Can Be the First Casualty

Whilst sample preparation may not be the most interesting aspect of NMR spectroscopy, it is nonetheless extremely important as it will have a huge bearing on the quality of the data obtained and therefore on your ability to make logical deductions about your compounds. This is particularly true when acquiring the most straightforward 1-D proton spectra. The most typical manifestation of sub-standard sample preparation is poor line shape. It is worth remembering that in terms of 1-D proton NMR, the devil can be very much in the detail . Detail , in this context, means fine structure and fine structure is always the first casualty of poor sample preparation. 

Because decontamination occurs after buildings have been evacuated and first responders have treated any casualties, it allows for some time lapse before decontamination begins. With some planning, damage can be minimized and the efficacy of the decontamination process can be maximized. For example, sensitive equipment, electronics, valuable artwork, and personal objects will require chemicals that are less harsh than those used to clean air ducts and walls. The lack of time sensitivity also allows the choice of a decontaminant that may have a longer reaction time, but that is more suitable for the surface or the ambient conditions suoh as humidity and temperature. Thus, it is best to obtain a suite of deoontamination methods. 

We have already seen that chemical incidents are relatively quick-acting and limited, whereas biological incidents would take time before they are recognized for what they are. In general, one can consider a chemical release or attack to be a lights and sirens affair, that is, rapid response and (hopefully) expeditious treatment of casualties. In a bioterrorist event, however, people would be unlikely to know that they were exposed to an infectious agent or toxin until the first symptoms appear, at the very least several hours following the event. 

In respect of potential CN terrorism we believe that the following three critical items should be added to the CDC recommendations. First, before antidotes are stockpiled there should be international agreement on the most appropriate antidote (or combinations) for the treatment of acute CN poisoning. It is our opinion that hydroxocobalamin is the optimum choice. In the context of mass casualty situations with terrorist release of cyanides on the public, the chosen antidote should be readily available, effective, easy to administer (even by responders with limited training), nontoxic, and does not adversely interact with other antidotes (Thompson, 2004). Second, with respect to CN analyses, there is a requirement for a portable equipment that is specific and, at least semiquantitative, that can be used for on-site reliable bioidentification of CN intoxication. There is also a need for a reliable and sensitive environmental method for the instantaneous measurement of HCN concentrations, and ideally continuous monitoring with automatic warning devices for installation in sites with a potential for HCN attack. Third, educational materials should be made immediately available for distribution to the general population so that they can be prepared for what to expect in the event of a CN terrorism event. 

Prehospital Setting. The most important care that the casualty receives is the care that is given within the first several minutes of a chemical attack. The conduct of the care given immediately after toxic chemical agent exposure, including the administration of antidotes, can literally mean the difference between life and death. This is not an overstatement (United States Army Medical Research Institute of Chemical Defense, June 2001). Since this care will be rendered in a warm zone, personal protective equipment (PPE) must be employed by the responder. 

The first rule for medical personnel must be that they protect themselves. Failure to use appropriate procedures or protective equipment places the individual, health care workers and the medical treatment facility at risk. During a mass casualty incident, many people require medical care neither health care personnel nor health care facilities can be compromised. 

---