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What's New on CHEMM?

Version 2.3, February 2024

  • Accessibility compliance updates.

Version 2.2, February 2019

  1. Updated and enhanced Decontamination Guidance for Chemical Incidents is available.
    • The Primary Response Incident Scene Management (PRISM) series has been updated and enhanced. was developed by experts in medicine and emergency response, written to provide authoritative, evidence-based guidance on mass patient disrobe and decontamination during a chemical incident. The updated (“Second Edition”) PRISM documentation comprises three volumes (Strategic Guidance, Tactical Guidance, and Operational Guidance): and
  2. ASPIRE (Algorithm Suggesting Proportionate Incident Response Engagement)
    • ASPIRE is a decision aiding tool based on PRISM. ASPIRE helps identify the need for patients exposed to chemical agents to undertake wet decontamination.

Version 2.1, January 2019

  1. Fourth Generation Agents
    • The White House National Security Council convened a federal interagency working group to identify and develop resources to help the emergency response community prepare for and respond to a fourth generation agent incident if one ever occurs in the U.S., as well as support the development of specific guidance and training to enhance overall preparedness efforts.

    • These resources meet the needs of U.S. emergency response professionals who sought to learn more about the agent used in the U.K. and how to protect themselves and respond if such incidents ever occur in their communities.

  2. Contingency countermeasures for Treating Nerve Agent Poisoning
    • These contingency countermeasures for Treating Nerve Agent Poisoning guidelines represent a subject matter expert (SME) panel consensus of contingency anticholinergic medications and benzodiazepine anticonvulsant medications that could be substituted for conventional therapies.

    • The Chemical Integrated Program Team (Chem IPT), an SME-membered federal interagency group addressing chemical defense issues, contributed and approved these guidelines, which align with a position statement by the American College of Medical Toxicology endorsing the consideration of Contingency therapies for nerve agent poisoning when conventional therapies are not available.

Version 2.0, September 2017

  1. An expansion of the toxidromes in CHEMM-IST, from the current four to seven, after completion of extensive evaluation of the expanded CHEMM-IST by medical toxicologists and first receivers.

  2. A new section of content entitled “In the First Minutes” has been included.

  3. New overview on Recognizing and Responding to Chemical-Assisted Suicides:

  4. Addition of the PRISM (Primary Response Incident Scene Management) series of reports providing authoritative, evidence-based guidance on mass casualty disrobe and decontamination during a chemical incident.

    The Primary Response Incident Scene Management (PRISM) series of reports were written to provide authoritative, evidence-based guidance on mass casualty disrobe and decontamination during a chemical incident. The PRISM guidance, based on scientific evidence gathered under a program of research sponsored by the Biomedical Advanced Research Development Agency (BARDA), is in three volumes: 1) Strategic Guidance, 2) Tactical Guidance, and 3) Operational Guidance.

  5. Enhanced content in CHEMM’s Information for the Hospital Providers. For example, an OSHA Best Practices for Hospital-Based First Receivers of Victims from Mass Casualty Incidents Involving the Release of Hazardous Substances Mass Casualty Chemical Attacks document has been added to CHEMM’s Information for the Hospital Providers content, and to the Response Planning “Key Guidance Documents” and Training and Education “Resources for Health Care Professionals” section, Educational and Facility Competencies” content.

  6. Addition of the Dermal Exposure Risk Management and Logic (DERMaL) e-tool developed by NIOSH.

    Under a partnership with NLM and the National Institute of Occupational Safety and Health (NIOSH), a new online tool called the Dermal Exposure Risk Management and Logic (DERMaL) e-tool, which provides emergency preparedness and response professionals a resource library for information related to skin exposure from chemicals, has been included in CHEMM.

  7. A new online and app resource for poison emergences. In addition to calling Poison Control at 1-800-222-1222, the webPOISONCONTROL® online tool is now available for poison emergencies in the U.S. (if a possible poison was swallowed and there are no symptoms), Also, a global directory of Poison Control Centers.

  8. An Updated and enhanced listing of organizations under CHEMM’s Other Resources

  9. Updated and enhanced risk assessment, risk perception and risk communication information

  10. Updated and enhanced training content for toxicologists, industrial hygienists, and others

  11. An addendum to the Report on Toxic Chemical Syndromes: Definition and Nomenclature (PDF - 2.01 MB) has been added, after completion of extensive discussion by members of the American College of Medical Toxicology working with medical toxicologists at the Department of Homeland Security’s Office of Health Affairs. The addendum recommends the current names to use for the toxidromes. These names for the toxidromes are incorporated into the expanded CHEMM-IST.

  12. An update of the CHEMM Chemical Toxidromes Lexicon Outreach Plan (PDF - 163 KB).

  13. CHEMM Toxidrome Cards, a series of quick reference aids to allow first responders to quickly identify the cause of the symptoms of a chemical exposure by toxidrome.

  14. Updated and enhanced records for the current 22 medical countermeasures in CHEMM’s countermeasures database, and addition of a new countermeasure, Fuller's Earth.

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Coming soon to CHEMM:

  1. Addition of US EPA’s Provisional Advisory Levels (PALs) for exposures to defined durations (24 hours, 30 days, 90 days, and to years. PALs are advisory risk values intended to aid decision-making during an emergency incident. PALs that provide responders and leaders with critical information about dangerous chemical compounds – what harmful effects (ranging from a temporary skin rash to immediate death) would be expected in people exposed to certain amounts of a dangerous chemical during relatively short periods of exposure. PALs have been developed for over 100 of the most dangerous chemical compounds

  2. A brief history of chemical warfare agents.

  3. Updates and new content as might be needed based on release of new research findings, new guidance, and other noteworthy documents.

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Previous CHEMM Updates

What's new in CHEMM Version 1.2, November 2014

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