ML110540377
| ML110540377 | |
| Person / Time | |
|---|---|
| Site: | Grand Gulf  |
| Issue date: | 01/10/2011 |
| From: | Lawrence Hammond US Dept of Homeland Security, Federal Emergency Management Agency |
| To: | Collins E Region 4 Administrator |
| Cecere, Bethanny NSIR/DPR 415-6754 | |
| References | |
| Download: ML110540377 (59) | |
Text
Grand Gulf Nuclear Station After Action Report/
Improvement Plan Drill Date - December 16, 2010 Radiological Emergency Preparedness (REP) Program Published January 10, 2011
Unclassified Radiological Emergency Preparedness Program (REP)
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Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station Grand Gulf Nuclear Station After Action Report/Improvement Plan Published January 10, 2011 Contents Executive Summary 3 Section 1: Exercise Overview 4 1.1 Exercise Details 4 1.2 Exercise Planning Team Leadership 4 1.3 Participating Organizations 5 Section 2: Exercise Design Summary 6 2.1 Exercise Purpose and Design 6 2.2 Exercise Objectives, Capabilities and Activities 6 2.3 Scenario Summary 6 Section 3: Analysis of Capabilities 7 3.1 Drill Evaluation and Results 7 3.2 Summary Results of Drill Evaluation 7 3.3 Criteria Evaluation Summaries 9 3.3.1 Support Jurisdictions 9 3.3.1.1 Riverland Medical Center 9 Section 4: Conclusion 13 Appendix A: Drill Evaluators and Team Leaders 14 Appendix B: Acronyms and Abbreviations 15 Appendix C: Exercise Plan 16 1
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Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station EXECUTIVE
SUMMARY
On December 16, 2010 an out-of-sequence remedial Medical Services drill was conducted for the Grand Gulf Nuclear Station (GGNS), located in Port Gibson, Claiborne County, Mississippi.
Personnel from the U.S. Department of Homeland Security/Federal Emergency Management Agency (DHS/FEMA) Region VI evaluated all activities. The purpose of the drill was to assess the level of preparedness of local responders to react to a simulated radiological emergency at GGNS. The previous plume exercise was conducted on September 9, 2009.
Personnel from the State of Louisiana, Riverland Medical Center, and Grand Gulf Nuclear Station participated in the drill. Cooperation and teamwork of all the participants was evident during the drill and DHS/FEMA wishes to acknowledge these efforts.
This report contains the final evaluation of the out-of-sequence drill. The participants demonstrated knowledge of their emergency response plans and procedures. There were no issues observed during this redemonstration. Prior issues documented during the drill conducted on September 28, 2010 have been resolved.
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Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station SECTION 1: EXERCISE OVERVIEW 1.1 Exercise Details Exercise Name Grand Gulf Nuclear Station Type of Exercise Drill Exercise Date December 16, 2010 Program Department of Homeland Security/FEMA Radiological Emergency Preparedness Program Scenario Type Radiological Emergency 1.2 Exercise Planning Team Leadership Lisa Hammond RAC Chair FEMA Region VI Technological Hazards Branch Chief 800 N. Loop 288 Denton, Texas, 76209 940-898-5199 lisa.hammond@dhs.gov Bill Bischof Federal Planning Team Lead FEMA Region VI Technological Hazards Specialist 800 N. Loop 288 4
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station Denton, Texas, 76209 940-898-5562 bill.bischof@dhs.gov Cheryl Chubb State Planner Louisiana Department of Environmental Quality Environmental Scientist 602 N. Fifth St.
Baton Rouge, Louisiana, 70802 225-219-3626 cheryl.chubb@la.gov 1.3 Participating Organizations Agencies and organizations of the following jurisdictions participated in the Grand Gulf Nuclear Station drill:
Support Jurisdictions Riverland Medical Center Private Organizations Grand Gulf Nuclear Station 5
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station SECTION 2: EXERCISE DESIGN
SUMMARY
2.1 Exercise Purpose and Design The DHS/FEMA Region VI Office evaluated the drill on December 16, 2010 to assess the capabilities of local emergency preparedness organizations in implementing their Radiological Emergency Response Plans and procedures to protect the public health and safety during a radiological emergency involving Grand Gulf Nuclear Station (GGNS). The purpose of this report is to present the results and findings on the performance of the offsite response organizations during a simulated radiological emergency.
2.2 Exercise Objectives, Capabilities and Activities Exercise objectives and identified Capabilities/REP Criteria selected to be exercised are discussed in the Exercise Plan (EXPLAN), Appendix C.
2.3 Scenario Summary The drill scenario was developed to evaluate the response of drill participants to an incident requiring evacuation of the public from the Louisiana portion of the 10-mile Emergency Planning Zone surrounding the Grand Gulf Nuclear Station. The drill scenario provided for the evaluation of the Riverland Medical Center's ability to treat a radiologically contaminated injured individual.
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Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station SECTION 3: ANALYSIS OF CAPABILITIES 3.1 Drill Evaluation and Results Contained in this section are the results and findings of the evaluation of all jurisdictions and functional entities that participated in the December 16, 2010, drill evaluation to test the offsite emergency response capabilities of Riverland Medical Center to treat a contaminated injured individual.
Each jurisdiction and functional entity was evaluated on the basis of its demonstration of criteria delineated in the exercise evaluation areas as outlined in the April 25, 2002, Federal Register, Radiological Emergency Preparedness: Evaluation Methodology. Detailed information on the exercise evaluation area criteria and the extent of play agreement used in this drill are found in Appendix C of this report.
3.2 Summary Results of Drill Evaluation The matrix presented in Table 3.1 on the following page, presents the status of all drill evaluation area criteria that were scheduled for demonstration during this drill by all participating jurisdictions and functional entities. Exercise criteria are listed by number and the demonstration status is indicated by the use of the following letters:
M - Met (No Deficiency or ARCAs assessed and no unresolved ARCAs from prior exercise)
D - Deficiency assessed A - ARCAs assessed or unresolved ARCAs from previous exercises P - Plan Issue N - Not Demonstrated 7
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station Table 3.1 - Summary of Drill Evaluation DATE: 2010-12-16 SITE: Grand Gulf Nuclear Station, MS RMC M: Met, A: ARCA, D: Deficiency, P: Plan Issue, N: Not Demonstrated Emergency Operations Management Mobilization 1a1 Facilities 1b1 Direction and Control 1c1 Communications Equipment 1d1 Equip & Supplies to support operations 1e1 M Protective Action Decision Making Emergency Worker Exposure Control 2a1 Radiological Assessment and PARs 2b1 Decisions for the Plume Phase -PADs 2b2 PADs for protection of special populations 2c1 Rad Assessment and Decision making for the Ingestion Exposure Pathway 2d1 Rad Assessment and Decision making concerning Relocation, Reentry, and Return 2e1 Protective Action Implementation Implementation of emergency worker exposure control 3a1 M Implementation of KI decision 3b1 Implementation of protective actions for special populations - EOCs 3c1 Implementation of protective actions for Schools 3c2 Implementation of traffic and access control 3d1 Impediments to evacuation are identified and resolved 3d2 Implementation of ingestion pathway decisions - availability/use of info 3e1 Materials for Ingestion Pathway PADs are available 3e2 Implementation of relocation, re-entry, and return decisions. 3f1 Field Measurement and Analysis Adequate Equipment for Plume Phase Field Measurements 4a1 Field Teams obtain sufficient information 4a2 Field Teams Manage Sample Collection Appropriately 4a3 Post plume phase field measurements and sampling 4b1 Laboratory operations 4c1 Emergency Notification and Public Info Activation of the prompt alert and notification system 5a1 Activation of the prompt alert and notification system - Fast Breaker 5a2 Activation of the prompt alert and notification system - Exception areas 5a3 Emergency information and instructions for the public and the media 5b1 Support Operations/Facilities Mon / decon of evacuees and emergency workers, and registration of evacuees 6a1 Mon / decon of emergency worker equipment 6b1 Temporary care of evacuees 6c1 Transportation and treatment of contaminated injured individuals 6d1 M 8
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station 3.3 Criteria Evaluation Summaries 3.3.1 Support Jurisdictions 3.3.1.1 Riverland Medical Center
- a. MET: 1.e.1, 3.a.1, 6.d.1.
- b. AREAS REQUIRING CORRECTIVE ACTION: None
- c. DEFICIENCY: None
- d. PLAN ISSUES: None
- e. NOT DEMONSTRATED: None
- f. PRIOR ISSUES - RESOLVED: 1.e.1, 3.a.1, 6.d.1.
ISSUE NO.: 28-10-1e1-A-01 ISSUE: The Ludlum 12 Survey Meters did not have a Range of Reading sticker affixed.
CORRECTIVE ACTION DEMONSTRATED: During a re-demonstration held Dec.
16, 2010, at Riverland Medical Center, hospital staff used two Ludlum 12 survey meters that had range of reading stickers affixed. The survey meters both had calibration due dates of January, 2011. One range of reading sticker listed between 9,000 counts per minute (CPM) and 15,000 CPM. The survey meter responded to its response check to a Cesium-137 source by the Buffer Zone (BZ) Nurse with a reading of 12,000 CPM. The second meter's sticker indicated a range of reading between 16,500 CPM and 27,500 CPM. It responded within the range at 25,000 CPM when the BZ Nurse checked the meter.
ISSUE NO.: 28-10-3a1-A-02 ISSUE: Administrative exposure limits and background levels were not identified to medical personnel at the hospital during the drill.
CORRECTIVE ACTION DEMONSTRATED: The Buffer Zone (BZ) Nurse briefed medical staff on radiation exposure limits and decontamination guidelines. After 9
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station issuing Thermoluminescent Dosimeters (TLDs) and high and low range dosimeters to staff positions, the BZ Nurse explained how to wear them and how to read them.
She told the staff they would be replaced if they reported a reading of 375 or 3/4 scale on the lower range dosimeter. She said 5,000 mR was the highest legal level of radiation exposure for emergency responders but that staff was to leave the area immediately at the 1,000 mR level. The BZ Nurse and an assistant used the procedures to instruct the staff in donning their Personal Protective Equipment (PPE).
The BZ Nurse logged the staff's first dosimetry readings and then logged them every 15 minutes throughout the drill. She established background at 20 CPM, instructing staff to decontaminate anything above 120 CPM.
ISSUE NO.: 28-10-6d1-D-03 ISSUE: Minimal or no contamination control; no radiological briefing for Emergency Workers (EWs); emergency workers assigned as Monitors were unsure of how to use or read the survey meters; and no range of readings stickers on survey meters. The following discrepancies were observed:
- Emergency workers were not provided a radiological briefing. EWs were not aware of the exposure limits or background levels. No contamination threshold limits were identified.
- The Monitor assigned to assist with transfer of patient from ambulance to hospital staff did not frisk the patient or gurney upon transfer from the ambulance to the hospital staff.
- During the ambulance survey, the monitor was not sure of what steps to take if contamination was found.
- The REA Monitor was unaware of how to use swipes and unclear of the procedures for disposal of contaminated waste.
- Monitors were not knowledgeable on how to use or read the survey meters when surveying the patient. The controller provided (simulated) reading that the meter was off scale, the monitor did not understand she needed to adjust the meter dial to the next higher scale and coaching was consistently provided throughout the drill.
- The REA Monitor did not conduct an initial patient contamination survey until after the first time out was called by the GGNS representative and conducted training on 10
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station how and why contamination controls are important.
- After training, the REA Monitor continued to demonstrate poor surveying techniques and required continued coaching.
- The REA medical staff used poor technique in removing potentially contaminated sheets, clothing and medical equipment (neck brace, backboard, etc).
- REA nurse may have cross contaminated medical equipment and supplies, prior to changing gloves, by accessing sealed cabinets and following the procedures to request supplies from Buffer Zone staff.
- REA staff did not perform glove changes until after time out and training was provided.
- Throughout the drill the REA Monitor did not survey the REA staff hands or potentially contaminated areas.
- A basin of contaminated saline used to irrigate the wound was left at the patients feet on the gurney and later on the counter without regard of proper disposal.
- The REA Monitor was the first EW to demonstrate the doffing of PPE and exit procedures from the REA. She left the still-running survey meter on the counter and proceeded to step on the step off pad without removing the booties or being surveyed by the Buffer Zone nurse. The monitor did not demonstrate the proper procedure to remove the PPE even though the procedures were posted on the wall.
- The Buffer Zone nurses surveying technique was too fast and the distance was inconsistent, at times too far (greater that 1/2 -1) and at times the meter came in contact with the EW being surveyed.
- Maintenance staff were tasked with completing the closeout of the REA and Buffer Zone area and had no knowledge or training of proper procedures.
- Majority of Emergency Workers departed the area prior to the drill being terminated.
CORRECTIVE ACTION DEMONSTRATED: The treatment of the contaminated injured individual was successfully demonstrated during the redemonstrated MS-1 drill on December 16, 2010. The REA staff properly demonstrated contamination control, a radiological briefing, proper use of equipment, background levels, action levels, exposure limits, patient and staff exit, and close out of the REA during the drill.
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Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station
- g. PRIOR ISSUES - UNRESOLVED: None 12
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station SECTION 4: CONCLUSION Based on the results of the drill, Riverland Medical Center satisfactorily demonstrated their required criteria and no additional demonstration is necessary until the next regularly scheduled drill/exercise at this location.
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Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station APPENDIX A: DRILL EVALUATORS AND TEAM LEADERS DATE: 2010-12-16, SITE: Grand Gulf Nuclear Station, MS LOCATION EVALUATOR AGENCY Riverland Medical Center *Bill Bischof DHS/FEMA Tim Pflieger DHS/FEMA
- Team Leader 14
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station APPENDIX B: ACRONYMS AND ABBREVIATIONS Acronym Meaning ARCA Areas Requiring Corrective Action BZ Buffer Zone CPM Counts Per Minute ER Emergency Room EW Emergency Worker GGNS Grand Gulf Nuclear Station PPE Personal Protective Equipment REA Radiation Emergency Area RMC Riverland Medical Center TLD Thermoluminescent Dosimeter 15
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station APPENDIX C: EXERCISE PLAN 16
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station RADIOLOGICAL EMERGENCY MEDICAL DRILL SCENARIO (MS-1)
FOR GRAND GULF NUCLEAR STATION December 16, 2010 Participants Riverland Medical Center 17
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station REVISION LOG Revision Date Record of Activity 0 11/12/10 Initial release.
Added revision log; changed 11:30pm &11:45pm to am; added Schedule Note; revised Extent of Play for 1.e.1 and 3.a.1; added 1 11/16/10 Controller Note to Messages 2 & 3; noted call to REAC/TS on Controller Message 5; added date & updated revision to footer.
Corrected all meter faces from 202-356 to 129; corrected Cue 2 11/19/10 Card lettering on #5M-#5U on Cue Card #5B.
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Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station I. PURPOSE This simulated radiation medical emergency is being conducted in order to exercise the emergency medical response for Grand Gulf Nuclear Station (GGNS) at Riverland Medical Center and Northeast Ambulance Service. The basic objective is to assess the ability of the hospital and ambulance emergency service to handle contaminated and injured patients.
II. PROPOSED SCHEDULE DATE: December 16, 2010 TIME: 8:30 am Drill Starts (GGNS General Emergency) 9:00 am Accident Reported 9:30 am Patient Arrives at Hospital 11:30 am Drill Terminates 11:45 am Evaluator Comments 12:00 pm Player Critique NOTE: Except for the drill start time, all other times are approximate and can be adjusted as needed.
LOCATION: Riverland Medical Center INJURY/ILLNESS: All terrain vehicle (ATV, four-wheeler) accident with broken right leg, sprained right wrist, and abrasions and lacerations to right leg and right palm.
III. DISCLAIMER Real life emergencies take precedence over this demonstration. In case of an emergency, the demonstration will be cancelled and rescheduled for a later date.
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Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station IV. EVALUATION AREAS AND EXTENT-OF-PLAY-OFFSITE A. EVALUATION AREA 1: EMERGENCY OPERATIONS MANAGEMENT Sub-element 1.e - Equipment and Supplies to Support Operations Criterion 1.e.1: Equipment, maps, displays, dosimetry, potassium iodide (KI),
and other supplies are sufficient to support emergency operation. (NUREG-0654, H.7, 10; J.10.a, b, e J.11; K.3.a)
Location Riverland Medical Center Extent of Play A range of readings sticker located on the Ludlum 12 survey meter will address the ARCA.
Correction-on-the-spot will be applicable for this demonstration.
ARCA 28-10-1e1-A-01 B. EVALUATION AREA 3: PROTECTIVE ACTION IMPLEMENTATION Sub-element 3.a - Implementation of Emergency Worker Exposure Control Criterion 3.a.1: The OROs issue appropriate dosimetry and procedures, and manage radiological exposure to emergency workers in accordance with the plans and procedures. Emergency workers periodically and at the end of each mission read their dosimeters and record the readings on the appropriate exposure record or chart. (NUREG-0654, K.3.a, b)
Location Riverland Medical Center Extent of Play Identification of administrative exposure limits and background levels to emergency personnel will address the ARCA.
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Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station Correction-on-the-spot will be applicable for this demonstration.
ARCA 28-10-3a1-A-02 C. EVALUATION AREA 6: SUPPORT OPERATION/FACILITIES Sub-element 6.d--Transportation and Treatment of Contaminated Injured individuals Criterion 6.d.1: The facility/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; K.5.a, b; L.1, 4)
Location Riverland Medical Center Extent of Play The initial call(s) will be simulated by cell phone from the Tensas Emergency Director who will be on location at Riverland Medical Center.
No actual surgical procedures, X-ray, blood samples, starting of IVs etc. will be demonstrated. Ambulance participation and travel time will be simulated. After approximately 30 minutes, a packaged patient will be pre-staged on a stretcher at the hospital entrance, simulating the arrival of the ambulance.
Correction-on-the-spot will be applicable for this demonstration.
Deficiency 28-10-6d1-D-03 D. GENERAL EXTENT-OF-PLAY (EOP)
- 1. With regard to last minute additions or changes to any previously approved Extent-of-Play, all suggested changes must be forwarded to the RAC Chair for approval.
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After Action Report/Improvement Plan Grand Gulf Nuclear Station
- 2. The goal of all offsite response organizations (ORO) is to protect the health and safety of the public. This goal is achieved through the execution of appropriate plans and procedures. It is recognized that situations may arise that could limit the organizations in the exact execution of these plans and procedures.
- 3. In the event of an unanticipated situation, OROs are permitted to exercise flexibility in the implementation of their plans and procedures in order to successfully achieve the objective of protection of public health and safety and protection of the environment.
- 4. As a statement of fact, no ORO will deliberately deviate from its plans and procedures with the intent of avoiding responsibility.
E. REFERENCES As indicated in the Extent-of-Play Agreement, the State of Louisiana requests the option to correct issues immediately as defined in FEMA Policy Paper, Strategic Review Steering Committee, Initiative 1.5, Correct Issues Immediately, effective March 31, 2000, signed by Kay C. Goss, CEM, Associate Director for Preparedness, Training and Exercises. Acceptable locations/activities for on-the-spot-correction are clearly indicated in the extent of play portion under each criterion.
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Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station V. NARRATIVE SCENARIO A. INITIAL CONDITIONS Grand Gulf Station has declared a General Emergency based on Offsite Radiation Monitoring Team reports. An evacuation of all people within five miles of Grand Gulf has commenced. The wind direction is from 90 degrees (blowing into the West), Protective Action Section (PAS) 12 is being evacuated to Tallulah and Ferriday. Areas within five miles of the plant are expected to be contaminated.
(Refer to Attachment A.)
A hunter in the area of Dishroon Lake, approximately 4 miles west of Grand Gulf, heard the sirens and evacuated the area. It took him twenty minutes to evacuate the area on his four-wheeler. After reaching Highway 608 on his four-wheeler, he skidded off the road into a ditch. He suffered the following injuries:
Broken right tibia Abrasions and lacerations with moderate bleeding to the right ankle Abrasions and lacerations with moderate bleeding to the right palm Sprained right wrist The hunter contacted 9-1-1 on his cell phone and was packaged and transported to Riverland Medical Center by Northeast Louisiana Ambulance Service.
B. NORTHEAST LOUISIANA AMBULANCE SERVICE Ambulance participation will be simulated.
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Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 1 Time: 0830 THIS IS A DRILL Controller: The controller will simulate a call from Grand Gulf Nuclear Station to the Tensas Parish 911 Center to report the General Emergency.
Message: Grand Gulf Nuclear Station has declared a General Emergency.
Anticipated Response: Tensas Parish Emergency Management will contact Riverland Medical Center.
Due to events in progress, the hospital should begin preparations for the treatment of the contaminated individual according to their procedures.
THIS IS A DRILL 24
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 2 Time: ~0900 THIS IS A DRILL Controller: NOTE: Confer with FEMA evaluator to determine the appropriate time to provide this message.
The controller will simulate a call from the Northeast Louisiana Ambulance Service to the hospital.
Message: We are transporting a patient. He is injured and radiologically contaminated. Injuries include: possible broken right wrist, possible broken right leg, and minor abrasions/lacerations. Patient is conscious and alert. ETA is thirty minutes.
Anticipated Response: The hospital should continue preparations to treat a contaminated/injured patient.
THIS IS A DRILL 25
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 3 Time: ~0930 THIS IS A DRILL Controller: NOTE: Confer with FEMA evaluator to determine the appropriate time to provide this message.
The controller will ensure the patient has been properly prepared for the exercise, including makeup and clothing. Patient must be packaged on a gurney as he would arriving in an ambulance. Once the REA is ready for a patient, the controller will notify the hospital of the ambulances arrival (simulated). When the hospital staff meets the ambulance, the controller will provide the following message:
Message: The patient has been removed from the ambulance.
The ambulance crew provides you with the following information:
The patient flipped his four wheeler while evacuating the Grand Gulf area. He is injured and radiologically contaminated. Injuries include:
possible broken right wrist, possible broken right leg, minor abrasions/lacerations. There is moderate bleeding from the right palm and right leg wounds. Patient is conscious and alert. Vital signs are stable, there have been no changes during transport.
The patient is ready for transfer.
Anticipated Response: Hospital staff should transfer the patient from the ambulance gurney to the hospital gurney and proceed to the REA.
THIS IS A DRILL 26
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: #4 THIS IS A DRILL Controller: The controller will provide the REA team additional information required to make a diagnosis and treat the patient, as requested.
Message: Injuries: Right leg - Abrasions and lacerations to an area roughly 4 x 6 with moderate bleeding Right hand - Abrasions and lacerations to an area roughly 2 x 2 on palm with moderate bleeding X-Rays: X-Rays are to be simulated Right leg - Give Cue Card #4A to REA staff.
Right wrist - Give Cue Card #4B to REA staff..
Survey Readings: For survey readings, see Cue Card #5.
Anticipated Response: The REA team should have the patients wounds surveyed for contamination and act accordingly. See Cue Card #5 for more information. REA staff should determine the right leg is broken, but the right wrist is sprained. REA staff should treat the patients injuries and contamination, while performing contamination control.
Blood or other samples, IVs, and surgical procedures, if required, will be simulated.
THIS IS A DRILL 27
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 4A Right Leg X-Ray 28
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 4B Right Wrist X-Ray 29
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: #5 THIS IS A DRILL Controller: The controller will provide the REA team additional information required to make a diagnosis and treat the patient, as requested.
Cue Cards: Cue Card #5A - overview of injured areas and contamination levels Cue Card #5B - summary of decontamination efforts, survey readings, cue cards Cue Card #5C - #5H - right leg survey cue cards Cue Card #5I - #5M - right hand survey cue cards Cue Card #5N - #5U - right arm survey cue cards Anticipated Response: The REA team should have the patients wounds surveyed for contamination.
Decontamination should start with wounds, then intact skin. The wound with the highest reading should be decontaminated first.
The team should decon the areas in the following order:
- 1. Right Leg (Wound: 2500 cpm)
- 2. Right Hand (Wound: 1500 cpm)
- 3. Left Arm (External/Intact skin: 2000 cpm)
Note: The hospital staff will use both mR/hr and cpm for radiation measurements. (Monitoring of the REA will be in mR/hr, while contamination surveys will be in cpm.)
The staff will be unable to decon the hand below 500cpm without damaging the wound further. They should call REAC/TS to get guidance on how to proceed. This call will not be simulated.
THIS IS A DRILL 30
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5A THIS IS A DRILL Patient Survey Form Anterior Posterior 2000 31
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: #5B THIS IS A DRILL Survey Information Cue Card # Scale Reading Note Description 5C x1 Off scale Right Leg -1 Before decontamination 5D x10 2500 cpm Leg-2 5E x10 500 cpm Leg-3 After 1st rinse 5F x1 500 cpm Leg-4 5G x10 <100 cpm Leg -5 After 2nd rinse 5H x1 <100 cpm Leg -6 5I x1 Off scale Right Hand -1 Before decontamination 5J x10 1500 cpm Hand -2 5K x10 500 cpm Hand -3 After 1st decontamination 5L x1 500 cpm Hand -4 5M Unable to decon further 5N x1 Off scale Left Arm -1 Before decontamination 5O x10 2000 cpm Arm -2 5P x10 1200 cpm Arm -3 After rinsing 5Q x1 Off scale Arm -4 5R x10 700 cpm Arm -5 After 1st scrubbing 5S x1 Off scale Arm -6 5T x10 <100 cpm Arm -7 After 2nd scrubbing 5U x1 <100 cpm Arm -8 THIS IS A DRILL 32
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5C THIS IS A DRILL Note: Right Leg - 1 THIS IS A DRILL 33
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5D THIS IS A DRILL Note: Leg - 2 THIS IS A DRILL 34
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5E THIS IS A DRILL Note: Leg - 3 THIS IS A DRILL 35
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5F THIS IS A DRILL Note: Leg - 4 THIS IS A DRILL 36
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5G THIS IS A DRILL Note: Leg - 5 THIS IS A DRILL 37
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5H THIS IS A DRILL Note: Leg - 6 THIS IS A DRILL 38
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5I THIS IS A DRILL Note: Right Hand - 1 39 THIS IS A DRILL
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5J THIS IS A DRILL Note: Hand - 2 THIS IS A DRILL 40
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5K THIS IS A DRILL Note: Hand - 3 THIS IS A DRILL 41
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5L THIS IS A DRILL Note: Hand - 4 THIS IS A DRILL 42
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5M THIS IS A DRILL Controller: The controller will continue to provide Cue Card #5K or Cue Card
- 5L, depending upon scale, to the REA staff.
Message: For x10 scale, show Cue Card #5K to the REA staff.
For x1 scale, show Cue Card #5L.
Anticipated Response: The REA team should determine that the hand wound cannot be cleaned further without more damage to the wound. The REA staff should contact REAC/TS for information on how to proceed.
The controller will simulate the REAC/TS role.
THIS IS A DRILL 43
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5N THIS IS A DRILL Note: Right Arm 1 THIS IS A DRILL 44
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: #5O THIS IS A DRILL Note: Arm 2 THIS IS A DRILL 45
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5P THIS IS A DRILL Note: Arm 3 THIS IS A DRILL 46
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5Q THIS IS A DRILL Note: Arm 4 THIS IS A DRILL 47
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5R THIS IS A DRILL Note: Arm 5 THIS IS A DRILL 48
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5S THIS IS A DRILL Note: Arm 6 THIS IS A DRILL 49
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5T THIS IS A DRILL Note: Arm 7 THIS IS A DRILL 50
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 5U THIS IS A DRILL Note: Arm 7 THIS IS A DRILL 51
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 6 THIS IS A DRILL Controller: Once the patient is successfully transferred from the room, the controller will instruct REA staff to demonstrate exit procedures.
NOTE: At this point, the drill is still in progress and has not been terminated.
After one person has demonstrated exit procedures, ask the FEMA evaluator if they would like to see another person demonstrate the exit procedures or if one was satisfactory.
Message: Demonstrate the REA exit procedures.
Anticipated Response: One REA team member will demonstrate removal of the personal protective equipment and exit survey technique.
If required by FEMA, other team members may also demonstrate the proper exit procedures.
THIS IS A DRILL 52
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 7 THIS IS A DRILL Controller: The controller will request personnel to describe how the REA would be returned to normal operations.
Note: FEMA may require some of the procedure be demonstrated, such as surveying and testing for contamination. Confirm with FEMA evaluator what they require before notifying the drill team.
Message: Please describe how you would return the REA to normal operations.
[Note: The contents of this message may change depending upon FEMA requirements.]
Anticipated Response: Staff will describe and/or demonstrate how they would survey and test for contamination, what they would do with the waste, and any other requirements to return the room to normal operations.
THIS IS A DRILL 53
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station CONTROLLER MESSAGE Cue Card: # 8 THIS IS A DRILL Controller: Once verbal confirmation has been received from FEMA that all requirements have been successfully demonstrated, the drill will be terminated.
Message: The drill is terminated.
Anticipated Response: The area will be returned to normal by the hospital staff.
THIS IS A DRILL 54
Unclassified Radiological Emergency Preparedness Program (REP)
After Action Report/Improvement Plan Grand Gulf Nuclear Station ATTACHMENT A 55
Unclassified Radiological Emergency Preparedness Program (REP)
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