ML17213A165

FEMA - After Action Report/Improvement Plan for Peach Bottom Wellspan Health York Hospital Medical Services Drill Held 05/26/2017

ML17213A165
Person / Time
Site:	Peach Bottom
Issue date:	07/17/2017
From:	US Dept of Homeland Security, Federal Emergency Management Agency
To:	Office of Nuclear Reactor Regulation, Office of Nuclear Security and Incident Response
References
Download: ML17213A165 (35)

Text

Peach Bottom Atomic Power Station Medical Services Drill After Action Report/Improvement Plan Drill Date - May 26, 2017 Radiological Emergency Preparedness (REP) Program.

~- FEMA Published, July 17, 2017

Peach Bottom Atomic Power Station WellSpan Health York Hospital Medical Services Driil (MS-I)

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Peach Bottom Atomic Power Station Medical Services Drill (MS-I)

After Action Report/Improvement Plan WellSpan Health York Hospital After Action Report/Improvement Plan CONTENTS Published, July 17, 201 7 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

..*...........*.....*.....*.*.*********.****.*..*..*.*....*.....*.*............ 8 2.1 Exercise Purpose and Design...... ;............................................................................................ 8 2.2 Exercise Objectives, Capabilities and Activities..................................................................... 10 2.3 Scenario Summary....................................... ~........................................................................ 10 SECTION 3: ANALYSIS OF CAPABILITIES ***.*..***.**.**..*.*....*..............*.....*..**.*********.**...*........**... 10 3.2 Summary Results of Exercise Evaluation.............................................................................. 11 3.3 Criteria Evaluation Summaries............................................................................................. 14 3.3.1 Private Jurisdictions................................................................................................................... 14 SECTION 4: CONCLUSION:........*...*.*..*..**.**..*...**..***..*..*..*...***...*.*..*...*.*.....***.*..*.*....*....***...... 15 APPENDIX A: EXERCISE EVALUATORS AND TEAM LEADERS..*......*..**...*****************........*.******* 16 APPENDIX B: ACRONYMS AND ABBREVIATIONS *..*....**....**......***..**..*.*...*....*.**.**.*....*..***.*.... 16 APPENDIX C: EXTENT OF PLAY.*****.******.*.*..*.*..*..*..**..*......*........**..*.*.****.**..*.**....*...........**..... 18 3

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

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WellSpan Health York Hospital

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital EXECUTIVE

SUMMARY

On May 26, 2017 a Medical Services (MS-1) Drill was conducted for the 10-mile Plume Exposure Pathway, Emergency Planning Zone (EPZ) around the Peach Bottom Atomic Power Station (PBAPS) by the Department of Homeland Security (DHS), Federal Emergency Management Agency (FEMA) Region III. The most recent prior MS-1 Drill for this site was conducted on May 28, 2015.

The purpose of the PBAPS MS-1 Drill was to assess the State and local off site response organizations preparedness in responding to a radiological medical emergency. The Drill was held in accordance with FEMA's policies and guidance concerning the evaluation of State and local Radiological Emergency Response Plans (RERP) and procedures.

FEMA wishes to acknowledge the efforts of the many individuals in the Commonwealth of Pennsylvania, York County Emergency Management Agency, WellSpan Health York Hospital (WYH) and the Delta-Cardiff Emergency Medical Services, who were evaluated during this Drill.

Protecting the public health and safety is the full-time job of some of the drill participants and an additional assigned responsibility for others. Still others have willingly sought this responsibility as volunteers providing vital emergency services twenty-four (24) hours a day to the communities in which they live. Cooperation and teamwork of all the participants was observed during this Drill.

This report contains the final evaluation of the MS-1 Drill. The Commonwealth of Pennsylvania, and local organizations demonstrated knowledge of their emergency response plans and procedures and adequately implemented them. There were no Level 1 or Level 2 Findings or Plan Issues as a result of this Drill.

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Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital SECTION 1: EXERCISE OVERVIEW 1.1 Exercise Details Exercise Name Well Span Health York Hospital Medical Services Drill (MS-1)

Type of Exercise Medical Services Exercise Date May 26, 2017 Program Department of Homeland Security/FEMA Radiological Emergency Preparedness Program Scenario Type Radioactive Contaminated/ Injured Person 1.2 Exercise Planning Team Leadership "Michael E Shuler, Sr.

Project Officer/ Site Specialist Technological Hazards Division 615 Chestnut Street, Sixth Floor Philadelphia, Pennsylvania 19106 (215) 435-3018 michael.shuler@fema.dhs.gov Laurin Fleming Exercise Planning Team Pennsylvania Emergency Management Agency (PEMA)

Emergency Management Specialist/ Medical Service (MS-1) Coordinator 1310 Elmerton A venue Harrisburg, Pennsylvania, 17110 717-651-2119 laufleming@pa.gov Chelsea Troutman Exercise Planning Team Exelon Nuclear Offsite Emergency Preparedness Coordinator P.O. Box 480 Middletown, Pennsylvania, 17057 607-742-9310 (Cell) 6

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Peach Bottom Atomic Power Station Medical Services Drill (MS-I)

After Action Report/Improvement Plan 717-948-2040 (TMI) 610-765-5141 (Kennett) chelsea.troutman@exeloncorp.com Shen Kreiser York County Office of Emergency Management 120 Davies Drive York, Pennsylvania 17 402 717-840-2981 shkreiser@ycdes.org WellSpan Health York Hospital Charles Stevens, Manager Emergency Management 1001 South George Street PO Box 15198 York, Pennsylvania 17405-7198 717-812-4140 cstevens2<@WellSpan.org 1.3 Participating Organizations WellSpan Health York Hospital Agencies and organizations of the following jurisdictions participated in the exercise:

State Jurisdictions Commonwealth of Pennsylvania Pennsylvania Emergency Management Agency (PEMA)

Risk Jurisdictions Chester County Emergency Management Agency (CRESCO)

Lancaster County Emergency Management Agency (LCEMA)

York County Emergency Management agency (YCEMA)

Support Jurisdictions None Private Organizations Delta Cardiff Emergency Medical Services (EMS)

WellSpan Health York Hospital Exelon Corporation Federal Organizations Federal Emergency Management Agency (FEMA) 7

Peach Bottom Atomic Power Station Medical Services Drill (MS-I)

After Action Report/Improvement Plan WellSpan Health York Hospital SECTION 2: EXERCISE DESIGN

SUMMARY

2.1 Exercise Purpose and Design On December 7, 1979, the President directed the Federal Emergency Management Agency (FEMA) to assume the lead responsibility for all off-site radiological planning and response.

FEMA's activities were conducted pursuant to 44 Code of Federal Regulations (CFR) Parts 350, 351 and 352. These regulations are a key element in the Radiological Emergency Preparedness (REP) Program that was established following the TMI accident in March 1979.

44 CFR 350 establishes the policies and procedures for FEMA's initial and continued approval of State and local governments' radiological emergency planning and preparedness for commercial nuclear power plants. This approval is contingent, in part, on State and local government participation in joint exercises with licensees. FEMA's responsibilities in radiological emergency planning for fixed nuclear facilities include the following:

A.

Taking the lead in offsite emergency planning and in the review and evaluation of radiological emergency response plans and procedures developed by State and local governments; B.

Determining whether such plans and procedures can be implemented on the basis of observation and evaluation of exercises of the plans and procedures conducted by State and local governments; C.

Responding to requests by the U.S. Nuclear Regulatory Commission (NRC) pursuant to the Memorandum of Understanding between the NRC and FEMA dated December 7, 2015 (Federal Register, Vol. 81, No. 57, March 24, 2016) and; D.

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

- U.S. Department of Commerce

- U.S. Nuclear Regulatory Commission

- U.S. Environmental Protection Agency

- U.S. Department of Energy

- U.S. Department of Health and Human Services

- U.S. Department of Transportation

- U.S. Department of Agriculture

- U.S. Department of the Interior

- U.S. Food and Drug Administration Representatives of these agencies serve on the Region III Regional Assistance Committee (RAC), which is chaired by FEMA. A Radiological Emergency Preparedness MS-1 Drill was conducted on May 26, 2017, to assess the capabilities of State and local emergency 8

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital preparedness organizations in implementing their radiological emergency response plans and procedures to protect the public health and safety during a radiological emergency involving Peach Bottom Atomic Power Station.

The purpose of this After Action Report is to present the Drill results, and findings on the performance of the Off-site Response Organizations (OROs) during a simulated radiological emergency involving a contaminated injured individual.

The Drill was designed to demonstrate and evaluate the responder's knowledge of patient and responder personal protective measures, equipment preparation and employment, and decontamination procedures. All activities were demonstrated in accordance with the participants' plans and procedures as they would be performed in an actual emergency, except as agreed to in the Exercise Plan and Extent-of-Play Agreement.

The findings presented in this report are based on the evaluations of the Federal evaluator team, with final determinations made by the FEMA Region III Regional Assistance Committee (RAC) Chairperson and approved by FEMA Headquarters. These reports are provided to the NRC and participating States. State and local governments utilize the findings contained in these reports for the purposes of planning, training, and improving emergency response capabilities.

Section 1 ofthis report, entitled Overview, presents the Exercise Planning Team and the Participating Organizations.

Section 2 of this report, entitled Design Summary, and includes the Purpose and Design, Objectives, Capabilities, and Activities, and the Scenario Summary.

Section 3 of this report entitled Analysis of Capabilities contains detailed Evaluation and Results; a Summary Results of Evaluation; and Criteria Evaluation Summary.

Information on the demonstration for each jurisdiction or functional entity evaluated is presented in a jurisdiction-based, issue-only format.

Section 4 ofthis report entitled Conclusion, is a description ofFEMA's overall assessment of the capabilities of the participating organizations.

The criteria utilized in the FEMA evaluation process are contained in the following:

NUREG-0654/FEMA-REP-1, Rev. 1, "Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants," November 1980; Radiological Emergency Preparedness Program Manual, January 2016 9

Peach Bottom Atomic Power Station Medical Services Drill (MS-I)

After Action Reportllmprovement Plan 2.2 Exercise Objectives, Capabilities and Activities WellSpan Health York Hospital The PBAPS MS-1 Drill evaluated by FEMA, was designed to demonstrate that the ORO can transport, transfer, monitor, decontaminate and treat a contaminated/injured person while minimizing any cross contamination during a radiological emergency.

The demonstration included the ability to:

A.

Respond to a radiation medical emergency following York County Emergency Management Agency, Well Span Health York Hospital and Delta-Cardiff Emergency Medical Services organization) procedures.

B.

Monitor for radiation contamination and uptake, and to validate persons providing these services are adequately prepared to handle contaminated individuals.

C.

Conduct timely and accurate communications between the hospital and offsite response agencies.

D.

Exhibit correct priorities and appropriate techniques in Emergency Medical Services (EMS); transportation of patients; and pre-hospital and hospital emergency care of radioactively contaminated patients.

E.

Demonstrate inter-agency cooperation between the Ambulance Service/EMS and the hospital.

2.3 Scenario Summary The scenario for this Medical Services Drill consisted of simulated notifications of escalating emergency classification levels at the Peach Bottom Atomic Power Station (PBAPS) initiated at the Site Area Emergency to a General Emergency. Subsequent to a release of radiological material the plant declared a General Emergency.

During an emergency at Peach Bottom Atomic Power Station a farmer was recommended to place his animals under roof and provide with stored feed and water. While herding his sheep into a shed he slipped and fell twisting his right knee. He crawled about 300 yards across the pasture to his vehicle. The sheep were milling about and one caught him on the cheek with her hoof during the sounding of the sirens. Peach Bottom Atomic Power Station recommended an evacuation at the General Emergency (GE) due to imminent or actual release of radiation. The farmer drove to a friend near Delta for assistance where the paramedics were called.

Patient rub left cheek with left hand several times in presence of EMS and was agitated about this "radiation disease". The patient could potentially touch EMS and hospital staff and spread contamination.

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Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital SECTION 3: ANALYSIS OF CAPABILITIES 3.1 Exercise Evaluation and Results Contained in this section are the results and findings of the evaluations of all jurisdictions and locations that participated in the May 26, 201 7, Peach Bottom Atomic Power Station MS-1 Drill. The Drill was conducted to demonstrate the ability of the OROs to respond to a potentially contaminated injured person associated with Peach Bottom Atomic power Station.

Each jurisdiction and functional entity was evaluated on the basis of its demonstration of the appropriate Demonstration Criteria contained in the REP Program Manual. Detailed information on the Demonstration Criteria and the Extent-of-Play Agreement are found in Appendix C.

The Drill was conducted and evaluated in accordance with the Radiological Emergency Preparedness Program Manual (January 2016) and NUREG-0654/FEMA-REP-l, Rev. 1. The Demonstration Criteria included:

l.e.1-Equipment, maps, displays, monitoring instruments, dosimetry, potassium iodide (Kl) and other supplies are sufficient to support emergency operations.

3.a.1-The OROs issue appropriate dosimetry, Kl, and procedures, and manage radiological exposure to emergency workers in accordance with the plans/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. OROs maintain appropriate record-keeping of the administration of KI to emergency workers.

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.

3.2 Summary Results of Exercise Evaluation The matrix presented in Table 3.1, on the following pages, presents the status of the Demonstration Criteria from the REP Program Manual that were scheduled for demonstration during this Drill by all participating jurisdictions and functional entities. Drill Demonstration Criteria are listed by number and the demonstration status of the criteria is indicated by the use of the following letters:

(Ll) 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 measures can be taken 11

Peach Bottom Atomic Power Station Medical Services Drill (MS-I)

After Action Report/Improvement Plan WellSpan Health York Hospital in event of a radiological emergency to protect the health and safety of the public living in the vicinity of a Nuclear Power Plant (NPP).

(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 off-site response organizations' emergency plan/implementing procedures, rather than that of the ORO's performance.

(N) Not Demonstrated: The term applied to the status of a REP Evaluation Area Criterion indicating that the ORO, for a justifiable reason, did not demonstrate the Evaluation Area Criterion, as required in the Extent-of-Play Agreement or at the two-year or eight-year interval required in the FEMA REP Program Manual.

(M) Met: The status of a REP Evaluation Area Criterion indicating that the participating ORO demonstrated all demonstration criteria for the Evaluation Area Criterion to the level required in the Extent-of-Play Agreement with no findings assessed in the current exercise and no unresolved prior findings.

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Peach Bottom Atomic Power Station WellSpan Health York Hospital Medical Services Drill (MS-1)

After Action Report/Improvement Plan Table 3.1 - Summary of Drill Evaluation Date: 2017-May-26 Site: Peach Bottom Atomic Power Station (M) Met, (1) Level 1 Finding, (2) Level 2 Finding, (P) Planning Issue Emergency Operations Management Mobilization Facilities Direction and Control Communications Equipment and Supplies to Support Operations Protective Action Decision Making Emergency Worker Exposure Control Accident Assessment and Pars for the Emergency Event PAD decision-making process and coordination for the General Public P ADs for disabilities & access/functional needs people Radiological Assessment & Decision making for the Ingestion Pathway Radiological Assessment & Decision making for Relocation/Reentry/Return Protective Action Implementation Implementation of Emergency Worker Exposure Control Implementation of KIP AD for Institutionalized Individuals/Public Implementation of P ADs for disabilities & access/functional needs people Implementation of PADS for Schools Implementation of Traffic and Access Control Impediments to Evacuation Implementation of Relocation/Reentry/Return Decisions Field Measurements and Analysis RESERVED Field Team Management Plume Phase Field Measurement, Handling, & Analyses Post Plume Phase Field Measurements & Sampling Emergency Notification and Public Information Activation of the Prompt Alert & Notification System (ANS)

RESERVED Activation of the Back-up ANS Activation of the Exception Area ANS Emergency Information & Instructions to the Public/Media Support Operations/Facilities Monitoring, Decontamination, & Registration of Evacuees Monitoring/Decontamination of Emergency Workers and Equipment Temporary Care ofEvacuees Transportation/Treatment of Contaminated Injured Individuals 13

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Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan 3.3 Criteria Evaluation Summaries 3.3.1 Private Jurisdictions WelJSpan Health York Hospital 3.3.1.1 York County, Delta-Cardiff Emergency Medical Services Ambulance In summary, the status ofDHS/FEMA criteria for the Private Sector Organizations are as follows:

a. MET: l.e.l; 3.a.l; 6.d.l

b. LEVEL 1 FINDINGS: NONE

c. LEVEL 2 FINDINGS: NONE

d. PLAN ISSUES: NONE

e. PRJOR ISSUES - RESOLVED: NONE

f. PRJOR ISSUES - UNRESOLVED: NONE 3.3.1.2 York County, WellSpan Health York Hospital In summary, the status of DHS/FEMA criteria for the Private Sector Organizations are as follows:

a. MET: l.e.l; 3.a.l; 6.d.l

b. LEVEL 1 FINDINGS: NONE

c. LEVEL 2 FINDINGS: NONE

d. PLAN ISSUES: NONE

e. PRJOR ISSUES - RESOLVED: NONE

f.

PRJOR ISSUES - UNRESOLVED: NONE 14

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital SECTION 4: CONCLUSION The Commonwealth of Pennsylvania and private sector organizations, except where noted in this report, demonstrated knowledge of their radiological emergency response plans and procedures and they were successfully implemented during the Peach Bottom Atomic Power Station WellSpan Health York Medical Services Drill evaluated on May 26, 2017.

Two FEMA evaluators provided analyses of six evaluation criteria. These analyses resulted in a determination of no Findings, no new Plan Issues, and no unresolved Plan Issues.

The Delta Cardiff Emergency Medical Services, Inc. (DCEMS) successfully demonstrated that necessary equipment and supplies were available to support the treatment of an injured/

contaminated patient. EMS personnel prioritized life-saving medical practices over contamination concerns, implemented protective measures through the use of Personal Protective Equipment, regular glove changes, and control of cross contamination. Appropriate patient assessments were demonstrated as well as regular and ongoing communications with WellSpan Health York Hospital.

The WellSpan Health York Hospital successfully demonstrated the mobilization of staff, staffing assignments, issue of dosimetry and monitoring equipment, and effective use of Personal Protective Equipment during the exercise. The hospital staff effectively responded to communications from the DCEMS, initiated the set-up and management of a Radiation Emergency Area, and accepted and successfully treated an injured/contaminated patient while administering life-saving medical attention over contamination concerns. In addition, the medical facility provided security control of the facility including the drop off bay for the patient and overall protective measures for contamination control and prevention of cross contamination.

Based on the results of the Drill and a review of the off site radiological emergency response plans and procedures submitted, FEMA Region III has determined they are adequate (meet the planning and preparedness standards ofNUREG-0654/FEMA-REP-1, Revision 1, November 1980, as referenced in 44 CFR 350.5) and there is reasonable assurance they can be implemented, as demonstrated during this Drill.

An Improvement Plan (IP) will not be developed as part of this report.

All activities were based on the ORO's plans/procedures and completed as they would be in an actual emergency, unless noted above or otherwise specified in the Extent-of-Play agreement.

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Peach Bottom Atomic Power Station WellSpan Health York Hospital Medical Services Drill (MS-1)

After Action Report/Improvement Plan APPENDIX A: EXERCISE EV ALU A TORS AND TEAM LEADERS DATE: 5/26/2017 SITE:

LOCATION TEAMLEADER Michael Shuler EVALUATOR Barton Freeman York County, Delta-Cardiff Emergency Medical Services Ambulance WellSpan Health York Hospital Michael Shuler Michael Shuler cronym ALARA ALC CPM DC EMS DHS EMS EMT EPZ FEMA GE KI IP MS-I NPP NRC ORO PEMA PBAPS RAC REA REPM RERP APPENDIX B: ACRONYMS AND ABBREVIATIONS Meanim?

As low As Reasonably Achievable Annual Letter of Certification Counts Per Minute Delta-Cardiff Emergency Medical Services, Inc.

Department of Homeland Security Emergency Medical Services Emergency Medical Technician Emergency Planning Zone Federal Emergency Management Agency General Emergency Potassium Iodide Improvement Plan Medical Services Nuclear Power Plant Nuclear Regulatory Commission Offsite Response Organization Pennsylvania Emergency Management Agency Peach Bottom Atomic Power Station Regional Assistance Committee Radiation Emergency Area Radiological Exercise Program Manual Radiological Emergency Response Plan 16 AGENCY FEMA FEMA

Peach Bottom Atomic Power Station SAE SAV YCEMA WYCH REP TMI Medical Services Drill (MS-1)

After Action Report/Improvement Plan Site Area Emergency Staff Assistance Visit York County Emergency Management Agency WellSpan Health, York Hospital Radiological Emergency Preparedness Three Mile Island 17 WellSpan Health York Hospital

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WelISpan Health York.ffospital APPENDIX C: EXTENT OF PLAY The Extent-of-Play Agreement was extracted from the Exercise Plan, which was diafted by the Commonwealth of Pennsylvania, Pennsylvania Emergency Management Agency, and is included in this Report as an Appendix. The Extent-of-Play was negotiated and agreed upon by FEMA Region III, and the Pennsylvania Emergency Management Agency.

The Exercises Plan was created as an overall tool for facilitation and implementation of the PBAPS MS-I Drill and to integrate the concepts and policies of the Homeland Security Exercise Evaluation Program with the Radiological Emergency Preparedness Program Exercise Methodology.

This Extent of Play) is for the 20 I 7 Peach Bottom Atomic Power Station WellSpan Health York Hospital Medical Services Exercise (MS-I) that will be conducted at WellSpan Health York Hospital.

All ttrfermatigu i~ ElaeH.'led eottficletttittl and e0nsid0r08: "Fot Officiai U:se Only." -

..fB e <r/, In WELISPAN York Hospital 18

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital PEACH BOTTOM ATOMIC POWER STATION WELLSP AN HEAL TH YORK HOSPITAL EXERCISE May 26, 2017 Method of Operation

1.

The Peach Bottom Atomic Power Station and its personnel will not play as active role in the facilitation of this Medical Services Drill. The plants simulated events, radiation releases, and emergency classifications will be injected by off-site Controllers. A pre-approved scenario will be used.

2.

The Pennsylvania Emergency Management Agency (PEMA), Area Office (Central Area) will not be activated as part of this drill. The Exercise Coordinator will provide pre-exercise coordination and observe exercise activities.

3.

PEMA Central Area Office will participate as a Controller in this exercise.

4.

York County Office of Emergency Management will participate in this exercise.

5.

Controllers will be supplied by PEMA and Exelon Corporation. Controllers are not players but will provide injects and information to initiate and stimulate drill play by providing radiological readings during the monitoring and decontamination of a potentially contaminated injured patient. Live radioactive sources will only be used to perform operational checks of radiological monitoring instruments.

6.

PEMA staff and qualified county emergency management personnel will be assigned to key locations for the purpose of observing, noting response actions and conditions, and recording observations for future use. Observers will not take an active part in the proceedings, but will interact with staff members to the extent necessary to fulfill their observer responsibilities. Coaching of players is not permitted, except as appropriate to provide training to participants awaiting a re-demonstration.

7.

Department of Homeland Security (DHS), Federal Emergency Management Agency (FEMA), Radiological Emergency Preparedness Program (REPP) Evaluators: FEMA Evaluators will be present at designated demonstration locations.

8.

Exercise activities are scheduled to commence on or about 7:30 a.m., May 26, 2017 and continue until the participants have completed the exercise objectives and demonstrated the Exercise Evaluation Criteria.

9.

Participants and agencies will Stand Down when the Controllers have confirmed with the Evaluators that all evaluation criteria have been demonstrated and when the State and County Observers are satisfied that the Objectives have been met.

10.

An emergency plan is drafted to address the generally expected conditions of an emergency. Not everything in the emergency plan may be applicable for a given 19

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital scenario. The main purpose of an emergency plan is to assemble sufficient expertise and officials so as to properly react to the events as they occur. The responders should not be so tied to a plan that they cannot take actions that are more protective of the public.

Therefore, if, by not following the plan, the responders protect the public equally, as well as provided in the plan, it should be noted for possible modification of the plan, but not classified as a negative incident. Furthermore, if, by following the plan there is a failure to protect the public health and safety, it should be noted so that the plan can be modified and the appropriate negative assessment corrected.

11.

During the exercise, any activity that is not satisfactorily demonstrated may be re-demonstrated by the participants during the exercise, provided it does not negatively interfere with the exercise. Refresher training may be provided by the players, observers, and/or Controllers. Evaluators are not permitted to provide refresher training. Re-demonstrations will be negotiated between the Players, Observers, Controllers, and Evaluators. PEMA may advise the Regional Assistance Committee Chair prior to initiating any re-demonstrations. It is permissible to extend the demonstration window, within reason, to accommodate the re-demonstration. Activities corrected from a re-demonstration will be so noted.

Objectives

1.

Demonstrate the ability to respond to a radiation medical emergency following the procedures of York County Emergency Management Agency, Delta-Cardiff Emergency Medical Transport Service, and WellSpan Health York Hospital.

2.

Demonstrate timely and accurate communications between the hospital and offsite response agencies. (Telephones will be used in lieu of radios whenever possible to limit the potential misinterpretation of the exercise as an actual event.)

3.

Demonstrate correct priorities and appropriate techniques in EMS, transportation of patients and pre-hospital and hospital emergency care of radioactively contaminated patients.

4.

Demonstrate inter-agency cooperation between the ambulance company/EMS and the hospital.

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Peach Bottom Atomic Power Station Extent of Play Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital Evaluation Area 1-Emergency Operations Management Sub-Element 1.e--Equipment and Supplies to Support Operations Intent This sub-element is derived from NUREG- 0654/FEMA-REP-1, which requires that Offsite Response Organizations (ORO) have emergency equipment and supplies adequate to support the emergency response.

Criterion 1.e.1: Equipment, maps, displays, monitoring instruments, dosimetry, potassium iodide (Kl), and other supplies are sufficient to support emergency operations.

(NUREG-0654/FEMA-REP-1, H.7, 10; 1.7, 8, 9; J.10.a, b, e, J.11, 12; K.3.a; K.S.b).

Assessment/Extent of Play Assessment of this Demonstration Criterion is accomplished primarily through a baseline evaluation and subsequent periodic inspections.

A particular facility's equipment and supplies must be sufficient and consistent with that facility's assigned role in the ORO's emergency operations plans. Use of maps and other displays is encouraged. For non-facility based operations, the equipment and supplies must be sufficient and consistent with the assigned operational role. At locations where traffic and access control personnel are deployed, appropriate equipment (e.g., vehicles, barriers, traffic cones, and signs) must be available, or their availability described.

Specific equipment and supplies that must be demonstrated under this criterion include KI inventories, dosimetry, and monitoring equipment, as follows:

Kl: Responsible OROs must demonstrate the capability to maintain inventories of KI sufficient for use by: (1) emergency workers; (2) institutionalized individuals, as indicated in capacity lists for facilities; and (3) where stipulated by the plans/procedures, members of the general public (including transients) within the plume pathway EPZ. In addition, OROs must demonstrate provisions to make KI available to specialized response teams (e.g., civil support team, Special Weapons and Tactics Teams, urban search and rescue, bomb squads, HAZMAT, or other ancillary groups) as identified in plans/procedures). The plans/procedures must include the forms to be used for documenting emergency worker ingestion of Kl, as well as a mechanism for identifying emergency workers that have declined KI in advance. Consider carefully the placement of emergency workers that have declined KI in advance.

ORO quantities of.dosimetry and KI available and storage locations(s) will be confirmed by physical inspection at the storage location(s) or through documentation of current inventory submitted during the exercise, provided in the ALC submission, and/or verified during an SAV.

Available supplies of KI must be within the expiration date indicated on KI bottles or blister 21 l

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital packs. As an alternative, the ORO may produce a letter from a certified private or State laboratory indicating that the KI supply remains potent, in accordance with U.S. Pharmacopoeia standards.

Dosimetry: Sufficient quantities of appropriate direct-reading and permanent record dosimetry and dosimeter chargers must be available for issuance to all emergency workers who will be dispatched to perform an ORO mission. In addition, OROs must demonstrate provisions to make dosimetry available to specialized response teams (e.g., civil support team, Special Weapons and Tactics Teams, urban search and rescue, bomb squads, HAZMAT, or other ancillary groups) as identified in plans/procedures.

Appropriate direct-reading dosimetry must allow an individual(s) to read the administrative reporting limits and maximum exposure limits contained in the ORO's plans/procedures.

Direct-reading dosimeters must be zeroed or operationally checked prior to issuance. The dosimeters must be inspected for electrical leakage at least annually and replaced when necessary. Civil Defense Victoreen Model 138s (CD V-138s) (0-200 mR), due to their documented history of electrical leakage problems, must be inspected for electrical leakage at least quarterly and replaced when necessary. This leakage testing will be verified during the exercise, through documentation submitted in the ALC and/or through a Staff Assistance Visit (SAV).

Operational checks and testing of electronic dosimeters must be in accordance with the

• manufacturer's instructions and be verified during the exercise, through documentation submitted in the ALC and/or through an SAV.

Monitoring Instruments: All instruments must be inspected, inventoried, and operationally checked before each use. Instruments must be calibrated in accordance with the manufacturer's recommendations. Unmodified CDV-700 series instruments and other instruments without a manufacturer's recommendation must be calibrated annually. Modified CDV-700 instruments must be calibrated in accordance with the recommendation of the modification manufacturer. A label indicating such calibration must be on each instrument or calibrated frequency can be verified by other means. In addition, instruments being used to measure activity must have a sticker-affixed to their sides indicating the effective range of the readings. The range of readings documentation specifies the acceptable range of readings that the meter should indicate when it is response-checked using a standard test source.

For FMTs, the instruments must be capable of measuring gamma exposure rates and detecting beta radiation. These instruments must be capable of measuring a range of activity and exposure, including radiological protection/exposure control of team members and detection of activity on air sample collection media, consistent with the intended use of the instrument and the ORO's plans/procedures. An appropriate radioactive check source must be used to verify proper operational response for each low-range radiation measurement instrument (less than IR/hr) and for high-range instruments when available. If a source is not available for a high-range instrument, a procedure must exist to operationally test the instrument before entering an area where only a high-range instrument can make useful readings.

22

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital In areas where portal monitors are used, the OROs must set up and operationally check the monitor(s). The monitor(s) must conform to the standards set forth in the Contamination Monitoring Standard for a Portal Monitor Used for Emergency Response, FEMA-REP-21 (March 1995) or in accordance with the manufacturer's recommendations.

Mutual Aid Resources: If the incoming resources arrive with their own equipment (i.e.,

monitors and/or dosimetry), they will be evaluated by REP Program standards. FEMA will not inventory equipment that is not part of the REP Program. If an agency has a defined role in the REP Plan, they are subject to the planning process and standards, as well as the guidance ofthis Manual.

All activities must be based on the ORO's plans/procedures and completed as they would be in an actual emergency, unless noted above or otherwise specified in the Extent-of-Play Agreement.

State Negotiated Extent of Play:

Ambulance crews are not trained or equipped to operate or carry radiological monitoring equipment. In accordance with PEMA SOP Annex E, Appendix 5 "Radiological Exposure Control" (March 2002), ambulance crews operating outside the 10 mile Emergency Planning Zone are considered "Category C" emergency workers; therefore, they are only required to implement protective measures consistent with protection against blood-borne pathogens; i.e.,

long sleeved garments, trousers, impermeable gloves, and surgical masks. "Category C" emergency worker dosimetry issue consists of one permanent reading dosimeter per worker.

Ambulance crews are provided additional dosimetry if they are tasked with entering the 10-mile EPZ.

Hospital personnel are also considered "Category C" emergency workers and will conform to PEMA SOP protective measures at mininium. Direct Reading Dosimeters may be issued individually; however, an Area Kit will be established in the Radiation Emergency Area (REA).

Individual PRDs will be issued by the hospital. Radiological Survey Instruments are calibrated per manufactures recommendations.

Outstanding Issues:

None 23

Peach Bottom Atomic Power Station Medical Services Drill (MS-I)

After Action Report/Improvement Plan Evaluation Area 3-Protective Action Implementation WellSpan Health York Hospital Sub-Element 3.a-Implementation of Emergency Worker Exposure Control Intent This Sub-element is derived from NUREG0654/FEMA-REP-1, 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 PA Gs, and the capability to provide KI for emergency workers, always applying the "as low as is reasonably achievable" principle as appropriate.

Criterion 3.a.1: The OROs issue appropriate dosimetry, KI, and procedures, and manage radiological exposure to emergency workers in accordance with the plans/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. OROs maintain appropriate record-keeping of the administration of KI to emergency workers.

(NUREG-0654/FEMA-REP-1, K.3.a, b; K.4)

Assessment/Extent of Play Assessment of this Demonstration Criterion may be accomplished during a biennial or tabletop exercise. Other means may include drills, seminars or training activities that would fully demonstrate technical proficiency.

OROs must demonstrate the capability to provide emergency workers (including supplemental resources) with the appropriate direct-reading and permanent record dosimetry, dosimeter chargers, KI, and instructions on the use of these items. For evaluation purposes, appropriate direct-reading dosimetry is defined as dosimetry that allows an individual(s) to read the administrative reporting limits that are pre-established at a level low enough to consider subsequent calculation ofTEDE and maximum exposure limits, for those emergency workers involved in lifesaving activities, contained in the ORO's plans/procedures.

Each emergency worker must have basic knowledge of radiation exposure limits as specified in the ORO's plans/procedures. If supplemental resources are used, they must be provided with just-in-time training to ensure basic knowledge of radiation exposure control. Emergency workers must demonstrate procedures to monitor and record dosimeter readings and manage radiological exposure control.

During a plume phase exercise, emergency workers must demonstrate the procedures to be followed when administrative exposure limits and tum-back values are reached. The emergency worker must report accumulated exposures during the exercise as indicated in the plans/procedures. OROs must demonstrate the actions described in the plans/procedures by 24

Peach Bottom Atomic Power Station Medical Services Drill (MS-I)

After Action ReporUimprovement Plan WellSpan Health York Hospital determining whether to replace the worker, authorize the worker to incur additional exposures, or take other actions. If exercise play does not require emergency workers to seek authorizations for additional exposure, evaluators must interview at least two workers to determine their knowledge of whom to contact in case authorization is needed, and at what exposure levels.

Workers may use any available resources (e.g., written procedures and/or co-workers) in providing responses.

Although it is desirable for all emergency workers to each have a direct-reading dosimeter, there may be situations where team members will be in close proximity to each other during the entire mission. In such cases, adequate control of exposure can be achieved for all team members using one direct-reading dosimeter worn by the team leader. Emergency workers assigned to low-exposure rate fixed facilities (e.g., EOCs and communications center within the EPZ, reception centers, and counting laboratories) may have individual direct-reading dosimeters or they may be monitored using group dosimetry (i.e., direct-reading dosimeters strategically placed in the work area). Each team member must still have his or her own permanent record dosimetry. Individuals authorized by the ORO to re-enter an evacuated area during the 'plume (emergency) phase, must be limited to the lowest radiological exposure commensurate with completing their missions.

OROs may have administrative limits lower than EPA-400-R-92-001 dose limits for emergency workers performing various services (e.g., lifesaving, protection of valuable property, all activities). OROs must ensure that the process used to seek authorization for exceeding dose limits does not negatively impact the capability to respond to an incident where lifesaving and/or protection of valuable property may require an urgent response.

OROs must demonstrate the capability to accomplish distribution of KI to emergency workers consistent with decisions made. OROs must have the capability to develop and maintain lists of emergency workers who have ingested KI, including documentation of the date(s) and time(s) they did so. Ingestion of KI recommended by the designated ORO health official is voluntary.

For evaluation purposes, the actual ingestion of KI shall not be performed. OROs must demonstrate the capability to formulate and disseminate instructions on using KI for those advised to take it. Emergency workers must demonstrate basic knowledge of procedures for using KI whether or not the scenario drives the implementation of KI use. This can be accomplished by an interview with the evaluator.

All activities must be based on the ORO's plans/procedures and completed as they would be in an actual emergency, unless noted above or otherwise specified in the Extent-of-Play Agreement.

State Negotiated Extent of Play:

Demonstrate appropriate procedures and equipment to manage radiological exposure to staff.

Demonstrate the ability to transport contaminated/injured individuals while using As Low As Reasonably Achievable (ALARA) principles.

Demonstrate the ability to utilize dosimetry, equipment and procedures to manage 25

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital radiological exposure to emergency workers as required by plans.

Radiological briefings will be provided to address exposure limits and procedures to replace personnel approaching limits and how permission to exceed limits is obtained. At any time, players may ask other players or supervisors to clarify radiological information. In Pennsylvania, emergency workers outside the EPZ do not have tum-back values. Standard issue of dosimetry and potassium iodide for each category of emergency worker is as follows:

Category A: 1PRD, 1 DRD, and 1 unit of KI Category B: 1 PRD and 1 unit of Kl Category C: 1 PRD All locations that have dosimetry equipment indicated within their Radiological Emergency Response Plan (RERP) will make the dosimetry equipment (and KI, as appropriate) available for inspection by the Federal Evaluator. Simulation PRDs with mock serial numbers may be used.

Outstanding Issues:

None 26

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action ReporUimprovemeot Piao Evaluation Area 6-Support Operation/Facilities WellSpan Health York Hospital Sub-Element 6.d-Transportation and Treatment of Contaminated Injured Individuals Intent This Sub-element is derived from NUREG0654/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.

Criterion 6.d.l: The facility/ORO has the appropriate space, adequate resources, and trained personnel to provide transport, monitoring, decontamination, and medical services to contaminated injured individuals.

(NUREG0654/FEMA-REP-1, F.2; H.10; K.5.a, b; L.1, 4)

Assessment/Extent of Play Assessment of this Demonstration Criterion may be accomplished during a biennial exercise, an actual event, or drills. FEMA has determined that these capabilities have been enhanced and consistently demonstrated as adequate; therefore, offsite medical services drills need only be evaluated biennially. FEMA will, at the request of the ORO, continue to evaluate the drills on an annual basis. All hospitals listed in the plan as medical services hospitals must be evaluated, with a transportation provider, every 2 years. Additional transportation providers will be rotated through the drills in the 8-year exercise cycle. For the ambulance providers who do not participate in an evaluated drill during the two year cycle, training will be provided. This training will be documented in the ALC.

Monitoring, decontamination, and contamination control efforts must not delay urgent medical care for the victim.

OROs must demonstrate the capability to monitor/decontaminate and transport contaminated injured individuals to medical facilities.

An ambulance must be used for response to the victim. However, to avoid taking an ambulance out of service for an extended time, OROs may use any vehicle (e.g., car, truck, or van) to transport the victim to the medical facility. It is allowable for an ambulance to demonstrate up to the point of departure for the medical facility and then have a non-specialized vehicle transport the "victim(s)" to the medical facility. This option is used in areas where removing an ambulance from service to drive a great distance (over an hour) for a drill would not be in the best interests of the community.

Normal communications between the ambulance/dispatcher and the receiving medical facility must be demonstrated. If a substitute vehicle is used for transport to the medical facility, this communication must occur before releasing the ambulance from the drill. This communication would include reporting radiation monitoring results, if available. In addition, the ambulance 27

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WelJSpan Health York Hospital crew must demonstrate, by interview, knowledge of where the ambulance and crew would be monitored and decontaminated, if required, or whom to contact for such information.

Monitoring of the victim may be performed before transport or enroute, or may be deferred to the medical facility. Contaminated injured individuals transported to medical facilities are monitored as soon as possible to assure that everyone (ambulance and medical facility) is aware of the medical and radiological status of the individual(s). However, if an ambulance defers monitoring to the medical facility, then the ambulance crew presumes that the patient(s) is contaminated and demonstrate appropriate contamination controls until the patient(s) is monitored. Before using monitoring instruments, the monitor(s) must demonstrate the process of checking the instrument(s) for proper operation. All monitoring activities must be completed as they would be in an actual emergency. Appropriate contamination control measures must be demonstrated before and during transport and at the receiving medical facility.

The medical facility must demonstrate the capability to activate and set up a radiological emergency area for treatment. Medical facilities are expected to have at least one trained physician and one trained nurse to perform and supervise treatment of contaminated injured individuals. Equipment and supplies must be available for treatment of contaminated injured individuals.

• The medical facility must demonstrate the capability to make decisions on the need for decontamination of the individual, follow appropriate decontamination procedures, and maintain records of all survey measurements and samples taken. All procedures for collection and analysis of samples and decontamination of the individual must be demonstrated or described to the evaluator. Waste water from decontamination operations must be handled according to facility plans/procedures.

All activities must be based on the ORO's plans/procedures and completed as they would be in an actual emergency, unless noted above or otherwise specified in the Extent-of-Play Agreement.

State Negotiated Extent of Play:

Demonstrate that the facility has the appropriate space, adequate resources and trained personnel to provide monitoring, decontamination and medical services to contaminated/injured individuals.

Demonstrate the ability to transport contaminated/injured individuals while using ALARA principles.

Delta-Cardiff EMS will pick-up a pre-staged simulated contaminated/injured victim.

Outstanding Issues:

None 28

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital WellSpan Health York Hospital Medical Services Drill (MS-1)

May 26, 2017 EXERCISE

SUMMARY

The purpose of this exercise is to demonstrate the capabilities of the emergency response organizations in York Cou,nty in handlmg contaminated/injured persons and to satisfy both the hospital's requirement for an emergency/drill and the "Medical Services Guidance Memorandum MS-1."

PARTICIPANTS WellSpan Health York Hospital Delta Cardiff Emergency Medical Services York County Office of Emergency Management Pennsylvania Emergency Management Agency Federal Emergency Management Agency CONTROLLERS Pennsylvania Emergency Management Agency York County Office of Emergency Management Exelon Corporation EVALUATORS Federal Emergency Management Agency OBSERVERS York County Office of Emergency Management Pennsylvania Emergency Management Agency Logistics Systems Incorporated 29

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan OBJECTIVES WellSpan Health York Hospital WellSpan Health York Hospital & Delta-Cardiff EMS A.

Demonstrate the ability to respond to a radiation medical emergency following Yark County Office of Emergency Management, Delta-Cardiff EMS and Well Span Health Yark Hospital procedures.

B.

Demonstrate timely and accurate communications between the hospital and offsite response agencies. (Telephones will be used in lieu of radios whenever possible to limit the potential misinterpretation of the exercise as an actual event.)

C.

Demonstrate correct priorities and appropriate techniques in EMS, transportation of patients and pre-hospital and hospital emergency care of radioactively contaminated patients.

D.

Demonstrate inter-agency cooperation between the Delta-Cardiff Emergency Medical Services Company and WellSpan Health Yark Hospital.

SCHEDULE OF EVENTS WellSpan Health York Hospital 0730 Exercise commence.

0740 Delta-Cardiff Emergency Medical Services Company and WellSpan Health York Hospital.are notified that the Emergency Classification Level (ECL) at Peach Bottom Atomic Power Station (PBAPS) has escalated to a Site Area Emergency.

0750 Delta-Cardiff Emergency Medical Services Company and WellSpan Health York Hospital are notified that the Emergency Classification Level at PBAPS has escalated to a General Emergency.

0800 Hospital is notified of a potentially contaminated injured patient.

09:00 Patient arrives at the Hospital.

1000 Exercise ends.

1015 Critique (Hotwash) immediately following the exercise 30

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital Delta-Cardiff Emergency Medical Services EMS 0730 Exercise commenced.

07 40 Delta-Cardiff Emergency Medical Services Company is notified that the emergency at the Peach Bottom Atomic Power Station (PBAPS) has escalated to a Site Area Emergency.

0750 Ambulance Company is notified that the emergency at PBAPS has escalated to a General Emergency.

0755 An Ambulance is requested to report to the accident site to pick up an injured and potentially contaminated individual. (Simulated - Staging will be at the Delta Cardiff EMS Station - 500 Main Street Delta, PA).

0800 Hospital is notified that an injured potentially contaminated victim will be brought in for treatment.

0805 Ambulance leaves for hospital. Ambulance Company will respond without siren and lights.

0900 Ambulance arrives at the hospital.

0915 Exercise ends for Ambulance crew.

1015 Critique at hospital immediately following the drill.

SCENARIO 0740 Ambulance and the Hospital are notified that an emergency at PBAPS has escalated to a Site Area Emergency.

0750 Ambulance Company and Hospital are notified that the PBAPS emergency has escalated to a General Emergency.

0755 Ambulance is requested to report to the accident scene (simulated-staging will be at the Delta Fire/EMS Station - 500 Main Street Delta, PA) to pick up an injured and potentially contaminated person.

0800 WellSpan Health York Hospital is notified that an __ injured potentially contaminated victim will be brought in for treatment.

0805 The ambulance leaves for the hospital.

0900 The ambulance arrives at the hospital.

31

Peach Bottom Atomic Power Station Medical Services Drill (MS-1)

After Action Report/Improvement Plan WelISpan Health York Hospital 0915 Exercise ends for the ambulance company, hospital staff takes control of the contaminated/injured person. Ambulance and crew are monitored before being released.

0955 After the patient is stabilized and decontaminated, cleanup of the area begins (explained not demonstrated).

1000 Exercise ends.

1015 Critique at hospital immediately following the drill.

CONTROLLER PROMPTS 0740 The ambulance company and the hospital are informed that the plant has declared a Site Area Emergency. Instruct staff to prepare for possible contaminated/injured victim.

0750 The ambulance company and the hospital are notified that he plant has declared a General Emergency.

0755 Notify Delta-Cardiff Emergency Medical Services Company to pick up potentially contaminated and injured victim. (Simulated - staging will be at the Delta-Cardiff Emergency Medical Services Company EMS).

0800 Notify the hospital that a potentially contaminated and injured victim is being brought in. The nature of the injuries and the extent of contamination are unknown.

0805 Release the Ambulance to leave for the Hospital.

0900 The ambulance arrives at the hospital.

NOTE: The EMS crew is working in the EPZ making them "Category A" Emergency Workers. The county will simulate the municipal dispersion of dosimetry/KI and provide a radiological briefing.

The controller should precede and conclude all transmissions with "THIS IS A DRILL" CONTROLLER ASSIGNMENTS York County Emergency Management Agency, Pennsylvania Emergency Management Agency Exelon Corporation 32

Peach Bottom Atomic Power Station WellSpan Health York Hospital Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital 1001 S. George Street Contact Chuck Stevens York, PA 17403 717-851-2345 Delta-Cardiff EMS 3576 Delta Road Contact Laura Taylor, EMS Chief Airville, PA 17302 717-673-0792 York County Office of Emergency Management 120 Davies Drive Contact Shen Kreiser York, PA 17402 717-840-2990 EMS Staging Location Delta-Cardiff Fire/EMS Company 500 Main Street Delta, PA 1 7314 INJURED PERSON During the emergency at Peach Bottom Atomic Power Station a farmer was following direction to place his animals under roof and provide with stored feed and water. While herding his sheep into a shed he slipped and fell twisting his right knee. He crawled about 3 00 yards across the pasture to his vehicle. The sheep were milling about and one caught him on the cheek with her hoof during the sounding of the sirens. Peach Bottom ordered an evacuation due to imminent or actual release of radiation during the time he was crawling across the pasture. When the farmer reached his vehicle, he drove to a friend's house near Delta Pennsylvania for assistance and when he arrived the friend called for EMS due to possible "radiation disease".

The patient rubbed his left cheek with the left hand several times in the presence of EMS and was agitated about this "radiation disease". The patient could potentially touch EMS and hospital staff and spread contamination.

Injuries: Laceration to left cheek and pairi in the right knee.

Contamination: Initial readings at the hospital are indicated in counts per minute ( cpm) below:

Laceration to Left Cheek - (2400 cpm) Initial Left Hand - (9,000 cpm) Initial Right Hand - (7,600 cpm) Initial Vitals Blood Pressure:

130/88 Pulse: 72 Breathing: 12 Temperature: Normal Nausea: No Vision: Clear, eyes equal and reactive (PEARL) 33

Peach Bottom Atomic Power Station No Known Allergies.

Medical Services Drill (MS-1)

After Action Report/Improvement Plan WellSpan Health York Hospital Complaint of pain on left cheek and right knee. Patient indicated pain upon palpation.

Upon inspection, medical providers saw a laceration to the left cheek. Patient had difficulty walking due to pain. Medical evaluation showed swelling to the knee and a 3" laceration with bleeding from the cheek. Patient provided appropriate responses to all other queries.

Neck-Front All Readings - 1000 Right Palm:

1st reading - 7,600 cpm 2°d reading - 5,500 cpm 3rd reading - 100 cpm Twisted Right Knee Yellow indicates areas of contamination Red indicates injury Laceration to Left Cheek:

1st reading - 2400 cpm 2nd reading _800 cpm 3rd reading _250 cpm Left Palm:

1st reading - 9000 cpm 2nd reading 4000 cpm 3rd reading 200 cpm Patient complaining of pain in Right Knee and Left Cheek. If X-rays are taken, the hospital will not find evidence of a fracture. Bleeding at the laceration was self-controlled before EMS arrival.

Controller/Evaluator Note: REAC/TS has been contacted and can participate in the exercise.

34

Peach Bottom Atomic Power Station Medical Services Drill (MS-I)

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35 WellSpan Health York Hospital