L-MT-03-069, to Emergency Plan Implementing Procedure A.5-30, Casualty Care at the Local Hospital
| ML032600969 | |
| Person / Time | |
|---|---|
| Site: | Monticello  |
| Issue date: | 09/09/2003 |
| From: | Thomas J. Palmisano Nuclear Management Co |
| To: | Document Control Desk, Office of Nuclear Reactor Regulation |
| References | |
| L-MT-03-069 | |
| Download: ML032600969 (10) | |
Text
Monticello Nuclear Generating Plant Committed to NudearExcel: IOperated by Nuclear Management Company, LLC L-MT-03-069 September 9, 2003 10 CFR 50, Appendix E Section V U.S. Nuclear Regulatory Commission ATTN: Document Control Desk Washington, DC 20555 Monticello Nuclear Generating Plant Docket 50-263 License No. DPR-22 Emergency Plan Implementing Procedure Furnished with this letter is a revision to the Monticello Nuclear Generating Plant Emergency Plan Implementing Procedures. The following procedure is revised:
Procedure Procedure Title Revision A.5-300 Casualty Care at the Local Hospital 4 Please post changes in your copy of the Monticello Nuclear Generating Plant Emergency Plan Implementing Procedures. The superseded procedure should be destroyed.
This revision does not reduce the effectiveness of the Monticello Nuclear Generating Plant Emergency Plan.
Please contact John Fields at (763) 295-1663 if you require further information.
Thomas J. Palmisano Site Vice President, Monticello Nuclear Generating Plant Nuclear Management Company, LLC cc: Regional Administrator, Region Ill, USNRC (with two copies of enclosure)
Project Manager, Monticello, USNRC (w/o enclosure)
Resident Inspector, Monticello, USNRC (w/o enclosure, EPIP distribution by Monticello Document Control)
Minnesota Dept. of Commerce (w/o enclosure)
Enclosure 2807 West County Road 75
- Monticello, Minnesota 55362-9637 Telephone: 763-295-5151
- Fax: 763-295-1454 BUS
MONTICELLO NUCLEAR GENERATING PLANT A.5-300 TITLE: CASUALTY CARE AT THE LOCAL Revision 4* -
- :I HOSPITAL : Page 1 of, 9 EMERGENCY PLAN IMPLEMENTING PROCEDURE - TABLE OF CONTENTS SECTION I - P)AGE 1.0 PURPOSE. ............... '.'... 2 2.0 APPLICABILITY ............. ...........................- 2 3.0 ORGANIZATION AND RESPONSIBILITIES .......................... 2 4.0 DISCUSSION . 2 5.0 PRECAUTIONS ........... . . . . . 2 6.0 INSTRUCTIONS ....................................... 3 6.1 Instructions for the Ambulance Escort (Controlled Area RPT). 3 6.2 Instructions for the Hospital RPT (Outside Controlled Area) ........ 5 6.3 Hospital/Vehicle Survey and Decontamination ................ 7 7.0 FIGURES ........ 9 7.1 Forms-Utilized in this Procedure .... ............................ 9
- This is a major rewrite, theref6re, no sidelines are required. ) f1 Prepared By:. Reviewed By:
OC Review Req'd. ' OC Meeting Number: 23' 7 C- 1 Date: / /
Approved By: Dt 4/:c
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S IK A T J Y ES.................................................................................
- ,A-JM t F& _Rk_ PTtWX WIViMCA I This revision incorporates Volume F Memos:____________________________
3087 (DOCUMENT CHANGE, HOLD, AND COMMENT FORM) Incorporated: '9/- 29c'9. On-/J-3
\.4Resp Supv:.- EP lAssoc Ref A.5 -\I.R: N IFreg: yyrs/
ARMS: A.5-300 Doc Tye: 1060 Admin Initials: Date I/mab
MONTICELLO NUCLEAR GENERA77NG PLANr. Jk A.5-300' TITLE: CAREAT-.THE LOCAL R6ision 4*
HOSPITAL Page 2 of 9 1.0 PURPOSE .. , r -
-The purpose of this procedure is tp provide instructions and guidance for the handling and treatmntrif of contaminated, injured person(s) at the local hospitaf (Monticello-Big Lake Hospital).' In addition, this procedure provides instruction for the surveying and decontamination of the hospital Emergency Room and general areas that may have become contaminated during such an event.
2.0 APPLICABILITY:.:
2.1 An accident has occurred at the MNGP resulting in the transport of an injured, contaminated person (or persons) to the'Monticello-Big Lake Community Hospital for medical treatment.-
3.0 ORGANIZATION AND RESPONSIBILITIES 3.1 Radiation Protection Technicians (RPT) are responsible for:
3.1.1 Responsible for radiological monitoring, personnel and vehicle decontamination, contamination control, hospital staff dosimetry processing, and. contaminated- waste control.
3.2 The Hospital Emergency Room Staff are responsible for:
3.2.1 Patient care and treatment.
3.2.2 Hospital emergency room set-up and dosimetry issuance to attending
-hospital personnel.
4.0 DISCUSSION 4.1 This procedure, provides instructions for MNGPRadiation Protection Tecfinician(s) (RPT) at the Monticello-Big Lake Hospital in response to an incident involving a contaminated,, injured person (or persons). In the event of such an incident, onhe RPT willaccompany the injured person to the hospital in the emergency vehice. UIpon arrival at the hospital, the RPT should accompany the injured person into the Emergency Room (ER) and advise the attending physician and nursing staff in matters relating to radiation protection and personnel decontamination. In accordance with Procedure A.5-1 00 (ON-SITE MEDICAL EMERGENCIES), a second RPT should be dispatched to the hospital and, upon arrival, should remain outside the Controlled Area (posted area) and 1) coordinate the ingress and egress of hospital personnel into the area 2) control and survey the vehicle used for transport and 3) control all radioactive material generated.
5.0 PRECAUTIONS 5.1 In all cases, the health-and safety of the injured person(s) is the primary
- concern. Prompt medical treatmenttakes precedence over radiological decontamination control methods when serious injury involving the potential loss of life or limb has occurred.
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MONTICELLO NUCLEAR GENERATING PLANT--.- .5-30
.TITLE: CASUALTYCARE-ATTHE:LOCAL- - Revision 4*
_ ~~~~~~~~~HOSP:ITAL :;- -;Pacge3 of 9.,
6.0 INSTRUCTIONS 6.1 Instructonts for the Ambufance Escort ntL1 'iAreA-fRP B.1.1 Upon arrival at the hospial observethe aimblatince 0irl9 process and - ,
A. Advise and assist ambulance personnel rwithoQpaureaton control during the unloading process.
B. Instruct ambulance personnel to close fafl ambulance doors and windows and post the, ambvlancee. -if C. Instruct the anburc thi WOsted.Area,:
Weiren after delivering the patient, until properly monitored and released (i.e., whole body friskj ii. :.
D. Instruct ambulance personnel to keep.arnbulafice gurney used
-- ;..fol patienttransferwithTthe 'posted a The potentially
--contaminate-d
' guzrneyay be placed backin the ambulance until the ambulance and gurney can be properly surveyed.
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- .6.1.2 Ensure any completed radiological survey forms are delivered to the ER for reference durirng patient dcbontrninatinh.
6.1.3 Verify -thi COntrolled"Area has'bpe'er'operly'established. If not, provide instructions to hospitaItpest6'nnetfoP:the establishment of a Controlled Area after the patient has been sfer Effiergency Room. -
6.'6i44- Check and 'verify tha 'hb4fital pbrgrinnadtidiir the' contaminated patient haVe fopLr.dosirh ty CrLI'and O.20 miIlirbr'dosimeter). If Ldosirnetryhas r'dot-y t b66rflsh a me iber of'thehospital eie
-staff to issue doimetry thalER er c '
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- A'- ) Dosimery issu~n e shuldb erorned oiF orm5790-100-02
(-PO METRY ISSUNCE FQRM ;
'B. Dosimieters,when issu d0, sholddbe rpadingJess than 25% full
'. .scale (5O millireii. - >: . '.
C. Rezero an individuals dosimeter if it reaches 75% full scale (150 millirem,).
6.1.5 As required, obtain a count rate meter, dose rate meter and smear
.-papers foruse in the ER from theernergencybtrnet.
6.1.6 Don appropriate protective' clothrrnd dmliftrv . nrt donned for ambulance transport) and rnter-the 8fhergen'~eyiroom.-
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MONrICELLO NUCLEAR GENERATING PLANT A.5-300
-TITLE: CASUALTY CARE AT THE LOCAL - Revision 4*
_~~_~ ' ~ HOSPITAL e Page 4 of 9 6.1.7 Direct the ER staff to periodically check their direct reading dosimeters if dose rates are a concern.
6.1.8 During medical treatment and stabilization, advise the ER staff on contamination control methods (i.e., glove changes). Provide information required by the ER staff'regarding contamination levels and dose rates. Provide radiological information in units of CPM or millirem per hour.
6.1.9 If, during medical treatment, the patient must be moved immediately to an Operating Room assist ER personnel with contamination control during patient transfer 6.1.10 Direct ER staff to obtain samples of contaminated areas of the victim.
Ifvictinhas as. acial wound, have ER staff'sampl victim's nose, mouth and/or ears as appropriate.
.1.11 Surveyall samples taken by-the ER staff during medical treatment and stabilization to determine the presence of radioactivity. Ensure proper storage of all samples retained in the ER (i.e., storage of high activity
... samples in the lead container).
6.1 .12 Survey all samples that must be removed from the ER for lab analysis (i.e., gbood samples, etc.). Ensure proper contamination control techniques are utilized when transferring samples (x-ray film cartridges, etc.) out of the Controlled Area.
NOTE: When staffed, the RPT outside the Controlled Area Is-responsible for surveying all materials (samples, x-ray film cartridges, trash, etc.) 'removed from the Controlled. Area.
6.1.13 Assist the ER staff in moving necessary equipment (i.e., x-ray machines, etc.,) into and out of the Controlled Area. Properly survey (smear and frisk) all materials to be removed from the area.
6.1.14 When the ER staff indicates patient decontamination may be performed, coordinate decontamination efforts as follows:
A. Using a count rate meter, survey the patient and identify areas of contamination paying close attention to areas that indicate potential inhalation (i.e., nose and mouth);
B. Decontaminate areas of higher contamination first, utilizing plastic coverings, etc., to prevent cross-contamination of other areas
- when rinsing; C. Assist the ER staff as necessary in patient decontamination.
D. Surveythe area after each decontamination effort and record the "-
results on Form 5790-100-01 (PERSONNEL SURVEY FORM);
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MON77CELLO NUCLEAR GENERATINGPLANT -. A.5-3 1TTLE: CASUALTY CARE AT THE LOCAL? . Revisidn 4* I HOSPITAL I Page 5 of 9 E. Continue decontamination efforts urntil -the patient is decontaminated or untl available methods to remove the contamination have been exhausted.'
6.1.15 Assist the ER staffc.in'the aclaan'transfer" of the pati-ent'to an
-.uncontaminated gurney for removal from the ER.
6.1.16 Advise ER personnel on proper techniques for doffing protective clothing when exiting the Controlled Area. Perform a whole body frisk of all personnel exiting the Controlled Area. -
--6.1.17 Control and package all potentially contaminated trash and material for transport to the plant for proper disposal.
6.2 InstructIons for the Hpspital RPTr(Outslde Co ntrolled Area) 6.2.1 Upon arrival at the hospital, contact the Emergency Room RPT and assume responsibility-for cordiixation of activities outside the Controlled Area: b- ;
6.2.2 Verify the Controlled Area -s.fdoped-offand -psted as a CONTAMINATED AREA, TLD and DOSIMETER required for entry
-% ! . (refer to Hospital Assistance- Plan for area §et'up): -
6.2.3 Obtain instruments and supplies as'necessaifrom the emergency -
cabinet.-
- 6.2.4- Chieck the' hicle used forpatfLt transporL to ensure Frpier;, .
'radiological 'posti-ngsand'Cce-ss to the vehicle is limitid.-Survey (smear and frisk), decontaminate if necessary, and rerease the vehicle fr unrestricted use when-time allows.
-6.2.5 -if the~ambulance crew hi. not been monitored out of the Controlled Area assist them In'exiting the area as follows:
A, Provide inhstructions for doffing protective clothing.
B. Perform- a whole body frisk of each individual as they exit the Controlled Area.
C. Decontaminate any ambulance crew members that are found to be contaminated., ,.
D. .- Obtain, read and record theresults of any dosimetry issued to ambulance personnel. Record the dosimeter OUT readings on
- Form 5790-1.00-02.
E. -Release ambulance persoanel when-monitoring and dosimetry processing is complete. -; i- :.
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6.2.D Onde the patient is in the Emergency Room coordinate the surveying and clearing of affected hospital areas outside the Emergency Room as follows:
A. -Survey the hallway and ambulance receing area for
- contamination. If contaminated, leave the CONTAMINATED AREA posting and decontaminate when resources are available.
If the areas are uncontaminated remove the posting (ropes, signs, and step-off pad) and clear ths area for use.
B. Place a step-off pad at the area immediately outside the Emergency Room.
C. Ensure the Controlled Area immediately-outside the ER and the ER are properly posted as a CONTAMINATED AREA and CONTROLLED AREA, TLD & DOSIMETER REQUIRED FOR ENTRY.,
D. Contain and properly bag all contaminated material for return to
- --the plant and proper disposal; 6.2.7 'Station yourself at the step-off pad area and'coordinate personnel and equipment movement into and out of the Controlled Area. Advise hospital personnel on radiological matters (iLe., protective clothing,
-floor decon, etc.J.
6.2.8 Survey all samples that must be removed from the ER for lab analysis (i.e., blood samples, etc.). Ensure proper contamination control techniques are utilized when transferring samples (x-ray film cartridges, etc.) out of the Controlled Area.
6.2.9 Assist the ER staff in moving necessary equipment (i.e., x-ray machines, etc.) into and out of the Controlled Area. Properly survey (smear and frisk) all materials to be removed from the area.
6.2.10 Advise ER personnel on proper techniques for donning and doffing protective clothing when entering and exiting the Controlled Area.-
Perform a whole body frisk of all personnel exiting the Controlled Area.
6.2.11 As personnel exit the ER collect their TLD and dosimeter and retain for processing. Record all dosimeter data on Form 5790-100-02.
6.2.12 Assist the ER staff in the 'clean transfer" of the patient to an uncontaminated gurney for removal from the ER.
6:2.213 If the hospital staff determines-the patient should be transferred to "North Memorial Hospital (or Regions in St. Paul) and the patient will be contaminated when transferred, perform the following:
A. If necessary, contact the RPC or Control Room Supervisor at the "-
plant and request additional radiation protection assistance.
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MONT7CELLO NUCLEAR GENERATING PLANT -A.5 0*
TITLE: CASUALTY CARE AT THE LOCAL . C Revision 4* ' ' I HOSPITAL Page 7 of 9
-8., Ensure a copy of the most recently completed Form 5790-100-01 on the patient is transferred with the patient or telecopied to the receiving hospital.-
C. Instruct amribulance or helicopter personnel on contamination control methods to be usedduring the transfer (i.e., wrap patient in sheet, etc.). -.
D. Refer to plant Medcal Procedure A.5-400 (CONTAMINATED PATIENT TRANSFER) and coordinate the radiological aspects of the transfer. -
6.2.14 Collect and return all TLDs (issued at the hospital or to ambulance personnel) to the-plant for-processingwith the completed Form 5790'1,00-02.
6.3 Hospiial/ehicle Survey and Decontamination.
3.1 . e6 f et.
6:3.1 Upon comp eti.n1 rnedicI treatnt~and after the patient has been transferred ouf o t e Conrolled Area ensure all established Controlled Areas arp posted and pryper1 pyconrttroIleitsurveyed and cleared.
6.a2 During, the,,survey and clearing-process priority should be given to the emergency vehicle used for corltaminated? patient transfer and areas of the hospital used by the general public.
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6.3.3 Survey and clear any Controlled Area(s):established including the n;ambulance receiving areae, travel routesor'Emergency Room as follows; - :
A. X Prior~to entering arid -sUrveyngthe'are,6Edon prbatctive clothing
.appropriate for anticipated 1 conditions.'
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B. Perform a loose surface contamipation survey of the area using cloth smears.i *
-C. Smear all exposed durfacea'wfthin the area, including floors, walls, cabinets, door handles, etc. K ,
D. z'Smear any e6uipmenft that was used for transport of patient (i.e.,
gurney, etc.). that is within the area. ;-
E. Label each smear with the location, time,:date and other pertinent information. Indicateithe wurvey i'cat -r-ona-MBLH CONTROLLED AREA FLTOIR0RLM4, and.record results on Form
- 5790-30-01 (HOSPITAL SURIVEY RESULTS LOG).
F. Perform a preliminary analysis bycounting each smear using a count rate meter with pancake probe in a low background area.
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MONTICELLO NUCLEAR GENERATING PLANT - A.5-300 MTITLE:- CASUALTY CARE' AT THE LOCAL Revision 4*
HOSPITAL - Pag.8 of 9 G. Bag and retain the smears for analysis at the pla tM.
H. Perform a-fixed contamination survey (frisk) of the irregular surfaces within the area (i.e., straps, cushions) using a count rate meter with a,pancake probe. Record results on Form' 5790-300-01.
6.3.4 Coordinate the decontamination of any contaminated areas or equipment identified-during the area surveys as follows:
A. Request the assistance of hospital Housekeeping department or obtain Nuclear Plant Helper support from the plant.
B. Survey the floor and decontaminate (if necessary) .
C. Using paper or cloth towels (with a typical hospital disinfectant) wipe smooth surfaces such as doors, door handles, gurney, etc.
D. Properly control (bag, label and isolate) all materials used for hospital decontamination.
6.3.5 'Resurvey areas, equipment after decontamination is complete.
6.3.6 Return all smears to the plant for analysis and complete documentation'in accordance with applicable RPP(s). Record results on Form 5790-300-01.
6.3.7 Properly bag and label all radioactive trash generated during the event.
6.3.8 Coordinate the transfer of any trash and materials generated during the event including decontamination materials (i.e., mop heads, rags, paper, used protective clothing, etc.) to the MNGP for proper disposal.
6.3.9 Coordinate the disposal of any contaminated water used for patient or hospital decontamination as follows:
A. Collect any potentially contaminated water used for patient or hospital decontamination.
B. Return the full (or partially full) containers, used for patient decontamination, to the plant for disposal.
6.3.10 Coordinate the restocking of emergency supplies in the hospital emergency equipment locker.
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MONTICE LLO NVUbLER'GNNN PLANT -- o. -- f A.5-'300' TITLE: CASUALTY CARE AT THE LOCAL .. =RevLsion 4*
. I HOSPITAL H1 .- Page9of 9 7.0 FIGURES 7.1-F., , tiie Pro-edure
.; ,7.1 Forms Utilized-Inthis Proceduire
- 1. 5790-100-02 (DOSIMETRY ISSUANCE FtORM) 1
- 2. 5790-100-01, (PERSONNEL SURVEY FORM)
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- 3. 5790-300 (HlOSPITAlL SURVEYt RESUL:TS LOG) 0
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