Our talk today is about the National Library of Medicine’s (NLM) resources that you may find useful for accessing disaster and disaster health related information. We will also update you on the activities of the Disaster Information Management Research Center and the work we are doing to support the development of a new librarian specialty – the Disaster Information Specialist.
A number of events over the past year have shown us that it is when, not if a disaster will strike. Whether local, national or international, there is always a need for authoritative health information and in ways that you might not be able to anticipate. The earthquake in Haiti - not a local or national disaster; yet medical libraries across the U.S. found themselves supporting the information needs of teams of health care responders who traveled to Haiti to help victims. To support this need, we compiled a resource page that consisted of numerous health related links, including a relatively robust section on health information in Haitian Creole. Even localized disasters can have far-reaching effects, consider the volcano in Iceland. In disaster situations, there is often little time to do research; your value maybe measured by being prepared with information and already being part of the efforts to support disaster response.
Before we proceed, I want to provide a brief background on who we are and why we are involved with disasters. The Disaster Information Management Research Center is part of the Specialized Information Services Division of the National Library of Medicine. Often abbreviated as DIMRC, our purpose is to Organize the disaster health literature [that literature is diverse and highly scattered and while links to peer-reviewed journal literature are available through PubMed, finding on-journal literature, such as planning documents, guidelines, etc, is not easy – time is usually critical in a disaster and conducting a wide search through multiple sources is not an option] Provide access to the literature Develop information tools Maintain library operations Conduct research and development
Who needs disaster health information? Our work is targeted to a number of audiences, including……… Librarians and other information professionals [This is our primary audience and more on this later] Public health workers Researchers Emergency managers First responders, and more….
The DIMRC Web site is NLM’s primary point of access for disaster health information. While NLM has been supporting disaster health information needs for many years, it was in 2008 that the Library created this center to coordinate the Library’s efforts to organize and improve access to disaster information, and to develop relationships with other agencies, organizations, and universities to learn more about disaster health and how to provide needed information quickly and easily.
If your work involves disasters, you know that there are multiple stages to a disaster or hazardous incident. Information support can come into play at any or all of these stages, and as mentioned earlier, time can be critical when information is needed in the second phase, response to immediate event. Information must be readily available at this point.
NLM has a number of resources to support all phases of disasters and disaster information support.
PubMed has over 30,000 citations to journal articles on some facet of disaster preparedness and response. The articles are widely scattered across many journals. While many medical journals cover disaster health-related topics, there are some that focus on disaster topics – 7 are indexed in PubMed; 15 additional Emergency Medicine journals with related content are indexed. Such as: Pre-hospital and Disaster Medicine Military Medicine Wilderness and Environmental Medicine Disaster Medicine and Public Health Preparedness Annals of Emergency Medicine Journal of Traumatic Stress There are more than 450 disaster-related MeSH terms, with more added each year.
PubMed covers the peer-reviewed journal literature, however, grey literature sources are critical in the disaster health field. We work jointly with the NY Academy of Medicine to publish the Resource Guide for Public Health Preparedness which catalogs resources such as guidebooks, factsheets, websites, research reports, and other tools. We are currently working on improving this database.
NLM also recently announced a separate Emergency Access Initiative to support medical efforts in Haiti. The Emergency Access Initiative (or EAI) provides free access to full-text articles from biomedical journals and reference books to assist health care professionals and libraries in areas affected by disasters. The collection contains more than 200 carefully selected journal titles, more than 30 reference books, as well as materials on emergency medicine. The EAI provides needed health and medical information when local libraries and access to local information resources are closed by a disaster. The EAI was designed to help U.S. medical professionals and libraries cope with disasters. The service was partially inspired by the unavailability of health information to physicians and emergency responders following Hurricane Katrina in the U.S. in summer 2005. NLM activated the EAI on January 25 in order to immediately help the medical and public health professionals working in Haiti. The resource is designed to meet medical and public health emergency response needs regardless of location in the future. The EAI includes participation from several international publishers, nongovernment, and scientific/medical organizations, who graciously provided free access to materials. To find the EAI website, type: 'eai.nlm.nih.gov' in a web browser, or type 'Emergency Access Initiative National Library of Medicine' in a search engine.
NLM has a number of topic pages, or subject guides that provide web links on specific disaster and environmental topics. New disaster health and enviro-health links pages were created this past year for a number of events – including H1N1, earthquakes, Haiti earthquake, Chile earthquake and most recently, the crude oil spill in the Gulf of Mexico. Resources are updated and added frequently during events. This year we created our first “widgets” or image links that others can copy and embed on their web pages to link directly to our resource pages. The two we have active are the Health Resources for Haiti and the Oil Spills & Health widgets. Embedding this on your page provides a direct link our resource page on the topic.
For the past several years, the National Network of Libraries of Medicine have focused on emergency preparedness for libraries and service continuity. Each Regional Medical Library has a back up Regional Medical Library and these partners agree to help each other if one is out of service. The National Network Office developed an Emergency Preparedness Toolkit to help libraries develop disaster plans, and Memorandums of Understandings with other libraries to assist each other in times of disaster; it includes a 10-step plan that can be implemented quickly and easily anytime, anywhere.
WISER, the Wireless Information System for Emergency Responders, continues to be an important tool for both emergency responders and for first receivers. Available in a number of platforms, including a downloadable Windows version and web version, the product interface has been improved this past year and new features added. Users can now view results of multiple substance searches side by side. GIS protective distance mapping has been added in the Windows version [the illustration here shows the area affected if a large chlorine spill occurred at the conference site location.] Imagery is now available for the biologicals. And, iPhone and Blackberry applications are near completion. All WISER platforms include data updates based on the latest Hazardous Substances Data Bank (HSDB), Radiation Event Medical Management (REMM), Center for Infectious Disease Research and Policy (CIDRAP) for biological agents, and U.S. Environmental Protection Agency Acute Exposure Guideline Levels (EPA AEGLs) content.
Our Radiation Emergency Medical Management tool, developed in conjunction with the ASPR, the Office of the Assistant Secretary for Preparedness and Response, helps responders manage radiation events. What you find in REMM: Radiation Principles (e.g., exposure vs contamination) Patient management algorithms Initial onsite activities Decontamination procedures Assess internal contamination Countermeasures REMM updates include a name change to Radiation Emergency Medical Management and: New videos, new animations/illustrations, mobile devices downloads, algorithm updates, among other things. An iPhone application is in the works.
Also, coming soon is CHEMM – the Chemical Hazards Emergency Medical Management tool. CHEMM p rovides a comprehensive and user-friendly resource to enable first responders, first receivers, other healthcare providers, and planners to plan for, respond to, recover from, and mitigate the effects of mass-casualty incident involving chemicals. It has a similar look/feel as REMM but with focus on chemicals. Is the chemical complement to REMM, and is also being developed with ASPR.
DIRLINE (the Directory of Information Resources Online) is NLM’s online database containing location and descriptive information about organizations, research resources, projects and databases concerned with health and biomedicine DIRLINE contains over 8,500 records and focuses primarily on health and biomedicine, although it also provides limited coverage of some other special interests. These information resources fall into many categories including federal, state, and local government agencies; information and referral centers; professional societies; self-help groups and voluntary associations; academic and research institutions and their programs; information systems and research facilities. Topics include HIV/AIDS, maternal and child health, most diseases and conditions including genetic and other rare diseases, health services research and technology assessment. This past year, we added and tagged nearly 700 records on state level agencies providing disaster services or information. To review records added to DIRLINE about state government agencies, search on “dimrc” (without the quotes). This search will retrieve all the new records. You can also search on “dimrc” AND the full name of a state to see resources for one state.
TOXNET is a large family of databases. You can search here for chemicals, drugs, household products, radiological agents, biological agents, and hazardous materials. A search will check all the databases and give you a list of results. TOXNET is updated throughout the year with new records.
MedlinePlusis available in Spanish and in English and some topics in other languages such as Arabic, Korean, and Russian. Among its over 700 health topics are a number of disaster related topics, such as floods, radiation exposure. Biodefense and bioterrorism. The links can be accessed from the DIMRC Web site.
Why librarians and disasters? librarians have a long tradition of service and information outreach librarians have experienced the impact of disasters first hand in their own buildings and communities and see how the need for information grows in a disaster situation librarians have the skills and tools to harness and manage critical information and know how to get it to those who need it Who benefits from disaster information outreach by librarians? everyone in our communities benefit from improved information access especially emergency responders, public heath staff, disaster response planners, hospital emergency planners, volunteers, and others What is NLM doing to support disaster information outreach by librarians? In addition to the information resources, tools, databases and other things that have been mentioned today, NLM has been investigating the concept of disaster information specialists or disaster health informationists to provide information outreach to their communities for all-hazards preparedness, response, and recovery. Some of the specific things we are doing to develop and support this community of informationists include: health information guides DISASTR-OUTREACH-LIB listserv of over 400 subscribers [if you are not on this list and would like to be, either fill in the sign up sheet on your chair, or leave your business card with me] monthly phone conferences where we all learn from the experiences of other librarians. partnership development for mutual aid, such as the Bethesda Medical Libraries Emergency Preparedness Partnership, which consists of 5 medical libraries in Bethesda, MD and, we are investigating the feasibility of a training program and certification as a librarian specialty. Ruth Holst, incoming MLS President, included the development of the disaster information specialist as a specialty area in the MLA CE program in her article about Rethink our Value and Roles; Presidential Priorities for 2010/11 which appeared in the April MLA News. She sees that librarians can “fill a key role in assisting organizations with planning for and responding to all types of emergencies.”
What do disaster information specialists do? “ Disaster information specialists” are active in ALL phases of preparedness, response, and recovery for both disasters and public health emergencies. Although the immediate response phase gets the most public attention, it is only one small part of the complete picture of disaster work. Many medical librarians were very busy during last year’s H1N1 outbreak getting constantly changing information to the right people. They forwarded critical information to decision makers; provided the latest treatment guidelines as they were being written by CDC and others; directed people to authoritative information, and provided references on vaccination and risks to help stem the spread of the virus.
But what do librarians do between disasters? Many of the tasks are familiar ones that a librarian might pursue in any subject area. Some activities require knowledge of disaster resources such as the Radiation Emergency Medical Management site. And some require a solid understanding of how disaster management works in a hospital or local community. A few examples include: Collect, organize and disseminate disaster materials from non-commercial sources, peer-reviewed literature, social media Expand collections of disaster-related resources Support hospital emergency planning activities Teach responders about REMM, WISER Participate in disaster drills Host community preparedness events Support researchers’ information needs Network with local emergency operations, public health Update Web sites, blogs, and library guides on disaster topics As noted earlier, in most situations, being prepared with information or knowing the sources is key in a disaster situation, when even seconds may count. Nicely crafted PubMed searches might not be what is needed.
We have added some new downloadable promotional resources to our Web site. We have a poster in two sizes – a table top that is 8 ½ x 11, and a larger one that is 21 x 32 inches. These can be printed and used in your libraries or at meetings. There is also an 8 ½ x 11 inch one page flyer that you can download and use.
If you want to contact us or want to learn more about DIMRC and/or how you can participate as a Disaster Information Specialist, please contact any of us.
National Library of Medicine Resources for Disaster Planning ...
National Library of Medicine
Resources for Disaster Planning
Disaster Information Management Research Center
Specialized Information Services
National Library of Medicine
Medical Library Association
NLM’s Disaster Information
Management Research Center
Organize the disaster health literature
Provide access to the literature
Develop information tools
Maintain library operations
Conduct research and development
Librarians and other information
Public health workers
First responders, and more….
NLM’s Disaster Information
Management Research Center
Preparedness, mitigation, education,
Response to immediate event
Recovery and rebuilding
NLM Disaster Resources
Medical and Public Health Literature
Topic Pages/Subject Guides
Disaster Information Specialist Program
Over 30,000 references to journal articles on
disaster/emergency preparedness and
7 Disaster Medicine specific journals indexed
15 Emergency Medicine journals indexed
450+ MeSH terms related to disaster health
with 15 new terms added in 2010
Resource Guide for Public
Partnership with NY
Academy of Medicine
Grey literature sources
Emergency Access Initiative
Sample Journal Titles
American journal of infection control
Depression and anxiety
Environmental toxicology and
Journal of emergency medicine
Journal of traumatic stress
New England journal of medicine
Sample Book Titles
Merck manual of diagnosis and therapy
Public health and prevention
Emergency medicine procedures
Infectious diseases: the clinician’s guide
to diagnosis, treatment and prevention
AHFS Drug Information
Emergency Preparedness Toolkit
Assists librarians in
Tools - WISER
Version 4.3 was released August 2009
Many enhancements to the WISER for
GIS support for protective distance
Biological agent imagery now available
Wireless Information System for Emergency Responders
Tools - REMM
New name/new version
New features and content
Downloads for mobile devices
Radiation Emergency Medical Management
Tools - CHEMM
Chemical Hazards Emergency Medical Management
Databases - DIRLINE
Database of over
Nearly 700 state
Databases - TOXNET
Family of databases
• Household products
• Radiological agents
• Biological agents
• Hazardous materials
Disaster Information Specialist
Health information guides on specific events: Haiti earthquake, H1N1,
Gulf oil spill
DISASTR-OUTREACH-LIB e-mail discussion list and weekly news to
400+ subscribers in 45 states and 10 countries
Building a community of practice, a culture of preparedness
Monthly calls on current disasters,
public health emergencies
Preparedness for impact on library
buildings, staff or services – a
major focus of the National
Network of Libraries of Medicine
Partnerships for mutual aid at the
national level (National Network of
Libraries of Medicine) or local
level (Bethesda, Sarasota)
What are Disaster Information
CASE STUDY: H1N1 outbreak
Forwarded critical info to hospital and government decision makers
Provided clinicians with latest treatment guidelines
Directed the public to trusted health information sources
Maintained quality, timely information on Web sites and publications
Provided references on vaccinations, risks to children and pregnant
women, public health measures to control the spread, epidemiology
What are Disaster Information
And when it’s quiet…
Collect, organize and disseminate disaster materials from non-
commercial sources, peer-reviewed literature, social media
Expand collections of disaster-related resources
Support hospital emergency planning activities
Teach responders about REMM, WISER
Participate in disaster drills
Host community preparedness events
Support researchers’ information needs
Network with local emergency operations, public health
Update Web sites, blogs, and library guides on disaster topics
For More on Disaster Health
Stacey Arnesen email@example.com
Cindy Love firstname.lastname@example.org
Elizabeth Norton email@example.com
Disaster Information Management Research Center
National Library of Medicine