The Potential of Paper Spray-Mass Spectrometry for the Analysis of NPS in Emergency Department

Ambient ionisation has recently become an attractive addition to toxicology workflows, as it provides rapid analysis of drugs of abuse compared with traditional chromatographic techniques such as LC-MS. Based on electrospray ionisation mechanisms, paper spray ionisation (PSI) generates ions directly from a sample spotted onto a paper substrate, minimising the cost and time of analysis. PSI uses dried matrix spots (DMS), a well-established but evolving trend in toxicology providing an alternative to collection of venous blood samples. DMS also offer improved matrix and analyte stability due to fewer enzymatic processes taking place as a result of matrix dehydration. Using DMS and PSI combined introduces the possibility of less invasive sample collection for the patient, no sample extraction or chromatography required facilitating lower cost per analysis, and quicker turnaround with earlier results available to clinicians. Emergency department (ED) presentations due to acute drug toxicity can be life-threatening; currently clinicians rely on self-report and clinical patterns of toxicity to determine the drug(s) likely to be involved. The use of PSI for identification and quantitation of NPS/other drugs can provide results on drugs present to inform patient care early in the patients’ ED presentation. With the NPS market continually expanding, PSI coupled to MS has the potential for a wide-reaching benefit to ED care, ultimately enabling clinicians to tailor patient care based on analytically confirmed NPS use. This presentation will illustrate our preliminary work using a VeriSpray PSI-MS.