Dr. Carol Wilson is with the Navy Medical Research Center (NMRC) which in addition to doing research on military and battlefield medicine also does research in the areas of infectious disease and biodefense. NMRC would respond to an outbreak of a chemical or biological agent on a Navy or Marine Corps base, but their biodefense division and labs are relatively small. The majority of research done to defend against chemical and biological attacks is done by the Centers for Disease Control and Prevention (mainly for civilian outbreaks), but the main agency that deals with biological and chemical attacks from a military standpoint is the United States Army Medical Research Institute of Infections Disease (USAMRIID). USAMRIID by far has the largest and most advanced facilities and equipment for responding to a biological and chemical attack. If a VX-like agent was being used in a potential attack on a US military base the USAMRIID would also respond.
The standard treatment for exposure to any of the V-series of nerve agents is a cocktail of atropine, pralidoxime and an anticonvulsant like diazepam or midazolam. Atropine is a naturally occurring tropine alkaloid, it is found in plants of the nightshade family. Atropine is an anticholinergic medication, meaning it blocks the action of the neurotransmitter acetylcholine; V-agents overstimulate acetylcholine receptors so atropine helps counteract that effect. It is used to treat exposure to certain nerve agents, pesticides and to lower heartrate, depending on dosage atropine can be a lifesaving medication or a deadly poison.
Pralidoxime is a synthetic oxime that was developed specifically for treating organophosphate poisoning. Organophosphates like sarin and V-agents, in addition to binding to acetylcholine receptors, also bind to acetylcholinesterase enzymes blocking their action, these enzymes are what remove acetylcholine from the receptor in order to deactivate it; with the acetylcholinesterase being inactivated the receptor is stuck in an active state preventing muscles from contracting and leaving them in a state of flaccid paralysis. Pralidoxime strips the organophosphate molecules away from the acetylcholinesterase enzymes restoring their function.
Diazepam (Valium) and midazolam (Versed) are benzodiazepine anxiolytic medications used to treat anxiety, seizures and muscle spasms. In the early stages of severe organophosphate poisoning one of the symptoms is severe muscle spasms and convulsions, benzodiazepines helps to lessen the severity of these, as they can sometimes cause cardiac issues. The US military developed an auto-injector pen specifically for exposure to nerve agents like sarin and VX, they are issued to soldiers who are going to be in a situation where they could be potentially exposed to any of these agents. The pens, called Antidote Treatment Nerve Agent Auto-Injectors (ATNAA), are dual chambered, one of the vials contains a mixture of atropine and pralioxime and the other contains an anticonvulsant like diazepam or midazolam.
Pralidoxime is a synthetic oxime that was developed specifically for treating organophosphate poisoning. Organophosphates like sarin and V-agents, in addition to binding to acetylcholine receptors, also bind to acetylcholinesterase enzymes blocking their action, these enzymes are what remove acetylcholine from the receptor in order to deactivate it; with the acetylcholinesterase being inactivated the receptor is stuck in an active state preventing muscles from contracting and leaving them in a state of flaccid paralysis. Pralidoxime strips the organophosphate molecules away from the acetylcholinesterase enzymes restoring their function.
Diazepam (Valium) and midazolam (Versed) are benzodiazepine anxiolytic medications used to treat anxiety, seizures and muscle spasms. In the early stages of severe organophosphate poisoning one of the symptoms is severe muscle spasms and convulsions, benzodiazepines helps to lessen the severity of these, as they can sometimes cause cardiac issues. The US military developed an auto-injector pen specifically for exposure to nerve agents like sarin and VX, they are issued to soldiers who are going to be in a situation where they could be potentially exposed to any of these agents. The pens, called Antidote Treatment Nerve Agent Auto-Injectors (ATNAA), are dual chambered, one of the vials contains a mixture of atropine and pralioxime and the other contains an anticonvulsant like diazepam or midazolam.
VX gas is an extremely toxic synthetic chemical, arguably the deadliest synthetic chemical compound ever created by man. It was developed into a chemical weapon by the military for use in chemical warfare after being somewhat accidentally discovered by British chemists Ranajit Ghosh and J. F. Newman in 1952. They were working on creating a new kind of pesticide based off research on organophosphates done in the 1930's by German chemist Gerhard Schrader. Schrader, Ghosh and Newman were not trying to create a chemical weapon of mass destruction, they were hoping to create a potent pesticide that could kill insects in very small doses, with those doses being too small to harm humans. However the compound they produced proved to be far more toxic than they ever anticipated, and research on this new chemical as a pesticide was halted in 1955 due to it being extremely dangerous to humans. However the British, Russian and US militaries soon heard of this new compound and began researching ways to make it even more toxic and potent, the result was a new group of nerve agents known as the V-agents (venomous agents), the deadliest of those being the VX agent developed by the British, with the Russian's VG agent being a close second.
VX (and the other V-agents) is in the organophosphate class of nerve agents, specifically it is a thiophosphonate, a type of acid made from phosphorus. VX is the deadliest synthetic toxin known to exist, with inhaled doses of only 10 milligrams being fatal, making it even more toxic than sarin gas. It is an oily, non-volatile compound and does not break down easily in the environment, properly dispersed in the air a teaspoon of VX gas could kill every person inside NCIS headquarters. V-series agents quickly and severely interrupt signaling between the nervous system and muscles, leading to a condition known as neuromuscular blockade, causing all the muscles in the body to become flaccid and unable to contract, including the diaphragm. Without the muscles in the diaphragm being able to contract, air is unable to be pulled into the lungs, resulting in death by asphyxiation.
VX (and the other V-agents) is in the organophosphate class of nerve agents, specifically it is a thiophosphonate, a type of acid made from phosphorus. VX is the deadliest synthetic toxin known to exist, with inhaled doses of only 10 milligrams being fatal, making it even more toxic than sarin gas. It is an oily, non-volatile compound and does not break down easily in the environment, properly dispersed in the air a teaspoon of VX gas could kill every person inside NCIS headquarters. V-series agents quickly and severely interrupt signaling between the nervous system and muscles, leading to a condition known as neuromuscular blockade, causing all the muscles in the body to become flaccid and unable to contract, including the diaphragm. Without the muscles in the diaphragm being able to contract, air is unable to be pulled into the lungs, resulting in death by asphyxiation.
NCIS has had many Star Trek actors, actresses and references. Towards the end of this episode Dr. Palmer, locked inside the lab with the poisonous toxin and his daughter, Victoria, outside the lab, both put their hands on the glass, as if to touch. A reference to Star Trek II: The Wrath of Khan where Spock, inside the chamber filled with radiation and Kirk outside of the chamber "touched".