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Handheld Help for Emergency Responders

July 2008
By Robert K. Ackerman
E-mail About the Author

 
Members of an emergency medical technician team train as emergency responders to a hazardous materials spill site. Green-suited personnel specialize in decontamination, and gray- suited personnel are rescuers. A handheld data system developed by the U.S. National Institutes of Health’s National Library of Medicine provides emergency personnel with vital response and treatment information on hundreds of hazardous materials. Photo courtesy of: FEMA/Win Henderson
A portable system puts government databases at user fingertips.

A system that began as a handheld reference device has burgeoned into a full-service emergency response aid that soon will be able to deduce the nature of hazardous substances on site. Known as the Wireless Information System for Emergency Responders, or WISER, the system is capable of being installed in a personal digital assistant, a Windows Mobile device or a smart phone, and serves an individual responder without any reach-back or networking requirement.

WISER originally was developed in 2004 by the U.S. National Library of Medicine (NLM), which is part of the National Institutes of Health. Its first iteration gave users a database of just 44 hazardous chemicals listed in their handheld devices. Now, the system provides greater functionality built around a database of more than 400 dangerous substances, and both the functionality and the number of database items are increasing.

Emergency personnel responding to the scene of a hazardous materials spill or dispersal can learn immediately the nature of the substances present, their characteristics—such as flammability—and their toxicity to humans or the environment. Responders even can use newer versions of the system to help identify a mystery substance from physical characteristics such as color and odor. And all of these functions can be performed on a device no more powerful than a rudimentary personal digital assistant (PDA).

Bijan Mashayekhi, a computer scientist at the NLM, is the project officer for WISER. He explains that WISER grew incrementally with input from emergency responders and experts at government agencies.

The NLM has a database known as the Hazardous Substances Data Bank, or HSDB, that includes information on about 5,000 chemicals. WISER began with 44 of those in a prototype version that was developed in cooperation with fire departments in Baltimore, Maryland, and Fairfax City, Virginia. The version released in 2004 was designed for the Palm PDA.

The NLM added chemical substances to that database by reviewing five national lists of various materials. Mashayekhi relates that from these lists, NLM experts selected the “bad actors” among substances that could pose a threat to the populace. Chemicals that appeared in four of the five bad-actor lists earned automatic inclusion in WISER.

When Microsoft released its Windows Mobile Pocket PC, the NLM developed a WISER version for that platform. When some local emergency responders explained that many do not have the budget to equip all of their personnel with PDAs, the NLM developed another version for installation on laptop or desktop computers. Headquarters personnel could radio WISER information to responders in the field.

A key feature of WISER is its lack of dependence on network connectivity. Mashayekhi explains that the basic system was designed to be independent of communications, which can break down during a significant crisis. The system is downloadable into a handheld device from the WISER Web site, often through the user’s PC. A future version may permit wireless installation directly into a handheld device, Mashayekhi offers.

By tapping databases throughout government, the NLM has been able to go beyond its normal subject matter. Recently, because of input from emergency responders, the NLM added 20 radiological and biological substances. This information came from these non-HSDB databases, Mashayekhi relates. For example, the biological information was gleaned from the Centers for Disease Control and Prevention’s (CDC’s) Category A substance list of biological agents, which comprises its most hazardous pathogens such as anthrax, plague, smallpox and viral hemorrhagic fevers.

Another key WISER asset is the Transportation Department’s Emergency Response Guidebook, or ERG. It provides vital information such as protective measures needed for various hazardous materials. The NLM has integrated ERG’s information into WISER, and the newest version—WISER 4.1—includes ERG 2008. Mashayekhi notes that the NLM gave the Transportation Department a digital version of ERG 2008, and the department in turn will distribute a DVD containing both ERG 2008 and WISER in limited numbers to some emergency responders.

Mashayekhi relates that NLM experts had to translate some of the textual information from the hazardous materials databases. Much of the data was designed for toxicologists, and it had to be presented in a format that would be useful to a range of emergency responders.

The result is that a WISER user not only can look up a broad range of information on a specific hazardous substance, he or she also can query the database to help identify an unknown material. For example, if an emergency responder arrives at an accident scene where an overturned truck spills its load and the driver is trapped and unconscious, he or she may use the system to identify the chemical spill.  The responder enters information about the spilled substance’s properties into WISER on a step-by-step basis—describing its state (type of liquid, solid or gas), its color, any odor, a pH level—and WISER will narrow down the list of suspects with each entry. Ultimately, the responder will be left with either a very short list of potential hazardous materials or even a specific identification. WISER then describes each substance’s hazards and warns against any action, such as the use of chemical detergents or firefighting materials, that could worsen a situation.

For emergency medical services, WISER also provides a means of determining hazardous materials exposure by listing the symptoms of people exposed to a substance. Variables such as body temperature, cardiovascular or respiratory rates, neurological states and skin condition are just some of the variables that WISER incorporates to determine a patient’s hazardous materials exposure and recommend appropriate emergency treatment.

If the emergency responder already knows the identity of a hazardous material at the scene, WISER can present a database’s worth of information about that substance. The user can click on a specific chemical to bring up warnings about it, and then other data categories provide facts and requirements such as protective equipment, protective distances, treatment for exposure, firefighting distances, health effects and reactive or incompatible substances.

NLM experts continuously strive to upgrade the system. Among recent developments is a smart phone version. Mashayekhi notes that where the Pocket PC version uses a stylus for navigation throughout the system and its menus, the WISER smart phone user interface allows a responder to navigate using the phone’s existing buttons.

BlackBerry users must employ the Web-based version of WISER to access the data. Known as WebWISER, this version can be accessed directly from the Web by any computer. When a BlackBerry user accesses WebWISER, the Web site detects the BlackBerry origin and switches to a user interface that fits that hardware.

However, this approach does not always work, especially in rural areas. So Mashayekhi reports that the NLM is considering the development of a dedicated BlackBerry version, but this will require writing code from scratch.

NLM experts recently have developed a WISER training element that is based on PowerPoint. This element comprises scenario-based modules that can be modified by users.

Mashayekhi explains that the NLM does not keep track of who is using WISER. However, the system has been downloaded more than 120,000 times, and the frequency is increasing. The NLM constantly seeks feedback from emergency responders, he continues. It always endeavors to learn which materials should be added to the system, and any substances already in the HSDB can be added easily to WISER.

For the future, NLM officials are looking to add more hazardous materials to the WISER database. The CDC’s Category B substance list of biological agents likely will be the next added, Mashayekhi offers. These pathogens tend to have lower mortality rates than those in Category A. Category B includes Q fever, ricin, typhus, viral encephalitis and food safety threats such as salmonella and E. coli.

NLM experts also are striving to give the emergency responder even more assistance in identifying unknown materials. Mashayekhi relates that researchers are trying to add an artificial intelligence function that would learn from data input in a substance identity search. This function in turn would steer the user toward providing better information faster.

As the user inputs information, WISER’s artificial intelligence narrows the search parameters logically. It would look for some kind of differentiating physical property that would help identify the chemical sooner for the responder. As the responder’s input narrowed the suspect substances down to a few, the system would compare the information it had on these materials and ask a question or request a sensor reading.

The concept would follow that employed by commercial “20 questions” games. Mashayekhi allows that the NLM has looked at these games to adapt this technology for WISER.

A related improvement would give WISER the ability to account for environmental differences such as air temperature and pressure. Hazardous materials effects differ at altitude and among seasonal changes.

Mashayekhi adds that some day WISER might be able to operate in a collaborative environment. In a major incident in which many different types of emergency responders are operating, different WISER units might be able to share information from the perspectives of these different personnel. Emergency medical personnel could learn from on-site hazardous materials experts just what threats they are dealing with as they rush to treat injured civilians, for example. Mashayekhi points out that an emergency responder wearing a hazard suit in a hot zone may not be able to operate a handheld device as easily as someone not in protective gear.

A bigger change may take place when the Android system enters commercial use. A product of the 30-company Open Handset Alliance and spearheaded by Google, Android is designed to be an open and free mobile phone operating system that includes middleware and key applications. Code written for Android would be usable on many wireless devices that currently are not compatible. Mashayekhi declares that, once Android hardware is available, the NLM would want to be able to support WISER on it, which would extend WISER’s reach considerably.

Web Resources
NLM: www.nlm.nih.gov
WISER: http://wiser.nlm.nih.gov
WebWISER: http://webwiser.nlm.nih.gov
NLM HSDB: http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?HSDB
CDC substance categories: www.bt.cdc.gov/agent/agentlist-category.asp