be detected with high-performance liquid chromatography (Koesters et al. 2002). As with MDMA, the initial assessment for ketamine intoxication includes the use of routine laboratory tests to detect electrolyte abnormalities and to evaluate renal and hepatic functioning (Koesters et al. 2002). 

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