ML100350403

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Lawrence & Memorial Hospital Medical Services, Millstone, Submittal of Final Report of Radiological Emergency Preparedness Program Drill, Conducted 12/08/09
ML100350403
Person / Time
Site: Millstone  Dominion icon.png
Issue date: 01/07/2010
From: Ford P
US Dept of Homeland Security, Federal Emergency Management Agency
To:
Document Control Desk, Office of Nuclear Reactor Regulation
References
Download: ML100350403 (22)
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{{#Wiki_filter:U.S. Department of Homeland Security FEMA Region I 99 High St., 5 th Floor Boston, MA 02110-2320 ~J FMA January 7, 2010 NRC Headquarters Document Control Desk US Nuclear Regulatory Commission Washington, DC 20555-0001

Dear Sir/Madam:

Enclosed is a copy of the final report for the Lawrence & Memorial Hospital Medical Services (MS-1) Drill that was conducted on December 8, 2009. The State of Connecticut, the Lawrence & Memorial Hospital, and Niantic Medical Services Ambulance (East Lyme) successfully demonstrated their capabilities to implement their off-site radiological emergency response plans and procedures. Based on the evaluation of this exercise by the Regional Assistance Committee Chair and the federal evaluators, there were no deficiencies, and no Areas Requiring Corrective Action (ARCA). State and local preparedness remains adequate to protect the health and safety of the public living in the vicinity of the Millstone Power Station and provides reasonable assurance that appropriate measures can be taken off-site in the event of a radiological emergency. If you have any questions regarding this matter, please contact Steve Colman, Regional Assistance Committee Chair at (617) 832-4731. ,8ft~rerely, Paul V.Fgord Acting Regional Administrator Enclosure cc: Ms. Lisa Gibney, NRC, REP HQ Branch Chief, and HQ Project www.fema.gov

Millstone Power Station Lawrence & Memorial Hospital MS-I Drill - December 8, 2009 Radiological Emergency Preparedness Program Final Report: January 7,2010 E A Region I

Final Drill Report Millstone Power Station Licensee: Dominion Nuclear Connecticut, Inc. Exercise Date: Report Date: December 8, 2009 January 7, 2010 U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY REGION I RADIOLOGICAL EMERGENCY PREPAREDNESS 99 HIGH STREET BOSTON, MASSACHUSETTS 02110

TABLE OF CONTENTS Page T A B LE O F C O N T E N T S.................................................................................................. 1..I EXECUTIVE

SUMMARY

2 II. INTRODUCTION...................................................................................................... 3 III. DRILL EVALUATION AND RESULTS...................................................................... 5 A. NIANTIC AMBULANCE................................................................................. 5 B. LAWRENCE & MEMORIAL HOSPITAL...................................................... 6 List of Appendices APPENDIX 1 DRILL EVALUATORS....................................................................... 7 APPENDIX 2 CRITERION AND EXTENT OF PLAY............................................... 8 APPENDIX 3 SCENARIO........................................................................................... 12 I

I Executive Summary .On December-8, 2009,-a MS-1 Drill was conducted at Lawrence & Memorial! Hospital, 5 New London, Connecticut. The purpose of this drill.was to assess the capability of the Lawrence & Memorial Hospital and Niantic Emergency1Medical.,Services.,(East, Lyme) to

  • irgspondto a radiological incidentinyo!ying the Millstone ýý,ower. Station., This' drill was T~~~~~~~ ~

~ ~ ~ -pnt a .ailgcl .ýMlso 7 held in accordance with FE-MA's policies,and guidance, concerning the.exerci~e of State and Local radiological emergency response plans (RERP).,and procedu-pres. I FEMA wishes to acknowledge the efforts of thermany individuals who-participated in this important medical :services drill,.theLawrence, & Memorial! Hospital Emergency a Department Staff and Support Staffs, the Niahtic Emergency Medipazl Services'. I Ambulance Team, and the attending;Millstone Health Physicist. Many tha.nks to all who participated in making this a successful MS-I Drill. Protecting the public health and safety is the full-time job of, some of the. drill participants and an additional assigned responsibility for others. Still others have willingly sought this , responsibility by volunteering to provide vitalemergency services to their co' munities. Cooperation and teamworkof all the participants were evident 1duriig this drill. This report contains the final. evaluatiop ofthe.MS-1 Drill. ,I The Lawrence & Memorial Hospital and the Niantic. Ambulance, demonstrated knowledge of their emergency response plans and procedures and adequately implemented them. There were no. Deficiencies identified and no, Areas Requiring

  • Corrective Action (ARCAS) identified as a result of this drill.

2I II-a'a a N al

II. Introduction fo December 7, 1979; the President dretted th d Feddral Emer~gencyManagent Agbncgy' (FEMA)"tb ass ume 'the lead respoh-siflit..fr ll 6ff--'git nuclear planniii1g and response. FEMA's activties were conducted purisuant to 44 Code: of Federal.Regulations '(CFRýParts 350,3'51-and 352ýTh&`e regulid6hre a key element in th' Radiolbgical 'Eni"rgeri cyPreparedhesý,(REP) Prdgrarh thl*it was e6tablished following'the Thrhe Mile Island Niclear Statioihfdccident iri'March 1979. ,44'CFR 350 establishes'the poliies and"'.Procedures f6r FEMA's initial and'contirued approval of Tribal,1State;ýandtlocal gov*hnients' radiblogiaal emergency plnning and preparedness foircommiercial fiuicledr*i*owerPla t". This approval i§ contingent, h part, on State -and local g6veinhidnt paftiipti6f oifin joirit-exerciseswith licensees.' FEMA's responsibilities in radiological emergency planning for fixed nuclear facilities -i clude the followifig:!.. Sj 2 Taking the kead iiioffsite emergenc plannin* and in the review "and,'&,~aluation of RERPdst aiid.1roced ui:e" sd velcped by S-(ate and local goveinments; :

  • Determining whether such'plans anld'ýprtceduýe's an be'implemertied ont the basis of observation and evaluation of exercises of the plans and procedures conducted by Sýtat'e ;andtloclal'governments;
  • Pesponding to, reqUests~by the U.S. Nuclear Regulat6ry Commission (NRC) pursuant to the Mem'oraidur of Understanding between the NRC and FEMA dated June 17, 1993 (Federal Register, Vol. 58, No. 176, September 14, 1993);

and

  • Coordinating the activities of Federal agencies with responsibilities in the radiological emergency planning process:

U.S. Department of Commerce, U.S. Nuclear Regulatory Commission, U.S. Environmental Protection Agency, U.S. Department of Energy, U.S. Department of Health and Human Services, U.S. Department of Transportation, U.S. Department of Agriculture, U.S. Department of the Interior, and U.S. Food and Drug Administration. Representatives of these agencies serve on the FEMA Region I Radiological Assistance Committee (RAC), which is chaired by FEMA Regional Office. 3

Formal submission of the RERPs for the Millstone Power Plant to FEMA Region I by the State of Connecticut and involved local jurisdictions occurred on September 4, 1981. Formal approval of the RERP was granted by FEMA on October 9, 1984, under 44 CFR 350. '1 A MS-i Drill was&6h'ducted on'D-&erhber 8, 2009, by FEN.-Region'Ito asgess-the capabilities of the Lawren&ee& Memfrnial Hospital and Niantic Emergency Medical Services in-impleiriefing their RERPs and pro'eduires to protect the pubhictheaflth and safety diring a radiological 'emergeiic -inVolving Millstone P6wer-Statioi'i.The purpose of this drill report is to present the drill results and findings on the performance of the off-I site response oiganizations (OROs)durifig a simulated radiologica~l-emergency. The findings presented irnhthis repci-t are based on' the evaiuatiohs of the Federal evaluator I team, with final determinations made by'the FEMA Region I RAC Chairperson;' and approved by the FEMA Region I Regional Administrator. The criteria utilized in the FEMA evaluation process are contained in the following:

  • NUREG-0654/FEMA-REP-1,'key. i, "'Criferiai' fofPrep'aration and Evaluation of I

Radiological Emergency Response Plans and Preparedness in Support of Nuclear PowerPlants,",November; 980;" o ",-Radiological Emergency" Preparedness: Exercise Evaluation Methodology," ý. published~in tlhe Federal!Register on September 12, 200.1, and: revised April 25, 2002. Section III of this report, entitled "Drill Evaluation and Results," presents detailed information on the demonstration of applicable exercise: objectiv'es at each jurisdiction or functional entity evaluated in a jurisdiction-based, issues-only format. This section also contains: (1) descriptions of all Deficiencies and Areasý Requirin'g Corrective Action (ARCAs) assessed during this drill, recommended corrective actions, and the State and Local Governments' schEdiule of:corre'dtive actidns'for each identified drill issue and (2) descriptions of unresolved ARCAs assessed during previous drills and the status of the ORO's efforts to resolve them. A' 4 I 41

III. DRILL EVALUATION AND RESULTS ,.Contai.ned in this secti,.)n arp the results andc:findings -f the evaluation, of the Niantic Ambulance, East Lyme,. CT, and the Lawrenge & Memorial.,Hospital, New London, CT, that parti~cipated-in the December 8, 2009, MS-i Drill to, test,the medical-service-capabilities to respond to an incident involvingthe.Millstone Power Station. Each functional entity was evaluated on the basis of ts demonstration of criteria delineated in the Evaluation Criterion contained in "Radiological Emergency, Preparedness: :Exercise Evaluation Methodology,".published in the FederalRegister on September 12; 2001,,andre*visedApri1,25,,2002,, The following is a status of functional entities evaluated. A.,:ý Niantic Ambulance (Niantic Medical Services) The Emergency Medical Technicians from' Niantic Ambulance. demonstrated the knowledge and expertise in caring for the injured contaminated worker. They accurately followed: the guidance of the MillstcnevHealth PhysicsTechnician.. mnimizing the possibility.of radioactive cross contaminaticn. lHaying a HP, tech rideialong in the ambulance was an excellent source of information. The Ambulance Crew did an excellent job of contamination control. a., MET: Criterion 6.d.1. .b. DEFICIENCY: NONE..

c.,AREASý REQUIRING CORRECTIVEACTION: NONE.
d. NOT DEMONSTRATED: NONE
e. PRIOR ARCAs - RESOLVED: NONE
f. PRIOR ARCAs - UNRESOLVED: NONE 5

B. Lawrence & Memorial Hospital I The Emergency Radiological Team at the Lawrence & Memorial Hospital ademonstrated the'ir knowle ge an expertise. -of tfe ho0`tl§rd~lg lrsos plan. As soon as the notification came into the Emergency Department, staff kept in I constant communication confirming the status of the injured worker en route to the hospital. The Emergency Radiological Team Was busy preparing the radiological 'emergncy roomi and entran~efor the arrival of the patient. The-pro'perly suited up Medical. Team provided excellent medical attention and care to the injured worker while attending to c6nftifnfi ation on his body, The use of a white board to record' where and what levels of contamination the patient had on his body was a great tool I keeping staff informed of the patient's decop status. Excellent job! II

a. MET: Evalu'ation 'Areia Criterion 6.d. 1
b. DEFICIENCY: NONE 3
c. AREAS REQUIRING CORRECTIVE ACTION: NONE
d. NOT DEMONSTRATED: NONE
e. PRIOR ARCAs - RESOLVED: NONE
f. PRIOR ARCAs - UNRESOLVED: NONE 6I

APPENDIX 1 DRILL EVALUATORS The followihg are the personnpel who, evaluated the, edical Services Drill (MS-1 Drill) for the Millstone Po'wer Siation :December 8, 2009, EVALUATION SITE',, 01 Niantic Ambulance Lawrence & Memorial Hospital 3JECTIVE 'EVALUATOR 6.d. I Don garlton ORGANIZATION DHS/FEMA DHS/FEMA DHS/FEMA (OJT) DHHS (OJT) 6.d.l Helen "LaForge' Barbara Thomas Gregory Banner 7

I APPENDIX 2 I CRITERION AND EXTENT OF PLkY EVALUATION AREA 6:, SUPPORT IP TIO?/ACILITIES Sub-element 6.d - Transportation and Treatment of Contaminated Injured Iivduals_ Intent. This sub-element is derived from NUREG-0654, which provides:that OROs, should have the, capability to transport contaminaed injured individualsto.iedical faciliuie, with the 'cpabilit*, to provide medical services. .1 I Criterion 6.d.1: The facilit/ORO has the appropriate space, adequate resources, and trained personnel to provide transport, monitoring,, decontamination, and medical services to contaminated injured individuals. (NUREG-0654, F.2, H.10.,.Ka.b.,L.I., 4.), Extent of Play - General OROs should demonstrate the capability to. transport contaminated injured individuals to medical facilities. However, to avoid taking an ambulance oat of service, any vehicle (e.g., cqar, truck, or ambulance) may be utilized to transport a simulated victim to the medical, facility-. If an ambulance is used, normal communications between the ambulance/ dispatcher and the receiving medical. facility should be demonstrated. This would include reporting radiation monitoring results, if available. Additionally, the ambulance crew sioýuld demonstrate, by inteiv:iew, knowledge of where the ambulance and crew would be monitrhed and dec&ntamfinated, if required, or whom to contact for such information. MIonitoring of the simulated victim iay bepef6rried prior tO trarisioirf,' done enroute, or deferr~ed t6 the medical facilhty.' Prior to, using a monitoring in~strumenit(s), the mnonitor(s) should I demonstrate the process of 1hecking the instrument(s) for proper operation. All mionitoring activities should be completed as they would be in an actual emergency. Appropriate coptamination control measures should be demonstrated prior to and during transport and at the receiving merdical facility. I The mnedical facility should demonstrate the capability to activate fnd set up a radiological emergency area for treatment. Equipment and supplies'should be available for the treatment of I contaminated injured individuals. The medical facility should demonstrate ;the c~apdbilfity to make decisions on the need for decontamination of the individual, to follow appropriate*decontamination procedures, and to maintain records of all survey measurements and saimples taken. All procedures for the collection and analysis of samples and the decontamination'of the individual should be I demonstrated or described to the evaluator. I I

Monitoring, decontamination, and contamination control efforts will not delay urgent medical care for the simulated victim. -All activities associated witfhthis criterion must be -based on -the ORO's plans and procedures, andcompleted a's they would be' in'an ýhctual emergency, unless otherwise' indicated'in the' etent of play agreement. Extent of Play - Specific: All respon~diring's't'tioriand offsite~mer'geny respofise *e~bnnei,'eq ipmenrt, and procedures will demonstrate respornse actions within ihe following lirnitatiions:.

1. All non-invasive medical protocol and contamination control (radiological and blood borne pathogen).rim'easure's wxIihi "bedemohn'strated. 'iMediical procedures 'will be conducted in"'

accordahce withMldtone Power Station, state,' local and hospital protocols.) In'vasiv` protocols will nod be denmoistra-e-d Mouiage,"itijured inidi'vidual r61&-playinj and scenario data will be used to simulate victim physical injuries as well as contamination levels. t2. The simulated accident will be staged on December 8, 2009 at Millstone Power Station. This areatmay be a simulated'or real Radiological Control Area (RCA) at Millsione Stationi The `maramy* be posted "tS a"Contaminated' Area, "Training Only" or 'Dfill Offly"but will not' f a f~l RC '"' usd all p~onndi enterintRC If a real CA iS used, ngthe,RCA must comply with HP RCA requirements' including use' of electronid d'osimetry afid sign in on a valid Radiation Work Permitn(RWP-32 Task 1 is available for EP activities).. If a real RCA is used, a tiMeout may be used to monitor the patient and caregivers as they exit the PRCA., If the patient is boarded arid coIlared, he/she will return to the station f61owting'relea'se" from the hospital and Will pass throu gh the routine RCA exit mqonitoring.

3. Security restrictions and controls cannot be suspended 'for simulated' emergencies. Note. that ambulances routinely respond to the site for real medical emergencies. Since the' process for granting non-emergency access to the Protected Area (PA) results in a substantial delay, one of the following simulations maybe'used:

The accident scene may be simulated to be within the PA. The actual location may be outside of the PA but still in the Owner Controlled Area (OCA). - or Th m u a c a .,4 ' , * 4 i*.,

  • the ambulance may be pre-staged'within the PA. Five minutes after radio dispatch, the* ambulance will simulate driving through the PA gate.,

-or-9

The ambulance may, r1espond real. time,, gojthrough.the.searchtprocess, ýAnddthe extra:,

tim e noted as, a. dri~ll i4rtifici ality,:.,.,,:7:,,,

.i,, ;,*-4,, ,,,:.r,,.,:,

4. Concurrent with this exercise, an off year training drill will be conducted with Middlesex Hospital a4d another local ambulance.;,Theresponseby the second ambulance, and Middlesex will not be evaluated by FEMA...
5. Two individuals will-role-play contaminated injured patients.' Simulated injuries Will be assessed medically and radiologically. Additional!fatally :iNjured patient(s), may be simulated by use of mannequin(s). Priorities of care will be determinedrbased on medical condition, simulated injuries and the magnitude of radioactive contamination.
6. For each patient, the destination hospital and ambulance to be used will be predetermined, Players will have advance knowledge that there are multiple patients and the facilities to be'ý used for each patient.
7. A controller will make the initial notification to the Millstone Unit 3 Control Room (2911) reporting the injuries. The Control Room will use station procedures and systems to dispatch first responders (radiological and emergency medical), request offsite assistance, and notify the hospital.
8. The patient for the evaluated exercise will be transported to L&M Hospital,, which is equipped to treat radiologically contaminated/injured individuals. The second patient will be transported to Middlesex Hospital (evaluated by FEMA in 2008) which is the backup hospital to L&M.
9. Per Millstone procedures, Millstone Health Physics (HP) Technicians will accompany the patients and transport vehicles to the hospitals. Additional pre-designated HP staff/supervision will travel to the hospitals to provide support. All scene personnel (EMTs, Fire Brigade, Security, HPs), facilities and equipment will be simulated "clean" and available upon departure of the patient from the accident scene.
10. Communications will be demonstrated between the vehicle (ambulance) crew and hospital via medical radio equipment (med patch).
11. The ambulance will respond in non-emergency mode at all times. Emergency lights and sirens will not be used. All normal traffic laws will be followed.
12. Regardless of the severity of injuries and Connecticut Trauma Regulations, neither Lifestar, nor any Trauma Center will be utilized for the drill. Advanced Life Support (Paramedic intercept service) will not be used.
13. Controllers will determine if the ambulance, crew, and/or equipment have been I

contaminated. Decontamination of ambulance personnel and emergency vehicles will be demonstrated through a discussion with players. I 10

14. The, exerc:,se, or.:pcrtiens thereof,.will be suspended: ifrcýnetgency responders are called upon for an actual emergency, a hosp if af'&1'ares a dive#Miofj, ý6r-'Aiis tone 'EP management determines immediate station needs require suspension.

15. The exercisewill be terminated based'on an agreement tetWeer'.the FEMA lead e(valuator and the drill manager.
16. Immediate Correction wili be allowedtif after iitially not being able to demonstrate -

proper practices or.show-proper equipment, supllies or documentation, the issue is: corrected witfh-further effortYinstruction. Area Requiring Corrective Action (ARCA) (None)

1.

j 'II., I 1~1 ( r I. I.., -I. I t .f I1

APPENDIX 3 'SCENARIO'

  • 3/4

<:..~.s Initial Conditions Estimated Events Time 0745 The drill date is assumed to be Tuesday, December 8, 2009.

°.

( Location and Staging A mock up of a contaminated airea hass'bee:n 'set up in the U23 Waste Disposal Bldg (Bldg 324 either the truck bay or outside' the fuel building door). The Accident One worker (Worker 3) falls from the overhead striking a. platform occupied by two other workers (workers 1 & 2)' ahd then falls onto a mietallic edgeresultingý in fatal injuries. The two other workers on the platform fall'- 4 feet to'the flo6dr, both receiving potential head 'and back trauma (NRC E-ent;45003.,',§' Turkey Point 4/20/09). M'essage No. la, lb, lc, ld I I I I I I I I I I I I I Sr:c'1' A ~ 12

The Injuries Worker 1 (transport by Niantic to L&M) has the following injuries: " Never lost consciousness and is,yignted to person, place, time and event.

  • Primary complaint is pain to the neck, head, and shoulder.

Minor pain and bruising on the knee. Patient can tolerate weight on the knee. There is a small laceration on the forehead. Bleeding is not severe.,,....

  • Pulse is as checked plus 10, Respirations are as checked plus 4, all other vitals are as obtained.

o Following simulation of 02 administration, all vitals are as checked

  • Distal pulses, qe present and capillary refill is appropriate.

Pulse Ox is as observed. " No chest pain or difficulty breathing.

  • Lung sounds are clear.

The Radiological Conditions s. Area - Contamination levels in the posted contaminated area are as high as 50,000 dpm/100cm2. All contamination levels outside the posted areaare <1-,000 dpmr1OOpm 2 unless spread. during drill. Dose rates in the area are <2 mr/hr. Workers - The workers' clothing is contaminated to 700 ccpm direct frisk. The workers' necks and the lacerations are also 700 ccpm. 13

I

:Detailed Scenario Timeline If at any time Advanced Life Support (Lifestar or Paramedic) is indicated, the appropriate I

Controller shall advise the player(s) that.no 'helicopter is available.. a,'..9 ALL TRAFFIC LAWS MUST BE OBEYED. No light or sirens, every transmission and phone I call includes the phrase "This Is aDrill." Exercise: For Hospital and A lnbulance players, IF perfoimance errors are observed, controllers m will consult with FEMA to determine if on the spot corrections are appropriates:>. Drill: For Hospital and Ambulance players, IF performance errors are observed, controllers will i I interact with players to discuss appropriate actions Performance issues (other than safety related) for Millstone personnel, will be addressed through I the critique process and addressed using the station corrective action' program. I Estimated Events......................... ,i.., Message Time No. 0759 Drill manager consi!ts with controllers at all., facilities to ensureý they are on board for the~drill m 0800 Controller calls 2911 - Unit 3 Control Room to report the injury 2 0801 Unit 3 Control Room implements C OP 200.3, "Responselto, Medical Emergencies" 0804 Unit 3 Control Room directs EMTs, fire brigade and Security to respond 0805 Unit 3 Control Room makes PA announcement: drilt,-medical I emergency, designated emergency medical personnel respond. 0805 EMTs and Fire Brigade leader and Fire Brigade Advisor respond -HP likely joins them: 0805 U3 Control Room contacts Unit 2 Control Room I 14

Estimated Events o 'z c Time 0805 Unit 3 Control Room may call Waterford Dispatchto request I, ambulances (this call may be delayed until requested by EMTs) Waterford Dispatch will be briefed to simulate. that, none of the six Waterford ambulances are available and to request mutual aid ambulances from, Niantic. and New London. 0806i EMTs. assess patients,; 0807 HP techs assess radiological conditions and determine the S*;patients are contaminated or potentially cor taminated. HP or.-{ EMTs inform Control Room of contamination,,... Message No. 3: 4 0807 EMTs request offsite assistance for two injured patients and ."inforra the control room that one individual is deceased. Waterford Dispatch will be briefed to simulate that none* of the six. Waterfordadinbulanceszar'er available, and, to request mutual aid ambulances from Niantic. and New London. 0808 Unit 3 Control Room uses hotline or 9-911 to contact Station W. (Waterford Dispatch) 0808 Unit 3 Control Room directs HP to respond (likely already responded) 0809 Station W contacts Station B (East Lyme Dispatch) and New London to request mutual ;aid ambulances.;r.- 0810 Unit 3 Control Room directs Security to respond 0810 Station B dispatches Niantic Ambulance. New London-dispatches ambulance. 0811 Ambulances en-route - contact Station W .,L, "," .'.,i

{

15

Estimated Events Time No. 0815 Unit 3 Control Room informs L&MEmergency Department.. 5 (ED) that contaminated patients will be transported. L&M requests that second patient be transported to Middlesex. HP may attempt limited decontamination, patients will remain above 500 CCPM 0816 L&M Hospital makes verification call :back.to.Unit 3 Control, Room. Unit 3 Control Room informs Middlesex Hospital. that apatient will be transported. I I I I I I I I I I I , f'! ý-.";' 0817 Middlesex Hospital makes verification call. back to the Unit 3 Control Room. 0820 The Hospital ED staffs s.huld each initiate their radiological,. emergency plan and prepare the Radiological, EmergencyAre.:. (REA) for contaminated/injured patient arrival 0821 Ambulances at FAP - ambulances may be delayed 5 minutes eachfor search.- Drill artifiiality 0822 REA cleared, dosimetry issue & PPE donning, Security establishes ambulance entrance 0830 Ambulances at VAP - ambulances may be delayed - 5 minutes for search and for personnel (ambulance crew and FEMA evaluator) to process into PA as visitors-Drill artificiality 0837 HP or Security issues dosimetry from ambulance kit 0837 Millstone EMTs complete packaging of patients, may reassess vitals, transports patients toward exit on backboards and perhaps in stokes baskets (If required controllers assist as muscle in moving patient to RCA exit). 0841 Ambulances arrive at RCA exit 0841 HP Briefs ambulance crews on radiological conditions 0842 Ambulance crews moves stretchers to RCA boundary 16 I I I I I I I

Estimated' E*efits Time ýMessage,, No. 0843 Millstone EMTs provide turnover,,of patient conditions to: ambulance crew ,: 7 ' iI. 0844 Patients are transferred to ambulance crews and loaded 0847 Ambulance crews evaluate patients 0850 EMTs / Fire Briga de Ad-iisor. notify UniV..3 Control: Room that patients have been loaded and are being transported. 0850 Ambulances depart scene 0851 Ambulances at VAP 0851 UNIT 3 CONTROL ROOM MAY MAKE SECOND CALL TO HOSPITALS TO INFORM THEM THAT AMBULANCES ARE DEPARTINGSITE (THIS JS NOT-REFLECTEDINC OP.200.3) ! 0854 Ambulances depart VAP Drill play terminated for Millstone EMTs, Fire Brigade, Security 6a, 6b, 6c and Operations, facilities placed back in order and critique begins. Scene controllers will take commients'to L&M critique. I I 17

I SECTION 2 - Niantic Ambulance - L&M Hospital Estimated Events Message. Time No. 0855 Ambulance departs, establishes patches into L&M ED. Provides medical conditions, radiologicalinform.ation and estimated time, of arrival. 0904 Ambulance arrival at hospital 0905 Patient turnover from ambulance'to hospital. I 0906 SecondHPintoREA. 0906 ED staff providing patient..care and performing.und area decontamination, based on the extent of injuries Two decontamination attempts will be sufficient to; rermiO.e. 1 contamination from the patient. The laceration is : decontaminated on the first attempt;,. The physicianwshould follow plan procedure regarding the taking of swipes or, samples 0910 X-Ray requested, X-ray tech suits up and provided dosimetry. Clean path established into treatment, area for X-ray machine and technician 0914 EMS personnel (once "released" from patient care 8 1 responsibilities) and the ambulance should be surveyed for contamination at this time or any time after, depending on the status and readiness of hospital and MP HP staff to perform this function 0910 - Neither the EMS personnel, nor the ambulance itself will be I 0925 contaminated, unless contamination was spread during the response/transit to the Hospital. [The Controller (who traveled in the ambulance and observed contamination control measures) shall make this determination, based on actual actions taken by ambulance personnel during ambulance transit to the hospital.] Ad hoc contamination levels if appropriate assigned by the patient Controller should be 200 CCPM for any contamination transferred from the patient I REA ED staff radiological exposures should be periodically monitored during and after patient receipt and care is provided. i 18

S I.., Estimated Events Time;'-, Message No. ? 0920 X-Ray complete 0935 After successful, patient decontaminatiohi1:-performed, the patient is transferred to OR (simulated). If medically necessary or released from REA 0940 The medical staff should be monitored for contamination upon completion of patient decontaminati"on-ayid prior t;ýexiting the REA. The REA and equipment should also be surveyed for contamination. Contaminated waste, such as used bandages, etc. should be dispositioned / gathered appropriately as radiological waste. REA ED staff radiological expolsures should beichecked and documented

  • ~l0

,,...i¸ 0950 Controllers will consult withfFEMA>3 ensure all required actions have been observed. Any'requiredn:' the spot corrections will be c6nd(ictedu..; Drill is termiieiaterd FEMA will conduct a debrief as appropriate Objective based, player.led-critique willfollow" 'I 19}}

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