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First Responders Respond Positively to REMM Training!

REMM website banner

Several resources from the National Library of Medicine are widely known and heavily used by librarians, clinicians, researchers and members of the public. The list includes PubMed, MedlinePlus,, and other useful resources which are accessed by users daily. However, there are NLM resources that are less known, but perhaps of far greater significance and benefit in times of emergency situations. REMM is one of those resources. REMM, Radiation Emergency Medical Management, is a web-based resource to provide guidance for health care providers and first responders about clinical diagnosis and treatment of radiation injury during radiological and nuclear emergencies. REMM aims to provide just-in-time, evidence-based information to users by providing sufficient background and context to make complex issues understandable to those without formal radiation medicine expertise.

NN/LM PSR recently had an opportunity to introduce REMM to an enthusiastic group of first responders based in Lake County, California. As part of its Emergency Preparedness and Response program, the Lake County Public Health Department sponsored the Disaster Medical Skills Workshop, a full-day of sessions on disaster medicine topics.

Opening Statements at the Public Health Disaster Medical Skills Workshop

The morning was structured with sessions that would appeal to all attendees, while the afternoon breakout sessions were geared to either clinicians or first responders. The keynote speaker delivered a very interesting talk on disaster medical care under austere conditions, having participated in the response to Hurricane Katrina, the Haiti earthquake, the tsunami in Indonesia and other mass casualty events. An additional session focused on cultural competency for responders. PSR was invited to provide training on REMM for one of the afternoon breakout sessions, alongside sessions on disaster medical skills for primary care providers with focus on prioritizing interventions; managing wounds and fractures; disaster triage for clinicians, and START Triage (Simple Triage and Rapid Treatment) for first responders.

In preparation for the training, I approached REMM as a first-time user might; I started with the basics to become familiar with the content, layout, search, and navigation features of the website. To learn about the user experience in the field, I downloaded REMM to my laptop, installed the REMM app on my smartphone, and I installed it on a USB drive.

Once again, the National Library of Medicine has created an amazing resource which has enormous potential in the case of an actual emergency. In addition to being free, the content is evidence-based and robust. All of the formats are extremely easy to access and use; and the variety of formats make it accessible for just about any mobile device a first responder might have available during an emergency. Given that Internet access may be unavailable during an actual emergency, a standalone version of REMM is available which includes the most essential information, tools, and calculators for response. The standalone version is browser-based, so while the content is installed locally on the computer, it uses the web browser as its interface. It looks identical to the full version, except that the URL/file path will point to the computer location instead of an Internet location. Some content, such as the videos from YouTube are not included in the standalone version. The mobile versions include a collection of essential content, calculators and triage algorithms in an easy-to-use design for small displays. Compare the screen shots below of the web-based version and the mobile display as examples.

REMM website and mobile display

A new version of REMM was released just a few days prior to the training session, so the attendees were treated to what was likely the first training session on the new content. Some of the key changes include a completely redesigned interactive tool for managing acute radiation syndrome, a new page titled Top 10 Items for Radiation Emergencies, new videos and content for understanding radiation, and new interactive tools for radiation units and conversions. For a complete listing of all the new tools and content, visit What’s New on REMM.

The breakout sessions followed two tracks: one structured for clinicians and health professionals and the other geared towards first responders and emergency personnel. Twenty-seven people attended the REMM session, including paramedics and emergency medical technicians (EMTs), nurses, law enforcement and fire district personnel, search and rescue teams, Medical Reserve Corp (MRC), Community Emergency Response Team members (CERT), and public health emergency/disaster planning staff. The workshop offered nursing continuing education (CE) and EMT/Paramedic contact hours. Attendees were encouraged in advance to bring their devices to the workshop, so nearly everyone downloaded REMM on the fly during the session. Extra devices were available for the few people who needed them, so everyone was able to participate in the exercises. Attendees also received a USB drive with REMM installed that could be used on a laptop or computer without Internet access. Evaluations for the session were overwhelmingly positive, and we received this note from the organizer after the event: “I received many verbal compliments on the workshop and the presentations. Everyone felt engaged, that it was a quality workshop, the best they had ever attended, and quality trainers. Thank you again for being a part of what made the workshop such a success.”

In summary, the workshop in Lake County was a very worthwhile outreach experience for this audience. In addition to introducing the attendees to REMM and other NLM resources, it was an opportunity to learn more about the needs of first responders and clinicians for future trainings. REMM is one of those resources we hope we never need to use, but if the need arises, the tools and information will be invaluable to the first responders and those affected by the disaster.

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