NLM’s Free Downloadable, Online, and Smartphone     Tools for First Responders and Others.  Part 2: CHEMM (Chemical Hazard...
NLM’s challengesNeed to compile authoritative, trustworthy informationInformation needs to meet the needs of the usersUser...
Chemical Hazards Emergency Medical Management                   (CHEMM)   http://chemm.nlm.nih.gov/                       ...
CHEMM was announced and released in July, 2011                                                     National Library of Med...
CHEMM – Overarching Goals    Provide a comprehensive, user-friendly resource that will     enable first responders, first...
Collaborative effort between:U.S. Department of Health and Human Services, Officeof the Assistant Secretary for Preparedne...
CHEMM - Audiences  Responders     Pre-hospital     Hospital-based        Emergency Department        Critical Care  ...
Role-based Navigation and Key Features                                                 National Library of MedicineNATIONA...
Role-based Navigation                                                 National Library of MedicineNATIONAL INSTITUTES OF H...
National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES                  ...
National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES                  ...
National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES                  ...
Introduction of Key Component #1:           CHEMM-IST                                                  National Library of...
Toxic Syndromes Diagnostic Expert System CHEMM toxic syndromes diagnostic system is “CHEMM-  IST” (CHEMM Intelligent Synd...
CHEMM-ISTThe CHEMM Intelligent Syndromes Tool                                                 National Library of Medicine...
CHEMM-IST is being validated                                                 National Library of MedicineNATIONAL INSTITUT...
After Two Questions                                                 National Library of MedicineNATIONAL INSTITUTES OF HEA...
After Eleven Questions. Done!http://chemm.nlm.nih.gov/chemmist.htm                                                 Nationa...
Introduction of Key Component #2:   Medical Management Content                                                  National L...
• Detailed step-by-step medical management  guidelines for first responders at the scene and  providers in the hospital in...
Example of Medical Management Content:       Prehospital Management Agent Management  Overview Hot Zone Decontamination...
Example of Medical Management Content:    Emergency Department/Hospital             Management Agent Management  Overview...
Resource comparison tool in CHEMM version 1.0                                                     National Library of Medi...
National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES                  ...
National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES                  ...
In ProgressEnhance Chemicals Content  Develop and add content to CHEMM. Goal: Include information  on all or nearly all ke...
In ProgressMedical Countermeasures Database Creation  Project to create a database searchable for the current  information...
CHEMM Outreach                                                 National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊...
CHEMM in the News                                                 National Library of MedicineNATIONAL INSTITUTES OF HEALT...
Chemical Hazards Emergency Medical Management                   (CHEMM)   http://chemm.nlm.nih.gov/                       ...
Providing Access (Smartphone apps will be added later)                                                     National Librar...
http://www.ncbi.nlm.nih.gov/pubmed/22289097                                                       National Library of Medi...
Radiation Emergency Medical Management                (REMM)             http://www.remm.nlm.gov/                         ...
Respond to Mass Casualty Radiation                EventsProvide:  Guidance for health care providers about clinical   dia...
How can you access REMM?    Web – www.remm.nlm.gov    Downloadable versions for Windows and Mac    Mobile REMM, with se...
What have we learned from work on WISER,CHEMM, and REMM?Authoritative, trustworthy information is needed – needmany types ...
Some of the Next Steps    Continue sustainment and development of CHEMM,     REMM and WISER         Engagement with expe...
How to stay informed                                                 National Library of MedicineNATIONAL INSTITUTES OF HE...
http://disasterinfo.nlm.nih.gov/                                                 National Library of MedicineNATIONAL INST...
http://disasterinfo.nlm.nih.gov/dimrc/disasterapps.html                                                    National Librar...
"   Comments?"   Suggestions?Pertti (Bert) J. Hakkinen, Ph.D.Senior Toxicologist, and Toxicology and Environmental Health ...
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Chemm slides

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  1. 1. NLM’s Free Downloadable, Online, and Smartphone Tools for First Responders and Others. Part 2: CHEMM (Chemical Hazards Emergency Medical Management) Pertti (Bert) J. Hakkinen, Ph.D. Senior Toxicologist, and Toxicology and Environmental Health Science Advisor Specialized Information Services, National Library of Medicine National Institutes of Health Also: Adjunct Associate Professor, Biomedical Informatics Department, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 1
  2. 2. NLM’s challengesNeed to compile authoritative, trustworthy informationInformation needs to meet the needs of the usersUsers need to have access when and where they need itUsers need easy access, e.g., during emergenciesInformation evolvesWays to deliver and access the information evolve National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 2
  3. 3. Chemical Hazards Emergency Medical Management (CHEMM) http://chemm.nlm.nih.gov/ National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 3
  4. 4. CHEMM was announced and released in July, 2011 National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 4
  5. 5. CHEMM – Overarching Goals  Provide a comprehensive, user-friendly resource that will enable first responders, first receivers, other healthcare providers, and planners to plan for, respond to, recover from, and mitigate the effects of a mass-casualty incident involving chemicals  Be available on the Internet and also for download so that it can be used in an emergency even without an Internet connection  Scope – to be used for:   Training   Planning   Response at time of an emergency National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 5
  6. 6. Collaborative effort between:U.S. Department of Health and Human Services, Officeof the Assistant Secretary for Preparedness andResponse (ASPR) - Office of Preparedness andEmergency Operations (OPEO)National Institutes of Health, National Library ofMedicine - Division of Specialized Information Services(NLMSIS)Many medical, emergency response, toxicology,industrial hygiene, and other experts National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 6
  7. 7. CHEMM - Audiences  Responders   Pre-hospital   Hospital-based   Emergency Department   Critical Care  Healthcare providers: follow-up/recovery  Planners  Trainers National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 7
  8. 8. Role-based Navigation and Key Features National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 8
  9. 9. Role-based Navigation National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 9
  10. 10. National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 10
  11. 11. National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 11
  12. 12. National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 12
  13. 13. Introduction of Key Component #1: CHEMM-IST National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 13
  14. 14. Toxic Syndromes Diagnostic Expert System CHEMM toxic syndromes diagnostic system is “CHEMM- IST” (CHEMM Intelligent Syndromes Tool) “FALCON: A Decision Support System for Hazardous Materials Incidents and Terrorism Response” is the foundation Experts (physicians and EMTs) have provided extensive technical consultation for implementation of the prototype rule base for toxic syndrome diagnosis Input of symptoms identifies the chemical group or syndrome likely to cause the symptoms so treatments can be rapidly initiated National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 14
  15. 15. CHEMM-ISTThe CHEMM Intelligent Syndromes Tool National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 15
  16. 16. CHEMM-IST is being validated National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 16
  17. 17. After Two Questions National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 17
  18. 18. After Eleven Questions. Done!http://chemm.nlm.nih.gov/chemmist.htm National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 18
  19. 19. Introduction of Key Component #2: Medical Management Content National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 19
  20. 20. • Detailed step-by-step medical management guidelines for first responders at the scene and providers in the hospital including the emergency department and intensive care• Guidelines for children, pregnant women, and elderly patients• Extensive input from other physicians National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 20
  21. 21. Example of Medical Management Content: Prehospital Management Agent Management Overview Hot Zone Decontamination Zone Support Zone and more National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 21
  22. 22. Example of Medical Management Content: Emergency Department/Hospital Management Agent Management Overview Hot Zone Decontamination Zone Treatment Area and more National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 22
  23. 23. Resource comparison tool in CHEMM version 1.0 National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 23
  24. 24. National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 24
  25. 25. National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 25
  26. 26. In ProgressEnhance Chemicals Content Develop and add content to CHEMM. Goal: Include information on all or nearly all key chemicals. National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 26
  27. 27. In ProgressMedical Countermeasures Database Creation Project to create a database searchable for the current information on medical countermeasures relevant to CHEMM- relevant hemical exposures, e.g., efficacy, relevant publications and toxicity profiles, research in progress, FDA and other global regulatory status… National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 27
  28. 28. CHEMM Outreach National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 28
  29. 29. CHEMM in the News National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 29
  30. 30. Chemical Hazards Emergency Medical Management (CHEMM) http://chemm.nlm.nih.gov/ National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 30
  31. 31. Providing Access (Smartphone apps will be added later) National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 31
  32. 32. http://www.ncbi.nlm.nih.gov/pubmed/22289097 National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 32
  33. 33. Radiation Emergency Medical Management (REMM) http://www.remm.nlm.gov/ National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 33
  34. 34. Respond to Mass Casualty Radiation EventsProvide:  Guidance for health care providers about clinical diagnosis and treatment during mass casualty radiological/nuclear events  Evidence-based information that makes complex issues understandable to those without formal radiation medicine expertise  Web-based information that is also downloadable in advance and available if the Internet is not accessible National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 34
  35. 35. How can you access REMM?  Web – www.remm.nlm.gov  Downloadable versions for Windows and Mac  Mobile REMM, with selected key files from the full version of REMM   iPhone®/iPod touch®   BlackBerry®   Windows Mobile®   Android®   Palm OS®  Selected content included in WISER National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 35
  36. 36. What have we learned from work on WISER,CHEMM, and REMM?Authoritative, trustworthy information is needed – needmany types of expertise and collaborationThat information needs to meet the needs of the users –need to interact with users to know/confirm needs. Expertmodels and mental models research (CHEMM)The users need to have access when and where theyneed it – need to keep up with devices/platformsThe users need easy access, e.g., during emergencies –make it easy to access, and provide online,downloadable, and in person training resources National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 36
  37. 37. Some of the Next Steps  Continue sustainment and development of CHEMM, REMM and WISER   Engagement with experts to keep the content up to date   Assure updates are widely available on mobile devices  Seek to create similar tools for other scenarios  Continue to explore and develop options for outreach and education  Given fiscal constraints, explore additional collaborations and sources of help and funding National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 37
  38. 38. How to stay informed National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 38
  39. 39. http://disasterinfo.nlm.nih.gov/ National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 39
  40. 40. http://disasterinfo.nlm.nih.gov/dimrc/disasterapps.html National Library of MedicineNATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 40
  41. 41. " Comments?" Suggestions?Pertti (Bert) J. Hakkinen, Ph.D.Senior Toxicologist, and Toxicology and Environmental Health Science Advisor (to the Director)Specialized Information Services, National Library of MedicineNational Institutes of HealthBethesda, MD USApertti.hakkinen@nih.gov http://sis.nlm.nih.gov/ National Library of Medicine NATIONAL INSTITUTES OF HEALTH ◊ U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 41
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