[ RadSafe ] Online Resource To Help Medical Responders During Radiation Emergencies

Susan Gawarecki loc at icx.net
Tue Oct 2 17:09:03 CDT 2007

Online Resource To Help Medical Responders During Radiation Emergencies
30 Sep 2007

Six years ago today, the terrorist attacks on America triggered a 
mobilization of national defense, preparedness, and resources that has 
no historical blueprint to follow. Plans to counter one of the most 
menacing threats - radiation contamination by nuclear explosion, "dirty" 
bomb, or some other device - have been developed with the help of NCI 
experts in radiation medicine.

The medical community around the globe has learned a great deal about 
how best to respond when people are exposed to radiation, based on 
decades of clinical experience with mass casualty radiation events: the 
atomic bombs dropped on Hiroshima and Nagasaki, nuclear reactor 
accidents such as Three Mile Island and Chernobyl, and accidental 
exposures during the transport of radioactive material.

The dilemma is that such knowledge resides primarily among experts and 
specialists, of which there are a limited number, and these experts may 
be especially scarce if the emergency were catastrophic and widespread. 
Also, the rarity of such an event means that up-to-date information is 
the optimal solution for health care providers.

This potential disconnect is addressed by Radiation Event Medical 
Management (REMM) <http://www.remm.nlm.gov/>, a new Web site developed 
by planners, physicians, radiation specialists, and other subject matter 
experts working with the Office of the Assistant Secretary for 
Preparedness and Response (ASPR) in the U.S. Department of Health and 
Human Services (HHS) in collaboration with the National Library of 
Medicine (NLM). The Web site was originally conceptualized by experts 
from NCI, ASPR, and NLM and the unique system was created by Dr. Judith 
Bader of NCI and a team from NLM (led by Florence Chang and colleagues).

Several of the key personnel on this project are on detail from NCI, 
including team leader Dr. Norman Coleman of NCI's Radiation Research 
Program in the Division of Cancer Treatment and Diagnosis 

"REMM was established to provide just-in-time information and guidance 
on diagnosis and treatment to health care providers - primarily 
physicians - who do not have formal radiation medicine expertise," 
explains Dr. Coleman.

He emphasizes that REMM is just one piece of the large government 
network being assembled by HHS and the Department of Homeland Security. 
Dr. Coleman and the REMM team are part of the Office of Preparedness and 
Emergency Operations (OPEO). Rear Admiral W. Craig Vanderwagen is the 
assistant secretary for preparedness and response; the OPEO team is led 
by Drs. Kevin Yeskey and Ann Knebel. In OPEO, they plan for the 
unthinkable regarding chemical, biological, radiological, and nuclear 
events and scenarios, as well as planning for natural disasters.

Part of REMM's solution to this challenge is a series of decision-tree 
algorithms for the nonexpert physician to follow at the scene. Because 
access to the Internet may be compromised during an emergency, the core 
of REMM also comes in the form of a diagnostic and treatment toolkit 
that can be downloaded in advance and stored on a local computer or 
storage device.

For REMM, the expert NLM content team gathered guidelines, protocols, 
procedures, and background from scores of sources, inside and outside of 
the federal government, and from scientific sources abroad. The initial 
Web site was reviewed by some 50 subject specialists from around the 
world and continues to be enhanced.

Written by: Addison Greenwood

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