About REMM


What are the goals of this site?


  • Provide guidance for health care providers, primarily physicians, about clinical diagnosis and treatment of radiation injury during radiological and nuclear emergencies
  • Provide guidance for the wider health care community (see Other Audiences), including trainers, about issues related to planning for and responding to radiation mass casualty incidents
  • Provide just-in-time, evidence-based, usable information with sufficient background and context to make complex issues understandable to those without formal radiation medicine expertise
  • Provide web-based information that is also downloadable in advance, so that it would be available during an emergency if the internet is not accessible

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Who produced this site?


  • REMM was produced by the US Department of Health and Human Services, Administration for Strategic Preparedness and Response. The REMM Team is grateful for the professional input from many subject matter experts from the US government as well as experts from academia in the US and internationally. See list of REMM consultants.
  • Those with major responsibility for the REMM Web site and their affiliations are listed below:

    The REMM Team
    NameExpertiseAgencyGroupDegree
    CAPT Judith Bader
    USPHS (Ret.)
    Managing Editor
    Radiation Oncologist
    Senior Medical Advisor, CBRN: Radiological and Nuclear mass casualty issues
    NIH
    HHS
    NCI
    ASPR/BARDA
    (contractor)
    M.D.
    C. Norman Coleman
    Senior Editor
    Radiation Oncologist
    Senior Medical Advisor
    NIH
    HHS
    NCI
    ASPR
    M.D.
    Special Acknowledgement for Historical Contributions by H. Florence Chang M.S. (Technology Lead, NIH NLM contractor).

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Medical Disclaimers


  • Health care providers should consider the specific circumstances of each patient encountered during an emergency and use his/her clinical judgment in providing care. REMM information is meant to supplement principles of good clinical management.
  • Recommendations for any patient's medical care should consider not only the specific circumstances of that patient but also the resources available during the emergency.
  • Inclusion of any bibliographic reference on REMM does not constitute official US government endorsement of its contents, data and/or conclusions. Inclusion in a REMM reference list may be simply to facilitate consideration and understanding of the complexities of that topic.
  • Reference in this Web site to any specific commercial product, process, service, manufacturer, or company does not constitute its endorsement or recommendation by the U.S. government or the U.S. Department of Health and Human Services or any of its agencies. HHS is not responsible for the contents of any "off-site" Web page referenced on this site.
  • When visiting our site, your Web browser may produce pop-up advertisements. These advertisements were most likely produced by other sites you visited or by third-party software installed on your computer. HHS does not endorse or recommend products or services whose pop-up advertisements may appear on your computer screen while visiting our site.
  • REMM medical recommendations are not the official policy of the U.S. government, HHS, or any of its agencies, including those agencies of the REMM developers.
  • Neither the U.S. government nor any agency thereof, nor any of their employees, makes any warranty, express or implied, or assumes any legal responsibility for the accuracy, completeness, or usefulness of any information on this site.
  • REMM recommendations are based on what is considered to be the best clinical evidence available. Whenever possible, primary sources of this evidence are cited, and users are encouraged to read these documents.
  • HHS and REMM authors and consultants are not responsible for the accuracy of hyperlinked content on Web sites outside of REMM.
  • REMM is updated frequently as new information becomes available. We encourage all REMM users to sign up for REMM email updates to be notified about these updates, especially if you have downloaded an earlier version of REMM.
  • REMM recommendations are not intended for use in claims for insurance reimbursement.
  • REMM recommendations are not intended for use in medicolegal claims.

Dose Estimator Disclaimer

  • Neither the US Government nor any of its agencies or departments makes any claim about the accuracy and validity of the REMM Dose Estimator for Exposure.
  • The Biodosimetry Assessment Tool (BAT), on which the REMM Dose Estimator for Exposure is based, has been used extensively by the US military and others to evaluate radiation victims.
  • The dose estimation output from BAT is based on many, well-studied clinical observations.
  • The REMM Dose Estimator for Exposure should always be used in conjunction with appropriate clinical judgment about each individual patient and the particulars of the incident.
  • The REMM Dose Estimator for Exposure has NOT been approved for clinical use by the US Food and Drug Administration.
  • See also the Medical Disclaimer for the entire REMM web site which also applies to this Dose Estimator Tool.

Scarce Resources Triage Tool Disclaimer

  • Neither the US government not any of its agencies or departments makes any claim about the accuracy and validity of the Scarce Resources Triage Tool and its suggestions for Triage Categories and Myeloid Cytokine Use.
  • The Tool is a product of the Nuclear Detonation Scarce Resources Project Working Group. It represents one part of the ten publications from this group.
  • The Tool provides suggestions but not formal guidelines or mandates.
  • Clinicians are urged to consider the specifics of every patient individually and the conditions (scarcity, danger, existing standards of care) where the patient is evaluated when making triage and cytokine recommendations.
  • The Tool should always be used in conjunction with appropriate clinical judgment about each patient.
  • The Tool has not been approved for clinical use by the US Food and Drug Administration.
  • See also the Medical Disclaimer for the entire REMM web site which also applies to this Scarce Resources Triage Tool.

Specific Advice on Medical and Other Queries from Our Users

  • REMM will not offer any official medical advice or recommendations about specific patients sent to our Contact Us Email.
  • REMM will not offer any official advice or recommendations to individuals or groups about specific equipment, devices, calculations, or plans sent to our Contact Us Email.
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Using REMM Assets

  • Unless otherwise noted, material presented on the REMM Web site is considered federal government information and is in the public domain.
  • That means this information may be freely copied and distributed. We request that you use appropriate attribution to REMM.
  • Many checklists and other materials are available in PDF format for ease of duplication. Note that if material is adapted or modified, all REMM citations and logos must be removed.
  • If copyrighted content, documents, images, or other materials appear at REMM, it will be noted, and the copyright holder should be consulted before that material is reproduced.
  • Web site managers are encouraged to link to REMM.
  • The REMM logo may be used in conjunction with your link. Download REMM Logo image
    Radiation Emergency Medical Management: REMM (US Department of Health and Human Services)
  • REMM has links to other federal agencies and to private organizations. You are subject to that site's privacy policy when you leave REMM.
  • The information at REMM provides general summary information for the public. Information at REMM does not supersede, preempt, or replace statutes, regulations, or other aspects of federal law.
  • REMM provides links to other Internet sites only for the convenience of World Wide Web users. REMM is not responsible for the availability or content of these external sites, nor does REMM endorse, warrant or guarantee the products, services or information described or offered at these other Internet sites. It is the responsibility of the user to examine the copyright and licensing restrictions of linked pages and to secure all necessary permission.
  • REMM is maintained by the U.S. government and is protected by various provisions of Title 18 of the U.S. Code. Violations of Title 18 are subject to criminal prosecution in federal court.
  • For site security purposes and to ensure that this service remains available to all users, we employ software programs to monitor traffic to identify unauthorized attempts to upload or change information or otherwise cause damage. In the event of authorized law enforcement investigations, and pursuant to any required legal process, information from these sources may be used to help identify an individual.

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List of consultants


REMM reviewers

  • Reviewers are not responsible for the text or editing of REMM content.
  • Listing as a reviewer does not imply his/her agreement with any specific REMM content.
  • Listing of a reviewer's institution is for information purposes only. It does not imply endorsement of any REMM content by the institution.
  • Each consultant is listed with the institution where they worked when they reviewed content for REMM. Subsequently, they may have changed institutions or status.

Content Expertise / Institution / Name

Acute Radiation Syndrome/Radiation Medicine

University of New Mexico
Fred Mettler

Armed Forces Radiobiology Research Institute
William Dickerson

Centers for Disease Control and Prevention
James M. Smith

Radiation Emergency Assistance Center/Training Site (REAC/TS)
Albert Wiley
Patrick Lowry

Yale University, Bridgeport Hospital
Nicholas Dainiak

Duke University
Nelson Chao

University of Rochester
Paul Okunieff

Oak Ridge Associated Universities/ REAC/TS
Albert Wiley

Walter Reed Army Institute of Research
Alan Epstein

University of Arkansas
Martin Hauer-Jensen

Medical College of Wisconsin
Eric Cohen
John Moulder

Penn State University
Kenneth Miller

Hartford Hospital, Hartford CT
Andrew Salner

National Institute of Radiological Sciences, Chiba, Japan
Makoto Akashi

National Research Institute for Radiobiology & Radiohygiene, Budapest, Hungary
István Turai

HHS/Office of the Secretary
James Donlon

National Cancer Institute
Nicole Simone

Biodosimetry

Radiation Protection Bureau, Health Canada
Helen Griffiths

Armed Forces Radiobiology Research Institute
William Blakely
Pataje G. S. Prasanna
Patricia Lillis-Hearne

MJW Corporation
Ronald Goans

Blood Banking

National Institutes of Health
Harvey Klein
Harvey J. Alter
Charles Bolan

HHS
Jerry A. Holmberg

Burn Care

American Burn Association
Joshua Carson
Rachel Williams
Colleen M. Ryan
William Hickerson
James C. Jeng
Annette Matherly
David Greenhalgh

Food and Drug Administration
Suzanne Schwartz

University of Texas Health Sciences at San Antonio
Steven Wolf

Washington Hospital Center, Washington, D.C.
James C. Jeng

Dose Reconstruction

Cascade Scientific, Eugene, OR
Helen Grogan

Drug Countermeasures

Food and Drug Administration
Zishan Zhao
Cheryl Turner
Larry Cress
Brad Leissa
Alla Shapiro
Narayan Nair
Joanne Holmes
Douglas Throckmorton
Mark Gonitzke
Robert Yaes
Patricia Keegan

Emergency Response/Policy

HHS/Administration for Strategic Preparedness and Response
Frederick Kass

HHS/Regional Emergency Coordinator
Michelle Watters

Hawaii State Department of Health
Paul Collins

Washington Hospital Center, Washington, D.C.
Susan Eckert
Craig DeAtley

Food Safety

Food and Drug Administration
Michael Noska

Organ System Evaluation and Treatment

Medical College of Wisconsin
Eric Cohen
John Moulder

Pediatric Radiation Medicine

Food and Drug Administration
Alla Shapiro

Personal Protective Equipment

Centers for Disease Control and Prevention
Michael Schwartz
Armin Ansari
Douglas Trout

Environmental Protection Agency
John Cardarelli

New York City Department of Health and Mental Hygiene
Katherine Uraneck

Vienna (Austria) EMS
Andreas Ziegler

Physics/Radiation Safety

Department of Homeland Security
Brooke Buddemeier

Centers for Disease Control and Prevention
James M. Smith
Charles W. Miller

Oak Ridge Associated Universities/ REAC/TS
Steve Sugarman
Albert Wiley

University of California Davis Health System
Jerrold Bushberg

National Cancer Institute
James Deye

National Institutes of Health
Robert Zoon

Food and Drug Administration, Center for Devices and Radiological Health
Michael Noska

Health Protection Agency Centre for Radiation,
Chemicals and Environmental Hazards Protection/UK
Duncan Cox

Mayo Clinic
Richard J. Vetter

Health Canada, Co-ordination and Operational Preparedness
Helen Griffiths

National Council on Radiation Protection and Measurements (NCRP)
David Schauer

Brookhaven National Laboratory
Stephen Musolino

Protective Action Guides

EPA
Sara DeCair

Psychological Responses to Mass Casualty Incidents

HHS/Administration for Strategic Preparedness and Response
Ann Norwood
David Reissman

University of Alabama, Birmingham
Steven Becker

Radiation and Environmental Epidemiology

National Cancer Institute
Steve Simon

Radiation Biology

National Cancer Institute
Helen Stone

Stem Cell Transplantation

National Marrow Donor Program
Nelson Chao
David Weinstock

Strategic National Stockpile

Centers for Disease Control and Prevention
Susan Gorman

Template for Hospital Orders

Memorial Sloan Kettering Cancer Center
Ann Jakubowski

Transportation Accidents

Department of Energy
Tom Clawson
Technical Resources Group, Inc., Contractor to DOE/TEPP


Veterinary Medicine

Minnesota Veterinary Medical Reserve Corps
Kathy Jorgensen

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Sign up for REMM email updates


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Contact us: Provide site feedback


  • Contact REMM with questions/feedback small red envelope
    • Report any issues or suggestions for REMM online or Mobile REMM.
    • Tell us about broken links, browser issues, difficulty with animations or video, difficulty with downloading REMM, typographical or numerical errors, content errors or suggestions, usability issues.
  • We sincerely appreciate your feedback, and will try to respond to your email and fix reported problems as soon as possible.

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Download REMM to your computer/mobile device


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REMM Web site wins awards


The REMM Web site has received a number of top awards, including the following:
  • Freddie Award: International Health and Medical Media
    Finalist - Community Health Category (2008)
  • Web Health Awards: best Web-based health-related content for consumers and professionals
    Bronze - Miscellaneous/Professional Class (Government Web Site Category) (2009)
  • eHealthcare Leadership Award
    Silver - Best Care/Disease Management Site, Physician/Clinician-Focused Site (2010)

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REMM system requirements


  • Browser: IE 11 or higher, Firefox, Google Chrome, Safari, or Opera
  • System: Windows, Mac, or Linux
  • Javascript: Enabled
  • View Images: Allowed
  • Pop-ups: Allowed from REMM Web-site
  • Cookies: None set by REMM
  • Screen resolution: Best viewed at 1024 x 768 pixels
  • WinZip: Required to extract (unzip) files from REMM download
  • Viewers and Players:

    You may need to download the following viewers and players to your computer in order to access NLM content in various formats.

    Viewer or Player How It Works Example
    Formats
    Apple Quicktime Media Player Play video and audio files on Apple operating systems. mov
    Apple iTunes Download NLM podcasts and applications. mp3
    mp4
    mov
    Adobe Reader Read and print Portable Document Format (PDF) from your Web browser. pdf
    Adobe Flash Player View applications, content, and videos developed with
    Flash on any platform or browser.
    swf
    flv
    Real Media Player Play video and audio files on PC operating systems. mp3
    mpeg4
    mov
    ram
    wav
    wmz
    Windows Media Player Play video and audio files on PC operating systems. mp3
    wav
    wmz
    Microsoft Excel Get an Excel App xls
    xslx
    Microsoft PowerPoint Get a PowerPoint App ppt
    pptx
    Microsoft Word Get a Word App doc
    docx

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Linking policy


  • The REMM encourages links to its pages. Links to the REMM home page (https://www.remm.hhs.gov) are preferred but links to individual pages within the REMM Web site are also permissible, provided attribution is made to HHS and/or REMM and any descriptive notes accurately reflect the content of the linked page(s). Links should refer to REMM as "Radiation Emergency Medical Management: REMM (US Department of Health and Human Services)."
  • We also encourage use of our logo for linking to REMM, provided the entire logo is used and the "alt tag" specifies "Radiation Emergency Medical Management: REMM (US Department of Health and Human Services)."

    Download REMM Logo image
    Radiation Evenet Medical Management: REMM (US Department of Health and Human Services)
  • You may not frame or manipulate Web addresses (URLs) so that REMM pages appear on a URL other than https://www.remm.hhs.gov or one of its subpages. You may not give the impression or create the illusion that REMM content is under another domain name or location.
  • Some pages on REMM may contain links to external Web sites. These links are provided for convenience and informational purposes, and do not represent endorsement of any specific commercial products. Links should not be displayed in any manner that would imply such an endorsement by REMM or the Department of Health and Human Services.

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Copyright


Unless otherwise noted, material presented on the remm.hhs.gov website is considered federal government information and is in the public domain. Works produced by the U.S. government are not subject to copyright protection in the United States. This information may be freely copied and distributed. Any such works found on the websites may be freely used or reproduced without permission in the U.S. Please acknowledge remm.hhs.gov as the source of the information by including the phrase “Courtesy of the USDHHS Radiation Emergency Medical Management” or “Source: https://remm.hhs.gov”. For National Library of Medicine content found on the site please reference the NLM Copyright page for details.

Many checklists and other materials are available in PDF format for ease of duplication. Note that if material is adapted or modified, all remm.hhs.gov citations must be removed. If copyrighted content, documents, images, or other materials appear on remm.hhs.gov, it will be noted, and the copyright holder must be consulted before that material may be reproduced.