Text

Submittal of After Action Report/Improvement Plan, Drill Date - November 3-4, 2015, Radiological Emergency Preparedness (REP) Program
	ML16015A010
Person / Time
Site:	Arkansas Nuclear
Issue date:	01/06/2016
From:	Lawrence Hammond; US Dept of Homeland Security, Federal Emergency Management Agency
To:	Dapas M; Office of Nuclear Reactor Regulation, Region 4 Administrator
References
	Download: ML16015A010 (32)
	v • d • e

U.S. Department of Homeland Security Region VI 800 N. Loop 288 Denton, TX 76209-3698

~#FEMA

,January 6, 2016 Mr. Marc Dapas Regional Administrator U.S. NRC, Region IV 1600 East Lamar Boulevard Arlington, TX 76011-4511

Dear Mr. Dapas:

Enclosed is a copy of the radiological emergency preparedness final report for the Arkansas Nuclear One (ANO) Medical Services Drill evaluated on November 3-4, 2015. FEMA Region VI staff evaluated the Pope County Emergency Medical Services, Main Station and University of Arkansas Medical Sciences located in Russeilville and Little Rock, Arkansas. There were no Findings or Plan issues identified during the drill, and no previous unresolved ARCAs remained.

Based on the results of the drill, the offsite radiological emergency response plans and preparedness for the State of Arkansas and affected local jurisdictions provide reasonable assurance that appropriate measures can be taken to protect public health and safety in the event of a radiological emergency. Therefore, 44 CFR Part 350 approval of the offsite radiological emergency response plans and preparedness for the State of Arkansas - specific to Arkansas Nuclear One will remain in effect.

A copy of this report was mailed to the NRC Headquarters Document Control Desk and a copy was transmitted electronically to RIV FEMADistribution(~nrc.gov as specified in the FEMA REP Program Manual dated June 2013. Should you have questions, please contact Lisa Hammond, RAC Chair at (940) 898-5199, or Elsa Lopez, Senior Site Specialist for Arkansas Nuclear One, at (940) 898-5308.

Sincerely, Lisa Hammond RAC Chair Enclosure cc: DHS/FEMA Headquarters - Vanessa Quinn, Jesse King ADH - Bernard Bevill ADEM - David Maxwell ANO - Robert Carey ¢ / q www.fema.gov

Arkansas Nuclear One After Action Report!

Improvement Plan Drill Date - November 3-4, 2015 Radiological Emergency Preparedness (REP) Program all Vd[,( 5,"F*

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After Action Report/Improvement Plan Arkansas Nuclear One Arkansas Nuclear One After Action Report/Improvement Plan Published EXECUTIVE

SUMMARY

................................................................................. 5 SECTION 1: EXERCISE OVERVIEW..................................................................... 6 1.1 Exercise Details ....................................................................................... 6 1.2 Exercise Planning Team Leadership ................................................................ 6 1.3 Participating Organizations.......................................................................... 7 SECTION 2: EXERCISE DESIGN

SUMMARY

.................................... i....................... 8 2.1 Exercise Purpose and Design......................... ................................................ 8 2.2 Exercise Objectives, Capabilities and Activities .................................................... 8 2.3 Scenario Summary.................................................................................... 9 SECTION 3: ANALYSIS OF CAPABILITIES ............................................................ 120 3.2 Summary Results of Exercise Evaluation ......................................................... 10 3.3 Criteria Evaluation Summaries .................................................................... 12 3.3.1 State Jurisdictions ..................................................................................... 12 3.3.2 Risk Jurisdictions ..................................................................................... 12 3.3.3 Support Jurisdictions ................................................................................. 13 3.3.4 Private Jurisdictions.................................................................................. .13 3.3.5 Federal Jurisdictions .................................................................................. 14 SECTION 4: CONCLUSION ............................................................................ 15 APPENDIX A: IMPROVEMENT PLAN ................................................................ 16 APPENDIX B: LESSONS LEARNED ................................................................... .17 APPENDIX C: BEST PRACTICES.................................................................. ...... 18 APPENDIX D: EXERCISE TIMELINE ................................................................... 19 APPENDIX E: EXERCISE EVALUATORS AND TEAM LEADERS....................................... 20 APPENDIX F: ACRONYMS AND ABBREVIATIONS................................................... 21 APPENDIX 6: EXERCISE PLAN .................................................. 22 3

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After Action Report/Improvement Plan Arkansas Nuclear One EXECUTIVE

SUMMARY

On November 3-4, 2015, an out-of-sequence Medical Services Drill was conducted in Russeliville, Arkansas for the Pope County Emergency Medical Services (EMS) - Main Station the University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas. Personnel from the U.S.

Department of Homeland Security/Federal Emergency Management Agency (DHS/FEMA) Region VI, evaluated all activities. The drill was conducted to assess the level of preparedness of local responders to react to a simulated radiological emergency at Arkansas Nuclear One (ANO). The previous UAMS and Pope County EMS - St. Mary's Station Medical Services Drill was conducted on May 16, 2013.

Personnel from the Pope County EMS and University of Arkansas Medical Sciences participated in the drill. Evaluation Areas demonstrated included: Equipment and Supplies to Support Operations, Implementation of Emergency Worker Exposure Control, and Support Operations/Facilities Transportation and Treatment of Contaminated Injured Individuals.

Cooperation and teamwork of all 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 and they adequately implemented them. There were no Findings or Plan Issues identified during the drill.

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvemient Plan Arkansas Nuclear One SECTION 1: EXERCISE OVERVIEW 1.1 Exercise Details Exercise Name 7 Drill 2015-11-04 Type of Exercise Drill Exercise Date November 4, 2015 Program Department of Homeland Security/FEMA Radiological Emergency Preparedness Program Scenario Type Not Applicable 1.2 Exercise Planning Team Leadership Lisa Hammond Technological Hazards Branch Chief FEMA Region VI 800 N. Loop 288 Denton, TX, 76209 (940) 898-5199 lisa.hammond@fema.dhs.gov Elsa Lopez Senior Site Specialist FEMA Region VI 800 N. Loop 288 Denton, TX, 76209 (940) 898-5308 elsa.lopez@fema.dhs.gov 6

Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One Don Greene Emergency Planner Arkansas Department of Health 4815 West Markham Street Slot 30 Little Rock, AR, 72205 (501) 661-2808 donald.greene@arkansas.gov 1.3 Participating Organizations Agencies and organizations of the following jurisdictions participated in the Arkansas Nuclear One exercise:

State Jurisdictions Arkansas Department of Health Risk Jurisdictions Pope County Emergecy Medical Services Support Jurisdictions University of Arkansas of Medical Sciences Private Organizations Arkansas Nuclear One Federal Organizations 7

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After Action Reportllmprovement Plan Arkansas Nuclear One SECTION 2: EXERCISE DESIGN

SUMMARY

2.1 Exercise Purpose and Design The DHS/FEMA Region VI Office evaluated the drill on November 3-4, 2015 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 Arkansas Nuclear One (ANO). 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).

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After Action ReportlImprovement Plan Arkansas Nuclear One 2.3 Scenario Summary The drill scenario was developed to evaluate the response of drill participants to an incident at Arkansas Nuclear One (ANO) requiring the transportation, treatment and decontamination of a radiologically contaminated injured individual. The drill scenario provided for the evaluation of the University of Arkansas for Medical Sciences (UAMS) and Pope County Emergency Medical Services (EMS) - Main Station.

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After Action Report/Improvement Plan Arkansas Nuclear One SECTION 3: ANALYSIS OF CAPABILITIES 3.1 Exercise Evaluation and Results Contained in this section are the results and findings of the evaluation of all jurisdictions and functional entities, which participated in the November 3-4, 2015 Medical Services Drill to test the offsite emergency response capabilities of local governments and support medical centers for Arkansas Nuclear One (ANO).

Each jurisdiction and functional entity was evaluated on the basis of its demonstration of criteria delineated in exercise evaluation area criteria contained in the Federal Register, Vol. 67, No. 80, "FEMA - Radiological Emergency Preparedness: Exercise Evaluation Methodology" (April 25, 2002) and the REP Program Manual. Detailed information on the exercise evaluation area criteria and the extent-of-play agreement used in this exercise are found in Appendix G of this report.

3.2 Summary Results of Exercise Evaluation The matrix presented in Table 3.1, on the following page(s), presents the status of all exercise evaluation area criteria from the REP Program Manual that were scheduled for demonstration during this exercise by all participating jurisdictions and functional entities. Exercise evaluation area criteria are listed by number and the demonstration status of those evaluation area criteria is indicated by the use of the following letters:

M - Met (No Deficiency or Areas Requiring Corrective Actions [ARCAs] assessed and no unresolved ARCAs from prior exercises)

Li - Level 1 Finding (An observed or identified inadequacy of organizational performance in an exercise that could cause a determination that offsite emergency preparedness is not adequate to provide reasonable assurance that appropriate protective measure can be taken, in the event of an incident, to protect the health and safety of the public.)

L2 - Level 2 Finding (An observed or identified inadequacy of organizational performance in an exercise that is not considered, by itself, to adversely impact public health and safety.)

P - Plan Issue (An observed or identified inadequacy in the offsite response organizations' (ORO's) emergency plan/implementing procedures) 10

Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One N - Not Demonstrated Tables 3.1 - Summary of Exercise Evaluation Table 3.1a - Exercise Evaluation by Classification I Date: 11/4/2015 Site: Arkansas Nuclear One Table 3.1b - Exercise Evaluation - Criteria Not Demonstrated i Date: 11/4/2015 Table 3.1c - Exercise Evaluation - Criteria Met Date: 11/4/2015 Site: Arkansas Nuclear One Pope County EMS Contaminated Injured Transport & Care6d Pope County EMS EW Exposure Control Implementation 3a 1 Pope County EMS Equipment and Supplies lel UAMS Contaminated Injured Transport & Care 6dl UAMS EW Exposure Control Implementation 3alI UAMS Equipment and Supplies lel 11

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After Action Report/Improvement Plan Arkansas Nuclear One 3.3 Criteria Evaluation Summaries 3.3.1 State Jurisdictions In summary, the status of DHS/FEMA criteria for the State jurisdiction is as follows:

a. LEVEL 1 FINDINGS: NONE

b. LEVEL 2 FINDINGS: NONE

c. PLAN ISSUES: NONE

d. PRIOR ISSUES - RESOLVED: NONE

e. PRIOR ISSUES - UNRESOLVED: NONE 3.3.2 Risk Jurisdictions 3.3.2.1 Pope County EMS In summary, the status of DHS/FEMA criteria for the State jurisdiction is as follows:

a. LEVEL 1 FINDINGS: NONE

b. LEVEL 2 FINDINGS: NONE

c. PLAN ISSUES: NONE

d. PRIOR ISSUES - RESOLVED: NONE 12

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e. PRIOR ISSUES - UNRESOLVED: NONE 3.3.3 Support Jurisdictions 3.3.3.1 University of Arkansas for Medical Sciences Hospital In summary, the status of DHS/FEMA criteria for the State jurisdiction is as follows:

a. LEVEL 1 FINDINGS: NONE

b. LEVEL 2 FINDINGS: NONE

c. PLAN ISSUES: NONE

d. PRIOR ISSUES - RESOLVED: NONE

e. PRIOR ISSUES - UNRESOLVED: NONE 3.3.4 Private Jurisdictions In summary, the status of DHS/FEMA criteria for the Private jurisdiction is as follows:

a. LEVEL 1 FINDINGS: NONE

b. LEVEL 2 FINDINGS: NONE

c. PLAN ISSUES: NONE 13

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d. PRIOR ISSUES - RESOLVED: NONE

e. PRIOR ISSUES - UNRESOLVED: NONE 3.3.5 Federal Jurisdictions In summary, the status of DHS/FEMA criteria for the Federal jurisdiction is as follows:

a. LEVEL 1 FINDINGS: NONE

b. LEVEL 2 FINDINGS: NONE

c. PLAN ISSUES: NONE

d. PRIOR ISSUES - RESOLVED: NONE

e. PRIOR ISSUES - UNRESOLVED: NONE 14

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After Action Report/Improvement Plan Arkansas Nuclear One SECTION 4: CONCLUSION Based on the results of the drill, the offsite radiological emergency response plans and preparedness for the State of Arkansas and the affected local jurisdictions are deemed adequate to provide reasonable assurance that appropriate measures can be taken to protect the health and safety of the public in the event of a radiological emergency. Therefore, 44 CFR Part 350 approval of the offsite radiological emergency response plans and preparedness for the State of Arkansas site-specific to Arkansas Nuclear One will remain in effect.

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After Action ReportlImprovement Plan Arkansas Nuclear One APPENDIX A: IMPROVEMENT PLAN No improvement plan added.

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After Action Reportllmprovement Plan Arkansas Nuclear One APPENDIX B: LESSONS LEARNED No lessons learned entered.

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After Action Report/Improvement Plan Arkansas Nuclear One APPENDIX C: BEST PRACTICES No best practices entered.

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After Action ReportlImprovement Plan Arkansas Nuclear One APPENDIX D: EXERCISE TIMELINE N/A DATE: 11/04/2015, SITE: Arkansas Nuclear One Site Area Emergency General Emergency Simulated Rad. Release Started Simulated Rad. Release Terminated 19

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After Action Report/Improvement Plan Arkansas Nuclear One APPENDIX E: EXERCISE EVALUATORS AND TEAM LEADERS DATE: 11/4/2015 SITE: Arkansas Nuclear One

..... LOCATION '::TEAM:LEADER " ..,AGENCY "'

Pope County EMS Timothy Pflieger DHS - FEMA University of Arkansas for Medical Sciences Hospital Elsa Lopez ______________

LOCATION i: ' *"EVALUATOR AGENCy

Pope County EMS Timothy Pflieger DHS - FEMA University of Arkansas for Medical Sciences Hospital Elsa Lopez ______________

University of Arkansas for Medical Sciences Hospital Scott Flowerday ______________

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After Action Report/Improvement Plan Arkansas Nuclear One APPENDIX F: ACRONYMS AND ABBREVIATIONS ANO Ag IArkansas Nuclear 3-One s I CDC Centers for Disease Control and Prevention DRO Direct Reading Dosimeter ED Emergency Department EMS Pope County Emergency Medical Services EW Emergency Worker 1(I Potassium Iodide OSL Optically Stimulated Luminescent PCEOC Pope County Emergency Operations Center PPE Personal Protective Equipment RSO Radiological Safety Officer TOCD Technical Operation Control Director UAMS University of Arkansas for Medical Sciences 21

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After Action ReportlImprovement Plan Arkansas Nuclear One APPENDIX G: EXERCISE PLAN Arkansas Nuclear One 2015 MS-i Drill (Final 1 September 2015)

SCENARIO: ANO and Pope County EMS This event will take place in a radiation area in the plant, however, for exercise purposes, the patient will be presented for transport by the Pope County Ambulance Service at the Reeve E.

Ritchie Training Center (RERTC).

Maintenance is being performed on a steam valve, when a spanner wrench slips and impacts a worker in the left leg. The impact shatters the workers leg, results in an open fracture of the leg below the knee and rips the workers protective clothing, exposing the wound area to a radiologically contaminated environment.

The Unit One Control Room is called to report a medical emergency. The control pages the ANO Emergency Management Team and calls the Pope County Ambulance Service to request an ambulance.

Initial radiation readings at the wound area are noted to be 20,000 cpm.

The ANO Emergency Medical Management Team stabilizes the patient and moves the patient to an area assessable to responding Pope County Ambulance Service personnel (at the RERTC).

The Pope County 911 center dispatches the Pope County Ambulance Service to the accident at ANO and advises the patient may be contaminated.

Upon arrival at the RERTC, ambulance personnel are met by members of the ANO Emergency Medical Team and a Health Physicist who have the patient stabilized and in a body bag to contain contamination.

The ANO Emergency Medical Team provides the following patient information to the ambulance personnel:

Patient is suffering from an open fracture to the left leg below the knee which has been splinted and bandaged for stabilization, but has not been reduced.

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There is a distal pulse present at the left ankle and there is no loss of motion or sensation in the left foot.

There is bleeding around the wound site, which is being controlled with a pressure bandage.

The patient is alert and denies loss of consciousness, but reports to be in a great deal of paint and is requesting pain medication.

The following vital signs are noted:

o BP is 160/90 o Pulse 130 and strong o Respiration is 30 and unlabored o The wound site is contaminated with a reading of 20,000 cpm The following patient information is available on request:

Lung sounds are clear

Movement is noted in all extremities

Medical history is negative for pre-existing chronic conditions

Patient is allergic to Penicillin

Patient has a hearing loss in the left ear Arkansas Nuclear One 2 015 MS-i Drill SCENARIO: UAMS Maintenance is being performed on a steam valve, when a spanner wrench slips and impacts a worker in the left leg. The impact shatters the workers leg, results in an open fracture of the leg below the knee and rips the workers protective clothing, exposing the wound area to a radiologically contaminated environment.

The Unit One Control Room is called to report a medical emergency. The control pages the ANO Emergency Management Team and calls the Pope County Ambulance Service to request an ambulance.

Initial radiation readings at the wound area are noted to be 20,000 cpm.

The ANO Emergency Medical Management Team stabilizes the patient and moves the patient to an area assessable to responding Pope County Ambulance Service personnel (at the RERTC).

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After Action Reportllnmprovement Plan Arkansas Nuclear One The Pope County 911 center dispatches the Pope County Ambulance Service to the accident at ANO and advises the patient may be contaminated.

Upon arrival at the RERTC, ambulance personnel are met by members of the ANO Emergency Medical Team and a Health Physicist who have the patient stabilized and in a body bag to contain contamination.

The patient is stabilized and transported via ambulance (simulated) to UAMS in Little Rock.

Pope County EMS (exercise controller) notifies UAMS that is inbound with an injured and radiologically contaminated patient. An ANO Radiation Technician is onboard the ambulance to provide radiological support to medical personnel.

Upon arrival at UAMS, the following patient infonnation is provided to UAMS personnel:

Patient is suffering from an open fracture to the left leg below the knee which has been splinted and bandaged for stabilization, but has not been reduced.

There is a distal pulse present at the left ankle and there is no loss of motion or sensation in the left foot.

There is bleeding around the wound site, which is being controlled with a pressure bandage.

The patient is alert and denies loss of consciousness, but reports to be in a great deal of paint and is requesting pain medication.

The following vital signs are noted:

o BP is 160/90 o Pulse 130 and strong o Respiration is 30 and unlabored o The wound site is contaminated with a reading of 20,000 cpm There have been no notable changes in vital signs during transport.

The following patient information is available on request:

Lung sounds are clear

Movement is noted in all extremities

Medical history is negative for pre-existing chronic conditions

Patient is allergic to Penicillin

Patient has a hearing loss in the left ear 24

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After Action Report/Improvement Plan Arkansas Nuclear One The initial radiological survey of the patient reveals a slow increase to a reading of 20,000 CPM at the wound site. All other survey results yield counts of less than 300 CPM.

Radiation readings following each decontamination step are noted in the chart below:

Initial Reading prior to Decontamination 20,000 CMIP Reading Following Decontamination Step #1 10,000 CPM Reading Following Decontamination Step #2 7,500 CPM Reading Following Decontamination Step #3 7,000 CPM Reading Following Decontamination Step #4 7,000 CPM Reading Following Decontamination Step #5 3,000 CPM Reading Following Decontamination Step #6 250 CPM 25

Unclassified Radiological Emergency Preparedness Prognam (REP)

After Action Report/Improvement Plan Arkansas Nuclear One Arkansas Nuclear One 2015 MS-i Drill Pope County EMS and University of Arkansas for Medical Sciences Hospital (UAMS) November 3-4, 2015 Extent-of-Play (EOP)

Agreement Between The Arkansas Department of Health's Nuclear Planning and Response Program, representing the Off-Site Response Organizations, and FEMA Region VI (Final October 19, 2015)

EVALUATION AREA 1 Emergency Operations Management Sub-element i.e - Equipment and Supplies to Support Operations INTENT This sub-element is derived from NUREG-0654, which provides that Offsite Response Organizations (ORO) have emergency equipment and supplies adequate to support the emergency response.

Criterion i.e. 1: Equipment, maps, displays, monitoring instruments, dosimetry, potassium iodide (K!) and other supplies are sufficient to support emergency operations (NUREG-0654/FEMA-REP- 1, IH.7, 10;IL.7, 8, 9; J.1O.a, b, e; J.11, 12;K.3.a; K..b)

Locations: UAMS Hospital, Little Rock; Pope County EMS (Main Station), Russellville.

EOP: 1. It is Arkansas policy to issue KI only to Emergency Workers (EW) in the 10- mile EPZ and institutionalized individuals. KI is not issued to the general public.

2. Meters have calibration sticks on the meters. Operational checks will be performed before use, using range of reading stickers on the meters. DRDs have "bar code" labels. Calibration dates of the DRDs and quarterly operational check dates of the meters and DRDs can be verified with the master database maintained by the NP&RP HP.

3. The quantities of Dosimetry and the quantities and expiration of KI will be confirmed by evaluators at locations identified in plans.

4. Meters that do not have "bar code" labels will have appropriate calibration stickers attached 26

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5. Correction-on-the-spot will be considered at these locations at the discretion of and concurrence between the evaluator and the controller.

Caution should be exercised to ensure that exercise play is not interrupted.

ARCA: None EVALUATION AREA 3 Protective Action Implementation Sub-element 3.a - Implementation of Emergency Worker Exposure Control INTENT This Sub-element is derived from NUREG-0654/FEMA-REP-l, which requires that OROs have the capability to provide for the following: distribution, use, collection, and processing of direct-reading dosimetry and permanent record dosimetry; reading of direct-reading dosimetry by emergency workers at appropriate frequencies; maintaining a radiation dose record for each emergency worker; establishing a decision chain or authorization procedure for emergency workers to incur radiation exposures in excess of the PAGs, and the capability to provide RI for emergency workers, always applying the --as low as is reasonably achievableU principle as appropriate.

Criterion 3.a. 1: The OROs issue appropriate dosimetry, K! and Prodedures, and manage radiological exposure to emergency workers in accordance with the plans/p rocedures.

Emergency workers periodically and at the end of each mission read their dosimeters and record the readings on the appropriate exposure record or chart. OROs maintain appropriate record-keeping of the administration of KI to emergency workers. (NUREGT-0654/FEMA-REP-1, J.1O.e; K.3.a, b; K.4)

Locations: UAMS Hospital, Little Rock; Pope County EMS (Main Station), Russeliville.

EOP: 1. Correction-on-the-spot will be considered at these locations at the discretion of and concurrence between the evaluator and the controller.

Caution should be exercised to ensure that exercise play is not interrupted.

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2. The State of Arkansas may not consider the termination of Emergency Worker (EW) exposure control to be at the end of the "plume phase".

The transition from EW exposure control to occupational exposure control will be made by the TOCD. The TOCD will make this decision after conferring with the Governor and County Judges who declared Emergencies in the State and County and after determining the potential for additional exposure during response activities.

3. The listing of EWs who have ingested KI would be developed after the exposure forms are turned in. Because of the length of this exercise, this requirement will not be demonstrated. Each EW who simulates taking KI will have a form documenting when it was taken. These forms would be the basis for developing this list. Forms will be available for evaluator

4. It is Arkansas policy to issue KI only to Emergency Workers (EW) and institutionalized individuals. County EWs who decline to take KI are not identified in advance. If they decline to take KI at their duty stations, they will not be placed in positions that would expose them to radiation.

KI is not issued to the general public

5. EMS crews will use gloves and booties as necessary. Hospital teams will wear "anti-Cs" JAW hospital plans.

6. Dosimetry and KI will be issued JAW plans.

7. The RO or designee will demonstrate the EW briefing, record keeping, and procedures for issuing and returning dosimetry and KI. The use of KI1 will be simulated.

ARCA: None 28

Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One EVALUATION AREA 6 Support Operation/Facilities.

Sub-element 6.d - Transportation and Treatment of Contaminated Injured Individuals.

INTENT This Sub-element is derived from NUREG-0654/FEMA-REP-1, which requires that OROs have the capability to transport contaminated injured individuals to medical facilities with the capability to provide medical services.98 Criterion 6.d. 1: The facility/ORO0 has the appropriate space, adequate resources, and trained personnel to provide transport, monitoring, decontamination, and medical services to contaminated injured individuals. (NUREG-O654/FEMA-REP-1, F.2; H.I1O; KS. .a, b; L. 1,4)

Locations: Pope County EMS (Main Station), Russellville EOP: 1. The Controller will contact Pope County 911 with the exercise message.

Communication between the ambulance and the EMS dispatch will be demonstrated. EMS dispatch will discuss procedures for passing information to UAMS.

2. The EMS crew will pick up the patient at an ANO facility. Prior to transfer of the patient, ANO and EMS personnel will demonstrate monitoring the patient. After patient simulated transfer, the EMS crew will demonstrate vehicle monitoring. The ambulance will not be draped.

3. This EA will be demonstrated at approximately 1500 on November 3, 2015.

4. Any real emergency will take precedence.

5. Correction-on-the-spot will be considered at these locations at the discretion of and concurrence between the evaluator and the controller.

Caution should be exercised to ensure that exercise play is not interrupted.

ARCA: None 29

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After Action ReportlImprovement Plan Arkansas Nuclear One Locations: UAMS Hospital, Little Rock.

EOP: 1. This BA will be demonstrated at approximately 1000 on November 4, 2015.

2. Any real emergency will take precedence.

3. The patient will be transported to UAMS via a non-emergency vehicle.

4. Radiation decontamination, monitoring and contamination control will be performed by ANO and UAMS personnel.

5. The State Controller will contact UAMS Emergency Room with the message approximately one and half (1.5) hours prior to patient arrival

6. The State Controller will contact UAMS Emergency Room with an update message approximately fifteen (15) minutes prior to patient arrival

7. UAMS personnel will not take any action to prepare for the demonstration of these evaluation areas before the one and half (1.5) hour notification.

8. No shift change will be performed. A list of second shift Key Personnel be given to the evaluator.

9. The 1 st shift may b*over staffed for training purposes. Some staff identified on the 2 nu shift roster may play with the 1 t team. In an emergency this over staffing would not be used..

10. Correction-on-the-snot will be considered at this location at the discretion of and concurrence between the evaluator and the controller. Caution should be exercised to ensure that exercise play is not interrupted.

ARCA: None 30

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U.S. Department of Homeland Security Region VI 800 N. Loop 288 Denton, TX 76209-3698

~#FEMA

,January 6, 2016 Mr. Marc Dapas Regional Administrator U.S. NRC, Region IV 1600 East Lamar Boulevard Arlington, TX 76011-4511

Dear Mr. Dapas:

Enclosed is a copy of the radiological emergency preparedness final report for the Arkansas Nuclear One (ANO) Medical Services Drill evaluated on November 3-4, 2015. FEMA Region VI staff evaluated the Pope County Emergency Medical Services, Main Station and University of Arkansas Medical Sciences located in Russeilville and Little Rock, Arkansas. There were no Findings or Plan issues identified during the drill, and no previous unresolved ARCAs remained.

Based on the results of the drill, the offsite radiological emergency response plans and preparedness for the State of Arkansas and affected local jurisdictions provide reasonable assurance that appropriate measures can be taken to protect public health and safety in the event of a radiological emergency. Therefore, 44 CFR Part 350 approval of the offsite radiological emergency response plans and preparedness for the State of Arkansas - specific to Arkansas Nuclear One will remain in effect.

A copy of this report was mailed to the NRC Headquarters Document Control Desk and a copy was transmitted electronically to RIV FEMADistribution(~nrc.gov as specified in the FEMA REP Program Manual dated June 2013. Should you have questions, please contact Lisa Hammond, RAC Chair at (940) 898-5199, or Elsa Lopez, Senior Site Specialist for Arkansas Nuclear One, at (940) 898-5308.

Sincerely, Lisa Hammond RAC Chair Enclosure cc: DHS/FEMA Headquarters - Vanessa Quinn, Jesse King ADH - Bernard Bevill ADEM - David Maxwell ANO - Robert Carey ¢ / q www.fema.gov

Arkansas Nuclear One After Action Report!

Improvement Plan Drill Date - November 3-4, 2015 Radiological Emergency Preparedness (REP) Program all Vd[,( 5,"F*

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After Action Report/Improvement Plan Arkansas Nuclear One Arkansas Nuclear One After Action Report/Improvement Plan Published EXECUTIVE

SUMMARY

................................................................................. 5 SECTION 1: EXERCISE OVERVIEW..................................................................... 6 1.1 Exercise Details ....................................................................................... 6 1.2 Exercise Planning Team Leadership ................................................................ 6 1.3 Participating Organizations.......................................................................... 7 SECTION 2: EXERCISE DESIGN

SUMMARY

.................................... i....................... 8 2.1 Exercise Purpose and Design......................... ................................................ 8 2.2 Exercise Objectives, Capabilities and Activities .................................................... 8 2.3 Scenario Summary.................................................................................... 9 SECTION 3: ANALYSIS OF CAPABILITIES ............................................................ 120 3.2 Summary Results of Exercise Evaluation ......................................................... 10 3.3 Criteria Evaluation Summaries .................................................................... 12 3.3.1 State Jurisdictions ..................................................................................... 12 3.3.2 Risk Jurisdictions ..................................................................................... 12 3.3.3 Support Jurisdictions ................................................................................. 13 3.3.4 Private Jurisdictions.................................................................................. .13 3.3.5 Federal Jurisdictions .................................................................................. 14 SECTION 4: CONCLUSION ............................................................................ 15 APPENDIX A: IMPROVEMENT PLAN ................................................................ 16 APPENDIX B: LESSONS LEARNED ................................................................... .17 APPENDIX C: BEST PRACTICES.................................................................. ...... 18 APPENDIX D: EXERCISE TIMELINE ................................................................... 19 APPENDIX E: EXERCISE EVALUATORS AND TEAM LEADERS....................................... 20 APPENDIX F: ACRONYMS AND ABBREVIATIONS................................................... 21 APPENDIX 6: EXERCISE PLAN .................................................. 22 3

Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One This page is intentionally blank.

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One EXECUTIVE

SUMMARY

On November 3-4, 2015, an out-of-sequence Medical Services Drill was conducted in Russeliville, Arkansas for the Pope County Emergency Medical Services (EMS) - Main Station the University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas. Personnel from the U.S.

Department of Homeland Security/Federal Emergency Management Agency (DHS/FEMA) Region VI, evaluated all activities. The drill was conducted to assess the level of preparedness of local responders to react to a simulated radiological emergency at Arkansas Nuclear One (ANO). The previous UAMS and Pope County EMS - St. Mary's Station Medical Services Drill was conducted on May 16, 2013.

Personnel from the Pope County EMS and University of Arkansas Medical Sciences participated in the drill. Evaluation Areas demonstrated included: Equipment and Supplies to Support Operations, Implementation of Emergency Worker Exposure Control, and Support Operations/Facilities Transportation and Treatment of Contaminated Injured Individuals.

Cooperation and teamwork of all 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 and they adequately implemented them. There were no Findings or Plan Issues identified during the drill.

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvemient Plan Arkansas Nuclear One SECTION 1: EXERCISE OVERVIEW 1.1 Exercise Details Exercise Name 7 Drill 2015-11-04 Type of Exercise Drill Exercise Date November 4, 2015 Program Department of Homeland Security/FEMA Radiological Emergency Preparedness Program Scenario Type Not Applicable 1.2 Exercise Planning Team Leadership Lisa Hammond Technological Hazards Branch Chief FEMA Region VI 800 N. Loop 288 Denton, TX, 76209 (940) 898-5199 lisa.hammond@fema.dhs.gov Elsa Lopez Senior Site Specialist FEMA Region VI 800 N. Loop 288 Denton, TX, 76209 (940) 898-5308 elsa.lopez@fema.dhs.gov 6

Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One Don Greene Emergency Planner Arkansas Department of Health 4815 West Markham Street Slot 30 Little Rock, AR, 72205 (501) 661-2808 donald.greene@arkansas.gov 1.3 Participating Organizations Agencies and organizations of the following jurisdictions participated in the Arkansas Nuclear One exercise:

State Jurisdictions Arkansas Department of Health Risk Jurisdictions Pope County Emergecy Medical Services Support Jurisdictions University of Arkansas of Medical Sciences Private Organizations Arkansas Nuclear One Federal Organizations 7

Unclassified Radiological Emergency Preparedness Program (REP)

After Action Reportllmprovement Plan Arkansas Nuclear One SECTION 2: EXERCISE DESIGN

SUMMARY

2.1 Exercise Purpose and Design The DHS/FEMA Region VI Office evaluated the drill on November 3-4, 2015 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 Arkansas Nuclear One (ANO). 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).

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action ReportlImprovement Plan Arkansas Nuclear One 2.3 Scenario Summary The drill scenario was developed to evaluate the response of drill participants to an incident at Arkansas Nuclear One (ANO) requiring the transportation, treatment and decontamination of a radiologically contaminated injured individual. The drill scenario provided for the evaluation of the University of Arkansas for Medical Sciences (UAMS) and Pope County Emergency Medical Services (EMS) - Main Station.

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One SECTION 3: ANALYSIS OF CAPABILITIES 3.1 Exercise Evaluation and Results Contained in this section are the results and findings of the evaluation of all jurisdictions and functional entities, which participated in the November 3-4, 2015 Medical Services Drill to test the offsite emergency response capabilities of local governments and support medical centers for Arkansas Nuclear One (ANO).

Each jurisdiction and functional entity was evaluated on the basis of its demonstration of criteria delineated in exercise evaluation area criteria contained in the Federal Register, Vol. 67, No. 80, "FEMA - Radiological Emergency Preparedness: Exercise Evaluation Methodology" (April 25, 2002) and the REP Program Manual. Detailed information on the exercise evaluation area criteria and the extent-of-play agreement used in this exercise are found in Appendix G of this report.

3.2 Summary Results of Exercise Evaluation The matrix presented in Table 3.1, on the following page(s), presents the status of all exercise evaluation area criteria from the REP Program Manual that were scheduled for demonstration during this exercise by all participating jurisdictions and functional entities. Exercise evaluation area criteria are listed by number and the demonstration status of those evaluation area criteria is indicated by the use of the following letters:

M - Met (No Deficiency or Areas Requiring Corrective Actions [ARCAs] assessed and no unresolved ARCAs from prior exercises)

Li - Level 1 Finding (An observed or identified inadequacy of organizational performance in an exercise that could cause a determination that offsite emergency preparedness is not adequate to provide reasonable assurance that appropriate protective measure can be taken, in the event of an incident, to protect the health and safety of the public.)

L2 - Level 2 Finding (An observed or identified inadequacy of organizational performance in an exercise that is not considered, by itself, to adversely impact public health and safety.)

P - Plan Issue (An observed or identified inadequacy in the offsite response organizations' (ORO's) emergency plan/implementing procedures) 10

Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One N - Not Demonstrated Tables 3.1 - Summary of Exercise Evaluation Table 3.1a - Exercise Evaluation by Classification I Date: 11/4/2015 Site: Arkansas Nuclear One Table 3.1b - Exercise Evaluation - Criteria Not Demonstrated i Date: 11/4/2015 Table 3.1c - Exercise Evaluation - Criteria Met Date: 11/4/2015 Site: Arkansas Nuclear One Pope County EMS Contaminated Injured Transport & Care6d Pope County EMS EW Exposure Control Implementation 3a 1 Pope County EMS Equipment and Supplies lel UAMS Contaminated Injured Transport & Care 6dl UAMS EW Exposure Control Implementation 3alI UAMS Equipment and Supplies lel 11

Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One 3.3 Criteria Evaluation Summaries 3.3.1 State Jurisdictions In summary, the status of DHS/FEMA criteria for the State jurisdiction is as follows:

a. LEVEL 1 FINDINGS: NONE

b. LEVEL 2 FINDINGS: NONE

c. PLAN ISSUES: NONE

d. PRIOR ISSUES - RESOLVED: NONE

e. PRIOR ISSUES - UNRESOLVED: NONE 3.3.2 Risk Jurisdictions 3.3.2.1 Pope County EMS In summary, the status of DHS/FEMA criteria for the State jurisdiction is as follows:

a. LEVEL 1 FINDINGS: NONE

b. LEVEL 2 FINDINGS: NONE

c. PLAN ISSUES: NONE

d. PRIOR ISSUES - RESOLVED: NONE 12

Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One

e. PRIOR ISSUES - UNRESOLVED: NONE 3.3.3 Support Jurisdictions 3.3.3.1 University of Arkansas for Medical Sciences Hospital In summary, the status of DHS/FEMA criteria for the State jurisdiction is as follows:

a. LEVEL 1 FINDINGS: NONE

b. LEVEL 2 FINDINGS: NONE

c. PLAN ISSUES: NONE

d. PRIOR ISSUES - RESOLVED: NONE

e. PRIOR ISSUES - UNRESOLVED: NONE 3.3.4 Private Jurisdictions In summary, the status of DHS/FEMA criteria for the Private jurisdiction is as follows:

a. LEVEL 1 FINDINGS: NONE

b. LEVEL 2 FINDINGS: NONE

c. PLAN ISSUES: NONE 13

Unclassified Radiological Emergency Preparedness Program (REP)

After Action ReportlImprovement Plan Arkansas Nuclear One

d. PRIOR ISSUES - RESOLVED: NONE

e. PRIOR ISSUES - UNRESOLVED: NONE 3.3.5 Federal Jurisdictions In summary, the status of DHS/FEMA criteria for the Federal jurisdiction is as follows:

a. LEVEL 1 FINDINGS: NONE

b. LEVEL 2 FINDINGS: NONE

c. PLAN ISSUES: NONE

d. PRIOR ISSUES - RESOLVED: NONE

e. PRIOR ISSUES - UNRESOLVED: NONE 14

Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One SECTION 4: CONCLUSION Based on the results of the drill, the offsite radiological emergency response plans and preparedness for the State of Arkansas and the affected local jurisdictions are deemed adequate to provide reasonable assurance that appropriate measures can be taken to protect the health and safety of the public in the event of a radiological emergency. Therefore, 44 CFR Part 350 approval of the offsite radiological emergency response plans and preparedness for the State of Arkansas site-specific to Arkansas Nuclear One will remain in effect.

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action ReportlImprovement Plan Arkansas Nuclear One APPENDIX A: IMPROVEMENT PLAN No improvement plan added.

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action Reportllmprovement Plan Arkansas Nuclear One APPENDIX B: LESSONS LEARNED No lessons learned entered.

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One APPENDIX C: BEST PRACTICES No best practices entered.

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action ReportlImprovement Plan Arkansas Nuclear One APPENDIX D: EXERCISE TIMELINE N/A DATE: 11/04/2015, SITE: Arkansas Nuclear One Site Area Emergency General Emergency Simulated Rad. Release Started Simulated Rad. Release Terminated 19

Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One APPENDIX E: EXERCISE EVALUATORS AND TEAM LEADERS DATE: 11/4/2015 SITE: Arkansas Nuclear One

..... LOCATION '::TEAM:LEADER " ..,AGENCY "'

Pope County EMS Timothy Pflieger DHS - FEMA University of Arkansas for Medical Sciences Hospital Elsa Lopez ______________

LOCATION i: ' *"EVALUATOR AGENCy

Pope County EMS Timothy Pflieger DHS - FEMA University of Arkansas for Medical Sciences Hospital Elsa Lopez ______________

University of Arkansas for Medical Sciences Hospital Scott Flowerday ______________

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One APPENDIX F: ACRONYMS AND ABBREVIATIONS ANO Ag IArkansas Nuclear 3-One s I CDC Centers for Disease Control and Prevention DRO Direct Reading Dosimeter ED Emergency Department EMS Pope County Emergency Medical Services EW Emergency Worker 1(I Potassium Iodide OSL Optically Stimulated Luminescent PCEOC Pope County Emergency Operations Center PPE Personal Protective Equipment RSO Radiological Safety Officer TOCD Technical Operation Control Director UAMS University of Arkansas for Medical Sciences 21

Unclassified Radiological Emergency Preparedness Program (REP)

After Action ReportlImprovement Plan Arkansas Nuclear One APPENDIX G: EXERCISE PLAN Arkansas Nuclear One 2015 MS-i Drill (Final 1 September 2015)

SCENARIO: ANO and Pope County EMS This event will take place in a radiation area in the plant, however, for exercise purposes, the patient will be presented for transport by the Pope County Ambulance Service at the Reeve E.

Ritchie Training Center (RERTC).

Maintenance is being performed on a steam valve, when a spanner wrench slips and impacts a worker in the left leg. The impact shatters the workers leg, results in an open fracture of the leg below the knee and rips the workers protective clothing, exposing the wound area to a radiologically contaminated environment.

The Unit One Control Room is called to report a medical emergency. The control pages the ANO Emergency Management Team and calls the Pope County Ambulance Service to request an ambulance.

Initial radiation readings at the wound area are noted to be 20,000 cpm.

The ANO Emergency Medical Management Team stabilizes the patient and moves the patient to an area assessable to responding Pope County Ambulance Service personnel (at the RERTC).

The Pope County 911 center dispatches the Pope County Ambulance Service to the accident at ANO and advises the patient may be contaminated.

Upon arrival at the RERTC, ambulance personnel are met by members of the ANO Emergency Medical Team and a Health Physicist who have the patient stabilized and in a body bag to contain contamination.

The ANO Emergency Medical Team provides the following patient information to the ambulance personnel:

Patient is suffering from an open fracture to the left leg below the knee which has been splinted and bandaged for stabilization, but has not been reduced.

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action Report/Improvement Plan Arkansas Nuclear One

There is a distal pulse present at the left ankle and there is no loss of motion or sensation in the left foot.

There is bleeding around the wound site, which is being controlled with a pressure bandage.

The patient is alert and denies loss of consciousness, but reports to be in a great deal of paint and is requesting pain medication.

The following vital signs are noted:

o BP is 160/90 o Pulse 130 and strong o Respiration is 30 and unlabored o The wound site is contaminated with a reading of 20,000 cpm The following patient information is available on request:

Lung sounds are clear

Movement is noted in all extremities

Medical history is negative for pre-existing chronic conditions

Patient is allergic to Penicillin

Patient has a hearing loss in the left ear Arkansas Nuclear One 2 015 MS-i Drill SCENARIO: UAMS Maintenance is being performed on a steam valve, when a spanner wrench slips and impacts a worker in the left leg. The impact shatters the workers leg, results in an open fracture of the leg below the knee and rips the workers protective clothing, exposing the wound area to a radiologically contaminated environment.

The Unit One Control Room is called to report a medical emergency. The control pages the ANO Emergency Management Team and calls the Pope County Ambulance Service to request an ambulance.

Initial radiation readings at the wound area are noted to be 20,000 cpm.

The ANO Emergency Medical Management Team stabilizes the patient and moves the patient to an area assessable to responding Pope County Ambulance Service personnel (at the RERTC).

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Unclassified Radiological Emergency Preparedness Program (REP)

After Action Reportllnmprovement Plan Arkansas Nuclear One The Pope County 911 center dispatches the Pope County Ambulance Service to the accident at ANO and advises the patient may be contaminated.

Upon arrival at the RERTC, ambulance personnel are met by members of the ANO Emergency Medical Team and a Health Physicist who have the patient stabilized and in a body bag to contain contamination.

The patient is stabilized and transported via ambulance (simulated) to UAMS in Little Rock.

Pope County EMS (exercise controller) notifies UAMS that is inbound with an injured and radiologically contaminated patient. An ANO Radiation Technician is onboard the ambulance to provide radiological support to medical personnel.

Upon arrival at UAMS, the following patient infonnation is provided to UAMS personnel:

Patient is suffering from an open fracture to the left leg below the knee which has been splinted and bandaged for stabilization, but has not been reduced.

There is a distal pulse present at the left ankle and there is no loss of motion or sensation in the left foot.

There is bleeding around the wound site, which is being controlled with a pressure bandage.

The patient is alert and denies loss of consciousness, but reports to be in a great deal of paint and is requesting pain medication.

The following vital signs are noted:

o BP is 160/90 o Pulse 130 and strong o Respiration is 30 and unlabored o The wound site is contaminated with a reading of 20,000 cpm There have been no notable changes in vital signs during transport.

The following patient information is available on request:

Lung sounds are clear

Movement is noted in all extremities

Medical history is negative for pre-existing chronic conditions

Patient is allergic to Penicillin

Patient has a hearing loss in the left ear 24