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About REMM

What are the goals of this site?
Who produced this site?
Guidelines for Selecting References for REMM
Medical Disclaimers
Using REMM assets
List of consultants
Sign up for REMM email updates
Contact us: Provide site feedback
Download REMM to your computer/mobile device
REMM Web site wins awards
REMM system requirements
Linking policy
Copyright

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

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:

Current REMM Managment Team

The current REMM management team is responsible for ensuring all content remains correct and up-to-date.

Name	Expertise	Agency	Group	Degree
Shannon Loelius	Radiation Medical Countermeasures Development	HHS	ASPR/BARDA/CBRN	Ph.D.
Dana Tedesco	Public Health	HHS	ASPR/BARDA/CBRN	D.V.M M.P.H.
Andrew Haskell	Radiation Physics and Mesenchymal Stem Cell Biology	HHS	ASPR/BARDA/CBRN (ORISE Fellow)	Ph.D. M. L. S

Original REMM Development Team

The REMM development team was responsible for the creation of the REMM concept and development of original content.

Name	Expertise	Agency	Group	Degree
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
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.

Current REMM Reviewers
Biomedical Advanced Research and Development Authority Brian Moyer William Keith Hoots Nelson Chao
Food and Drug Administration Susan Zhao Centers for Disease Control and Prevention Art Chang National Institutes of Health Andrea DiCarlo-Cohen Administration for Strategic Preparedness and Response Kenneth Cliffer Matt Clay U. S. Nuclear Regulatory Commission Todd Smith Radiation Injury Treatment Network (RITN) Nelson Chao

Historical Reviewers
Information in this table reflects the position and title of individuals at the time of original REMM content development and review. This table may not reflect the current position or title of the individuals listed as historical reviewers

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 Adela Salame-Alfie 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
- 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
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.