ML18327A042

After Action Report/Improvement Plan

ML18327A042
Person / Time
Site:	Arkansas Nuclear
Issue date:	11/14/2018
From:	US Dept of Homeland Security, Federal Emergency Management Agency
To:	Office of Nuclear Reactor Regulation, NRC Region 4
Shared Package
ML18327A065	List: ML18327A041 ML18327A042
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Download: ML18327A042 (29)

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I After Action Report/

I Improvement Plan I

Drill Date - September 2 7, 2018 I .Radiological Emergency Preparedness (REP) Program I

I FEMA November 14, 2018 I

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I Unclassified Radiological Emergency Preparedness Program (REP)

I After Action Report/Improvement Plan Arkansas Nuclear One I

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

SUMMARY

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

SUMMARY

................................................................................8 I 2.1 Exercise Purpose and Design ................................................................................................... 8 2.2 Exercise Objectives, Capabilities and Activities ......... :............................................................. 8 2.3 Scenario Summary ....................................... :.......................................................................... 8 I SECTION 3: ANALYSIS OF CAPABILITIES._. .................................................................................9 3.1 Exercise Evaluation and Results .............................................................................................. 9 I 3.2 Summary Results of Exercise Evaluation .................................................................... 9 3.3 Criteria Evaluation Summaries .............. .-.............................................................................. 11 3 .3. I Risk Jurisdictions ....................................................................................................................... 11 I SECTION 4: CONCLUSION ..................................................................................................... 14 APPENDIX A: EXERCISE EVALUATORS AND TEAM LEADERS ................................................... 15 I APPENDIX B: ACRONYMS AND ABBREVIATIONS ................................................................... 16 APPENDIX C: EXPLAN ........................................................................................................... 17 I

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EXECUTIVE

SUMMARY

I On September 27, 2018, Out of sequence Medical Services and Reception Center drills were I conducted for St Mary's Medical Center, Pope County Emergency Medical Services (EMS)- St Mary's Station in Russellville and the Paris Reception Center in Paris, Arkansas. Personnel from the U.S. Department of Homeland Security/Federal Emergency Management Agency I (DHS/FEMA) Region VI, evaluated all activities. The drills were conducted to assess the level of preparedness oflocal responders to react to a simulated radiological emergency at Arkansas Nuclear One (ANO). The previous St. Mary's Medical Center and Pope County EMS-St.

I Mary's Station drill was conducte_d on October 20, 2016.

I Personnel from the Pope County EMS, St. Mary's Regional Medical Center, City of Paris, City of Ratcliff, City of Midway, City of Subiaco and Logan County Emergency Management participated in the drills. Evaluation Areas demonstrated included: Facilities, Equipment and I 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 drills, and

• DHS/FEMA wishes to acknowledge these efforts.

I This report contains the final written evaluation of the out of sequence drills. The participants I demonstrated knowledge of their emergency response plans and procedures and they adequately implemented them. There were no Level 1 Findings, and two Level 2 Findings identified which were corrected during the drill. There were no Plan Issues identified.

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SECTION 1: EXERCISE OVERVIEW I 1.1 Exercise Details I Exercise Name Arkansas Nuclear One I Type of Exercise I Plume - Out of Sequence Drills Exercise Date I September 27, 2018 Program I Department of Homeland Security (DHS)/Federal Emergency Management Agency (FEMA) Radiological Emergency Preparedness Program I Scenario Type Plume - Medical Services Drill and Reception Center Drill I 1.2 Exercise Planning Team Leadership I Denise Bordelon Technological Hazards Branch Chief I FEMA Region VI 800 N. Loop 288 Denton, TX, 76209 I (940) 383-7387 .

Denise.Bordelon@fema.dhs.gov I Nan Williams RAC Chair FEMA Region VI I 800 N. Loop 288 Denton, TX, 7 6209 I (940) 898-5398 Nan.Williams@fema.dhs.gov I 6 I

I Unclassified Radiological Emergency Preparedness Program (REP)

I After Action Report/Improvement Plan Arkansas Nuclear One I Elsa Lopez Senior Site Specialist I FEMA Region VI 800 N. Loop 288 I Denton, TX, 76209 (940) 898-5308 elsa.lopez@fema.dhs.gov I J. Chris Meyer Section Chief/State Planning Team Lead I Arkansas Department of Health Nuclear Planning & Response Program I 305 South Knoxville Avenue Russellville, AR 72801 (479) 968-7171 I chris.meyer@arkansas.gov I 1.3 Participating Organizations Agencies and organizations of the following jurisdictions participated in the Arkansas Nuclear I One drills:

State Jurisdictions I Arkansas Department of Health Risk Jurisdictions I Paris Fire Department Paris School District Pope County Emergency Medical Services - St. Mary's Station I Logan County Office of Emergency Management Support Jurisdictions Midway Rural Fire Department Ratcliff Rural Fire Department Subiaco Crossroads Volunteer Fire Department Private Organizations American Red Cross Arkansas Nuclear One St. Mary's Regional Medical Center

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SECTION 2: EXERCISE DESIGN

SUMMARY

_I 2.1 Exercise Purpose and Design I The DHS/FEMA Region VI Office evaluated the drills on September 27, 2018 to 'assess the capabilities oflocal emergency preparedness organizations in implementing their Radiological .

I 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 I simulated radiological emergency.

I 2.2 Exercise Objectives, Capabilities and Activities I Exercise objectives and identified Capabilities/REP Criteria selected to be exercised are discussed in the Exercise Plan (EXPLAN).

I 2.3 Scenario Summary I The driH 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 I radiologically contaminated injured individual and reception center support operations. The drill scenario provided for the evaluation of the Paris Reception Center, St. Mary's Medical Center and Pope County Emergency Medical Services (EMS)- St. Mary's Station.

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SECTION 3: ANALYSIS OF CAPABILITIES I

3.1 Exercise Evaluation and Results I Contained in this section are the results and findings of the evaluation of all jurisdictions and functional entities, which participated in the September 27, 2018 Medical Services and I Reception Center drills to test the offsite emergency response* capabilities of local governments and support medical centers for Arkansas Nuclear One (ANO).

I Each jurisdiction and functional entity was evaluated on the basis of its demonstration of criteria delineated in the exercise evaluation areas as outlined in the REP Program Manual, dated I January 2016. Detailed information on the exercise evaluation area criteria and the extent of play agreement used in these drills are found in Appendix C of this report.

I 3.2 Summary Results of Exercise Evaluation I The matrix presented in Table 3 .1, on the following page, presents the status of all exercise evaluation area criteria from the REP Program Manual that were scheduled for demonstration I during these drills 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:

I M - Met (No Findings assessed and no unresolved Level 2 Findings from prior exercises) ,

I 1 - Level 1 Finding Assessed I 2 - Level 2 Finding Assessed I P - Plan Issue I N - Not Demonstrated I 9 I

I Unclassified Radiological Emergency Preparedness Program (REP)

I After Action Report/Improvement Plan Arkansas Nuclear One I Tables 3 .1 - Summary of Exercise Evaluation I Table 3.la - Exercise Evaluation - Criteria Met I -,, .. -,_

Date: 9/27/2018 Site: Arkansas Nuclear One

.. <JI/:;/'.I:.,6cad.Qr(-"'. '., _/: **.- _ <: .ci;it~'iia.1'1t1e<. -- - )\' . ' *i:*: *;- I/!-*:::,:-'

--:--: ..-,:.. ;Criteria(}':_  :,

I Pope County EMS-St. Mary's Station Contaminated Injured Transport & Care 6dl Pope County EMS-St. Mary's EW Exposure Control Implementation 3al I Station Pope County EMS-St. Mary's Equipment and Supplies lel Station I St. Mary's Regional Medical Center St. Mary's Regional Medical Contaminated Injured Transport & Care EW Exposure Control Implementation 6dl 3al 1

I Center St. Mary's Regional Medical Center Equipment and Supplies lel I Paris Reception Center Paris Reception Center Paris Reception Center Facilities Equipment and Supplies EW Exposure Control Implementation lbl lel 3al Paris Reception Center Monitoring, Decontamination & Registration of I Paris Reception Center Evacuees Temporary Care of Evacuees 6al 6cl I

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I After Action Report/Improvement Plan Arkansas Nuclear One I 3.3 Criteria Evaluation Summaries I 33.1 Risk Jurisdictions I 3.3.1.1 Pope County EMS - St. Mary's Station I In summary, the status ofDHS/FEMA criteria for the Risk jurisdiction is as follows:

a. MET: l.e.1, 3.a.1, 6.d.1 I b. LEVEL 1 FINDINGS: NONE I c. LEVEL 2 FINDINGS: NONE I d. PLAN ISSUES: NONE

,- e. PRIOR ISSUES - RESOLVED: NONE

f. PRIOR ISSUES - UNRESOLVED: NONE 1 3.3.1.2 St. Mary's Medical Center I In summary, the status ofDHS/FEMA criteria for the Risk jurisdiction is as follows: *

a. MET: l.e.1, 3.a.l, 6.d.l I b. LEVEL 1 FINDINGS: NONE I c. LEVEL 2 FINDINGS: NONE ISSUE NO.: 01-18-6dl-L2-0l I CRITERION: Transportation and treatment of contaminated injured individual I CONDITION: Following transfer of the patient to the hospital Wash Down Room, the Radiation Safety Officer commenced surveying the patient, it was I noted that the pancake probe touched the draping and the cord also was toughing the draping. In addition, the surveying technique was too fast to properly detect I contamination.

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POSSIBLE CAUSE: Weak monitoring skills and lack of knowledge of I procedures.

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REFERENCE:

NUREG-0654/FEMA-REP-1, K.5.b EFFECT: A potenticil of spread of contamination to the patient and/or hospital I staff in the Wash Down Room.

I CORRECTIVE ACTION DEMONSTRATED: A timeout was called by the controller and training was conducted. The controller re-started the drill and the Radiation Safety Officer re-surveyed the patient using proper monitoring I technique.

I ISSUE NO.: 01-18-6dl-L2-02 CRITERION: Transportation and treatment of contaminated injured individual.

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.CONDITION: Following the last de-contamination attempt using wet gauze wipes (reducing contamination below 300 cpm) the Radiation Safety Officer (RSO) conducted a survey of the wound area of the leg omitting the back of the leg. *

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I POSSIBLE CAUSE: Weak monitoring skills and no posters or cue cards to assist ii with monitoring procedures or technique.

REFERENCE:

NUREG-0654/FEMA-REP-1, K.5.a, b.

EFFECT: The pahent was scheduled for an x-ray and then being transferred to the operating room which could potentially spread contamination into the hospital and members of the public.

I CORRECTIVE ACTION DEMONSTRATED: A time out was called by the controller and training was conducted. The controller re-started the drill and a I thorough survey of the wound area and leg were demonstrated adequately.

I d. PLAN ISSUES: NONE 12 I

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e. PRIOR ISSUES - RESOLVED: NONE I f. PRIOR ISSUES - UNRESOLVED: NONE I 3.3.1.3 Paris Reception Center I In summary, the status ofDHS/FEMA criteria for the Risk jurisdiction is as follows:

I a. MET: l.b.l, l.e.l, 3.a.1, 6.a.l, 6.c.l

b. LEVEL 1 FINDINGS: NONE I d. LEVEL 2 FINDINGS: NONE I d. PLAN ISSUES: NONE

e. PRIOR ISSUES - RESOLVED: NONE I f. PRIOR ISSUES - UNRESOLVED: NONE I

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I After Action Report/Improvement Plan Arkansas Nuclear One I SECTION 4: CONCLUSION I 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 I 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 I Arkansas site-specific to Arkansas Nuclear One will remain in effect.

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APPENDIX A: EXERCISE EVALUATORS AND I TEAM LEADERS I DATE: 9/27/2018 SITE: Arkansas Nuclear One I

I Pope County EMS, St. Mary's Station Brad DeKorte Elsa Lopez DHS-FEMA DHS-FEMA I St. Mary's Medical Center Nan Williams Tonya Davis DHS-FEMA DHS - FEMA OJT Elsa Lopez DHS-FEMA I Paris Reception Center Nan Williams Brad Dekorte DHS-FEMA DHS-FEMA Tonya Davis DHS - FEMA OJT I

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APPENDIX B: ACRONYMS AND I ABBREVIATIONS I Acronym Descrjption ADH Arkansas Department of Health I ANO ARC Arkansas Nuclear One American Red Cross I ANO CPM Arkansas Nuclear One Counts per Minute DHS/FEMA Department of Homeland Security/Federal Emergency Management Agency I DRD EMS Direct Reading Dosimeter Emergency Medical Services

.1 EPD ER Electronic Personnel Dosimeter Emergency Room EW Emergency Worker I KI NP&RP Potassium Iodide Nuclear Planning and Response Program I OEM OSL Office of Emergency Management .

Optically Stimulated Luminescent PPE Personnel Protective Equipment I RC Reception Center Radiological Emergency Preparedness REP I RSO RT Radiation Safety Officer Radiological Technician Wash Down Room I WDR I

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APPENDIX C: EXERCISE PLAN I

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St Mary's MS-1 and Paris Care Center Evaluation I September 27, 2018 Extent-of-Play (EOP) Agreement Between I The Arkansas Department of Health, representing the Off-Site Response Organizations, and FEMA Region VI I

EVALUATION AREA 1 I Emergency Operations Management I Sub-element 1.b- Facilities INTENT I This sub-element is derived from NUREG-0654, which provides that Offsite Response Organizations (ORO) have facilities to support the emergency response.

I Criterion 1.b.1: Facilities are sufficient to support the emergency response. (NUREG-0654/FEMA-REP-1, H.3; G.3.a; J.10.h; J.12; K.5.b)

Locations: Paris Reception Center Paris I EOP: First time in new 8-year cycle.

I ARCA: None I

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I After Action Report/Improvement Plan Arkansas Nuclear One Sub-element 1.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 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; /.7, 8, 9; J.10.a, b, e; J.11, 12; K.3.a; K.5.b)

• Locations: Paris Reception Center, Paris; Pope County EMS St. Mary's Station, Russellville; St Mary's Hospital, Russellville.

EOP: 1. Meters or DRDs that have labels that have their calibration and quarterly I operational check dates. Operational checks of meters will be performed before use, using range of readings stickers on the meters.

2. The quantities of Dosimetry and the*quantities and expiration of Kl will be I confirmed by evaluators at locations identified in, plans.

3. It is Arkansas policy to issue Kl only to Emergency I Workers (EW) and institutionalized individuals. Kl is not issued to the general public.

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

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

I ARCA: None I

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I After Action Report/Improvement Plan Arkansas Nuclear One I EVALUATION AREA 3 I Protective Action Implementation Sub-element 3.a - Implementation of Emergency Worker Exposure Control I INTENT This Sub-element is derived from NUREG-0654/FEMA-REP-1, which requires that OROs have the I capability to provide for the following: distribution, use, collection, and processing of direct-reacling dosimetry and permanent record dosimetry; reading of direct-reading dosimetry by emergency workers at appropriate frequencies; maintaining a radiation dose record for each emergencyworker; establishing a decision chain or authorization procedure for emergency workers to incur radiation exposures in excess I of the PAGs, and the capability to provide Kl for emergency workers, always applying the -as low as is reasonably achievableJJ principle as appropriate.

I 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-I keeping of the administration of Kl to emergency workers. (NUREG-0654/FEMA-REP-1, J.10.e; K.3.a, b; K.4)

I Locations: Paris Reception Center, Paris; Pope County EMS St. Mary's Station, Russellville; St. Mary's Regional Medical Center, Russellville.

EOP 1. It is Arkansas policy to issue Kl only to Emergency I Workers (EW) and institutionalized individuals. Kl is not issued to the general public.

I 2. The listing of EWs who have ingested Kl 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 Kl will have a form documenting when it was taken. These forms would be I the basis for developing this list. Forms will be available for evaluator review.

I 3. It is Arkansas policy to issue Kl only to Emergency Workers (EW) and institutionalized individuals. EWs that decline to take Kl may not be identified in advance. If they decline to take Kl at their duty stations, they will not be placed in positions that would expose them to radiation. Kl is I not issued to the general public.

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

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

ARCA: None I

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I After Action Report/Improvement Plan Arkansas Nuclear One I EVALUATION AREA 6 I Support Operation/Facilities Sub-element 6.a - Monitoring and Decontamination of Evacuees and Emergency Workers and

. Registration of Evacuees I INTENT I This Sub-element is derived from NUREG-0654/FEMA-REP-1, which requires that OROs have the capability to implement radiological monitoring and decontamination of evacuees, while minimizing contamination of the facility. OROs must also have the capability to identify and register evacuees at reception centers I Criterion 6.a. 1: The reception center facility has appropriate space, adequate resources, and trained personnel to provide monitoring, decontamination, and registration of evacuees. (NUREG-I 0654/FEMA-REP-1, A.3; C.4; J.10.h; J.12)

Locations: Paris Reception Center, Paris I EOP: 1. One portal monitor and one side of decon will be set up.

A minimum of 6 people and 2 vehicles will go through the reception and monitoring procedures.

I One person and one vehicle will visit the decon facility.

Qecon will be performed IAW procedures, however, only one decon area will be setup and demonstrated.

I 2. Alternate locations for vehicleDecon may be required because of school activities. Interior of vehicles will not be monitored or decontaminated.

Due to a previously scheduled activity, an area will be roped off to reserve I 3.

it for the decon demonstration.

This EA will be demonstrated out-of-sequence on September 27, 2018 at approximately 1830.

I 4. Sealed lockers will not be opened unless necessary.

I 5. Twenty percent of the expected population at the Paris Reception Center is 179. In order to monitor this number in 12 hours1.388889e-4 days <br />0.00333 hours <br />1.984127e-5 weeks <br />4.566e-6 months <br />; 14.9 people per hour must be monitored. Since, 1 person can be monitored every 20 seconds using the portal monitors, 180 persons can be monitored per hour. That I would require one portal monitor and less than one hour to complete.

Since only 1/3 of the required needed to monitor 20 percent is required for demonstration, only one monitor will be set up. The minimum of 6 people I 6.

will be monitored.

Personnel supporting the RC out of sequence activities will be alerted and notified at approximately 1800 hours0.0208 days <br />0.5 hours <br />0.00298 weeks <br />6.849e-4 months <br />. The controllers will call the County I Warning Point to start the notification.

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I After Action Report/Improvement Plan Arkansas Nuclear One I 7. Correction-on-the-spot will be considered at these locations at the discretion of and concurrence between the evaluator and the controller.

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

IAW plans, ADH staff will be available at centers to provide technical assistance.

I 9. Personnel who are not contaminated will be allowed into the registration area without documentation that their vehicles are free from contamination.

I Vehicles of contaminated registrants will be identified with "possible interior contamination" and will be impounded until they are monitored and decontaminated. Interior monitoring and decontamination will not be demonstrated.

I ARCA: NONE I

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I Sub-element 6.c - Temporary Care of Evacuees INTENT I This Sub-element is derived from NUREG-0654/FEMA-REP~1. which requires OROs to have the capability to establish relocation centers in host/support jurisdictions. The American Red Cross normally provides congregate care in support of OROs under existing letters of agreement I Criterion 6.c. 1: Managers of congregate care facilities demonstrate that the centers have resources to provide services and accommodations. consistent with American Red Cross I planning guidelines. Managers demonstrate the procedures to assure that evacuees have been monitored for contamination and have been decontaminated as appropriate prior to entering congregate care facilities. (NUREG-0654/FEMA-REP-1, J.10.h, J.12)

I Locations: Paris Reception Center, Paris I EOP: 1. The RC shelter manager or designee will be interviewed about RC activities.

I 2. An American Red Cross representative will be interviewed (location and time TBD) about Mass Shelters and the American Red Cross plan for converting Care Centers to Mass Shelters.

I 3. :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 I ARCA: None

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I After Action* Report/Improvement Plan Arkansas Nuclear One I Sub-element 6.d - Transportation and Treatment of Contaminated Injured Individuals INTENT I 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 I

Criterion 6.d.1: The facility/ORO has the appropriate space, adequate resources, and trained I personnel to provide transport, monitoring, decontamination, and medical services to contaminated injured individuals. (NUREG-0654/FEMA-REP-1, F.2; H.10; K.5.a, b; L.1, 4)

I Locations:

EOP:

Pope County EMS St. Mary's Station, Russellville

1. ThE_l EMS will pick up the patient at an Entergy facility. Prior to transfer of patient to the hospital, the EMS will I demonstrate monitoring the patient. After patient transfer, the EMS will demonstrate vehicle monitoring.

The ambulance will not be draped.

I 2. This EA will be demonstrated out-of-sequence on or about 0830 on September 27, 2018.

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Any real emergency will take precedence.

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

I ARCA: .None Locations: St Mary's Regional Medical Center, Russellville.

I EOP: 1. This EA will be demonstrated out-of-sequence on or about 0830 on September 27, 2018.

I 2. Any real emergency will take precedence.

3. Procedures at the hospital do not require draping of I halls and entrances.

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

5. The play of ANO technicians at the hospital will be limited.

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I Arkansas Nuclear One 2018 MS-1 Drill I September 27, 2018 I

SCENARIO: ANO and Pope County EMS I

I Stipulations:

Although the event takes place in a radiation area in the plant, for exercise purposes, the patient will be presented for transport by the Pope County Ambulance Service at the Reeve E. Ritchie Training Center I (RERTC}.

Evasive medical procedures, such as, IV Therapy, will be simulated.

I EMS personnel will wear gloves, but not anti-c clothing.

Emergency situations will take precedence over exercise activities.

I EVENT:

Outage maintenance is being performed on a steam line in the Unit 2 Containment Building, when a I worker loses his footing and tumbles from a scaffolding and falls approximately 12 feet to the concrete floor below. The impact results in a compound fracture to the workers right ankle. The workers anti-c clothing is ripped and the wound sight is contaminated.

I The ANO medical team responds, performs a primary medical survey, controls the bleeding with a pressure bandage and immobilizes the extremity. Due to the fall, the patient is placed in a cervical collar and on a spine board. The ANO medical team removes the patient from the radiation area and awaits an I ambulance from Pope County EMS.

The Unit Two Control Room notifies Pope County that an ambulance 'is needed.

I The Pope County 911 center dispatches the Pope County Ambulance Service (St. Mary's Station) to the accident at ANO and advises the patient may be contaminated.

I Initial radiation readings at the wound area are noted to be 12,500 cpm.

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I After Action Report/Improvement Plan Arkansas Nuclear One I Up on arrival at the RERTC, ambulance personnel are met by members of the ANO Emergency Medical Te am, who have the patient stabilized and in a body bag to contain contamination.

I Th e ANO Emergency Medical Team provides the following patient information to the ambulance pe rsonnel:

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• Patient is suffering from an open fracture to the right ankle, which has been splinted and bandaged, but has not been reduced.

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• There is a diminished pulse present in the right foot and there is loss of motion in the right foot.

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

• bandage.

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

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• The following vital signs are noted:

o BP is 100/65 o Pulse is rapid I o Respiration is rapid and shallow o The wound site is contaminated with a reading of 12,500 cpm I Th e following patient information is available on request:

• Lung sounds are clear I

• Movement is noted in upper extremities Medical history is negative for pre-existing chronic conditions

• Patient has no know allergies I

Th ere have been no notable changes in vital signs during transport.

I Th e initial radiological survey of the patient reveals a slow increase to a reading of 12,500 CPM at the WO und site. All other survey results yield counts of less that 300 CPM.

I Ra diation readings following each decontamination step are noted in the chart below:

I Initial Reading prior to Decontamination Reading Following Decontamination Step #1 12,500 CMP 5,000 CPM I Reading Following Decontamination Step #2 Reading Following Decontamination Step #3 1,25 CPM Back Ground I

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I Arkansas Nuclear One 2015 MS-1 Drill I SCENARIO: St. Mary's Regional Medical Center:

I Stipulations:

I Although the event takes place in a radiation area in the plant, for exercise purposes, the patient will be presented for transport by the Pope County Ambulance Service at the Reeve E. Ritchie Training Center (RERTC).

I Evasive medical procedures, such as, IV Therapy, will be simulated.

I Diagnostic procedures, such as x-rays, will be simulated.

Emergency situations will take precedence over exercise activities.

I EVENT:

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Outage maintenance is being performed on .a steam line in the Unit 2 Containment Building, when a worker loses his footing and tumbles from a scaffolding and falls approximately 12 feet to the concrete floor below. The impact results in a compound fracture to the workers right ankle. The workers anti-c I clothing is ripped and the wound sight is contaminated.

The ANO medical team responds, performs a primary medical survey, controls the bleeding with a I pressure bandage and immobilizes the extremity. Due to the fall, the patient is placed in a cervical collar and on a spine board. The ANO medical team removes the patient from the radiation area and awaits an ambulance from Pope County EMS.

I The Unit Two Control Room notifies Pope County that an ambulance is needed.

I The Pope County 911 center dispatches the Pope County Ambulance Service (St. Mary's Station) to the accident at ANO and advises the patient may be contaminated.

The patient is stabilized and transported via ambulance to St. Mary's Regional Medical Center.

I Pope County EMS notifies St. Mary's that is inbound with an injured and radiologically contaminated patient. An ANO Radiation Technician is onboard th.e ambulance to provide radiological support to I medical personnel.

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I Unclassified Radiological Emergency Preparedness Program (REP)

I After Action Report/Improvement Plan Arkansas Nuclear One I Upon arrival at St, Mary's the following patient information is provided to St. Mary's personnel:

I Patient is suffering from an open fracture to the right ankle, which has been splinted and bandaged, but has not been reduced.

I There is a diminished pulse present in the right foot and there is loss of motion in the right foot.

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

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

The following vital signs are noted:

I 0 BP is 100/65 0 Pulse is rapid I 0 Respiration is rapid and shallow I 0 The wound site is contaminated with a reading of 12,500 cpm The following patient information is available on request:

I Lung sounds are clear Movement is noted in upper extremities I Medical history is negative for pre-existing chronic conditions Patient has no know allergies I There have been no notable changes in vital signs during transport.

I The initial radiological survey of the patient reveals a slow increase to a reading of 12,500 CPM at the wound site. All other survey results yield counts of less that 300 CPM.

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

I Initial Reading prior to Decontamination 12,500 CMP Reading Following Decontamination Step #1 5,000 CPM I Reading Following Decontamination Step #2 Reading Following Decontamination Step #3 1,25 CPM Back Ground I

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I Unclassified Radiological Emergency Preparedness Program (REP)

I After Action Report/Improvement Plan Arkansas Nuclear One I

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