ML20062B364
| ML20062B364 | |
| Person / Time | |
|---|---|
| Site: | Saint Lucie  |
| Issue date: | 06/20/1981 |
| From: | LAWNWOOD MEDICAL CENTER, FT. PIERCE, FL |
| To: | |
| Shared Package | |
| ML17212B786 | List: |
| References | |
| PROC-810620-01, NUDOCS 8208040459 | |
| Download: ML20062B364 (20) | |
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- LAWNWOOD MEDICAL CENTER
-f DISASTER MANUAL r E i e
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_ ..._ .- . - . . . . . . - ~ ~ . . . . - - - . - - - - ---- - - - - -- "---^ s PO LICY AND PROCEDURE M A NU A L DEPT. br>rml/4-r/cd-y;o s/ MANUAL. 1.5 ,qcr -r 6 b
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s Signatures below indicate that au policies and procedures in this manual have been reviewed as of the latest date
; indicated on this cover sheet and revised as required.
j f Revision dates are noted on the specific policy / procedure, A I s M - 7/ 6/7A'/}X Dept. Head '
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f h 1 i 1 . I f LAWNWOOD MEDICAL CENTER i j MAJOR DISASTER PLAN a.
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{. Table of Contents Turpose f General Procedure for Implementing Disaster Code f Depart = ental Duties I. Hospital' Administration II. Physicians ,
, III. Nursing Administration i
IV. Duties of Nur: ling Units l V. Emergency Room Duties ' VI. Admission Office . s il VII. Business Office VIII. Cardiorespiratory . II. Environmental Service Coordinator X. Fcod Services XI. Housekeeping XII. Human Resources l XIII. Laboratory j XIV. Laundry
} (- ' XV. Mcintenance
,(' XVI. Materials Management XVII. Medical Records XVIII. Pharmacy 1
XIX. Rad $alogy
, XX. Security
'! XXI. Switchboard i
Designated Disaster Areas in a CODE 7 Disaster Areas ! I. Triage Area II. Shock & Trauma III. First Aid & Delayed Treatment IV. Orthopedics V. Decontamination Area j VI. Major Surgery Holding Area & Post Surgery S Equipment & Supplies l Cardiorespiratory Department Pharmacy Haterials Management !l
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. /, Table of Conten'ts - continued.....
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t \ Addendum "A" - Disaster Log Addendum "B" - Emergency Supply Cart for First Aid Area i Addendum "C"' - Housekeeping (Radioactive supplies) Addendum "D" - MaterialsNanagement(Radioactivesupplies) .; Addendum "E" - Disaster Tag a- ! t 1 Radiation Accident Plan i '
-l Fire & Evacuation Plan N
1 1 Bomb Threat Plan
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4 i I t t I.AWIN00D MEDICAL CENTER 4 j RADIATION ACCIDENT PLAN 1 i
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4 RADIATION PLC
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i 4 1 1 [j purnose vide safe, efficient,The Radiscion Flan of I.awnrocd Medical Center is desig i=rediate care to a victi= of a radiation
"{ accident and at the same time protect those individuals fron contanination as they care for the victim.
- for the containnent and preper safe disposal of any contaminatedThe plan also pr i
materials so as to protect all personnel, patients and visitors of Lawnvood Medical Center. I j 1 _Ohiectivas of Decentamina-fon
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- 1. Ao prevent' injury caused b radioactive substance on the body. ,
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- 2. To theprevent patient.the spread of contamination over and into
- 3. To protect attending persennel frem becc=ing contani-i- nnted or in extrene cases from being exposed to a source
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~l y CARE CF TIC RAI)IATION ACCIDE!!T VICTIM
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i l GENERAI. PRINCI?LES A. In the actual care of a Radiation Accident Victi=, there are two prine cen~cepts of i=pertance. I 1. Knculedge of the level of risk 1 j 2. Knotiledge of urgency of treat =ent The basic concepts of treat =ent and general principles of first aid cust be stressed.
] , B. I=portant Point: In the event of conbined injuries where
'I trau=stic uounds are life threatenin; er shock is present, j radiation contaninction or expcsure is net of pri=e 1 portance.
j The e=crgency treat =ent of the patient is the nu=ber one cencern. . C. Prevention of centa=ination frc= victi= to personnel or non-
.] conta=inated areas of victi is prevented by knculedge of the
! attendants and strict surgical isolatien techniques, i
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D.- Preparation of the E=crgency Rec = prior to the arrival of a
.j- radiation accident victi: is the res;cnsibility of all
- l Energency Roon personnel. Adequate preparation depends on:
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- 1. Obtaining accurate and cc=plete information.frc= the '
1 , i person reporting the accident (See Addendu= A). !-4 ii 2. Prc=;it notification of all the proper respcnsible staff 'j - s needed to care for the e=ergency.
- 3. Preparation of decontanination area.
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'1 4. Making available all supplies needed for care and con-tain=ent of contaminated =aterials.
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, NURSING CARE CUIDELINF.S - RADIATION ACCIDENT 4
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) DEFINITION OF RADIATION ACCIDENT CASES i'
There are four types of radiation accident patients: 4
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1 A. Radiation Ex:csure - The individual who has received whole or partial l body external radiation may have received ~a lethal dose of radiation, but j he is no hazard to attendants, other patients or the environ: ent. He is o
- no different than the radiation therapy or diagnostic x-ray patient.
s l B. Internal Contaminatien - Such cont'a=ination results from inhalatien or ingestion of radioactive =aterial. Such a person is no hazard to attendants, other patients or the environment. Folleuing cleansing of minor amounts of contaminated material deposited on the body surface fro = airborne exposure, this person should be handled similar to a' chemical poisoning case such as lead. His body wastes should be collected and saved in order that measurements of the amount of radio-active =aterials present can be made as an assist in determining appropriate therapy. C. _ External Contamination - External contamination of body surface and/or
} clothing by radioactive liquids or by dirt particles presents a type of j' ( . case with problems si=ilar to ver=in infestation. Surgical isolation ,j techniques to protect other patients and the hospital environ =ent must 4 be c= ployed in order +.o confine and renove any potential hatard. .)
- i j D. Contaminated Wounds - When external contaminatien is complicated by a wound, care must be taken not to cross-contaminate surrounding sufaces y frc= the wound and vice versa. The wound and surrounding surfaces are
-t , cleansed separately and sealed off when clean.
9 These rad'intion and/or conta=ination proble=s =ay or =ay not be complicated ., by injury. 1 O . . NN='== Aa;r t'em. _;:2:JB. .. . *:i kt -t ""* * *.*
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All victims of a radiation accident that results in contamination or suspected contat:tination will enter the hospital through the Emergency Room entrance. The Decontamination Area shall consist of: The shower with holding tank The Cast Room The Storage Room adjacent to the shower
. Responsibilities ,
I. CPERATOR
- 1. If the operator receives a call from the nuclear plant regarding a nuclear accident, she should transfer the call immediately to the nursing supervisor.
- 2. Be prepared to assist the nursing supervisor in noti-fication of responsible personnel.
. II. NURSING SUPERVISOR
( The Nursing Supervisor or the Emergency Room surse w111 - receive the call regarding a radiation accident. -
, 1. When the Nursing Supervisor receives the call from the '
i nuclear plant regarding a radiation accident, she will l complete as thoroughly as possible, The Radiation
! Emergency Notification Report.
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- 2. When notified directly or by the E=ergency Room nurse, j the Supervisor will verify the report by contacting i Florida Power and Light Nuclear Plant (Telephone No.
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1, , j' 3. Notify the Radiologist responsible for radiation control --
..j (Radiation Control Officer) -..
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Radiction Plan - continued..... II. SURSING St.7I~'.7!SCR - centinued. . . . A
.4. Motify ths Ecdiolegical '!cchnicien en duty or ene desi;;nated by the Radiation Centrol Officer.
- 5. Evalucte the sitection and determine the necessity of callin; a Ccde 7. (Use Ccdc 7 caly if large nu=ber of victics).
- 6. Kotify Adninictrator or Assistant Administrator.
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- 7. Notify Director of Nursing Service, Chief of Zncrgency Rcon, Environ = ental Services Director, and E=er;;ency Roen Supervisor as the sicus ion deens necessar/.
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Radiation Plan - continued. . . . III. RADIOLOGIST (RADIATION CONTROL OFFICER) The Radiologist has the overall responsibility for main-taining contamination control. The Radiologist and his appointed Radiologic Technician shall report to the Emergency Room to serve as the Radiation Control Team. Responsibilities
- 1. Supervise Emergency Personnel in instituting con-tanination control procedures prior to arrival of victim.
- 2. Assist Emergency Room personnel in instituting con-tamination control procedures at the time of a
; radiation emergency admission.
- 3. Notify additional Radiation Control Personnel if needed.
- 4. Establish a checkpoint and monitoring station for entry and exit frcm centamination control area.
j 5. Work with Florida Power and Light Nuclear Plant personnel when they arrive at the hospital. .
- 6. Survey patients and advise Emergency Room Physician on external radiation levels to personnel.
4
} 7. Advise Emergency Room Physician regarding the areas i and degree of contamination of the victim.
- 8. Advise Emergency Room Physician regarding decon-
'j tamination procedure for patient.
t , 1 9. Survey personnel, equipment and facilities and desig-l -..j nate those that must be restricted for decontamination. 2 , }f 10. Supervise decontamination of personnel and facilities 'd and release areas that are not contaminated. ( )j , . ~ .~.. . . 11. Direct handling of radioactive waste. LA' *
- 12. Determine the safety (in regard to contamination leve'1)
I as to the disposition of the patient.
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- 13. Complete Radiation Survey Report (Addendum B).
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- 8. 14. Arrange for whole body counting and radionssays. , .
15, Determine background levels of radiation before arrival - -'>$8.h'f[tl?-!! f q
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V. DIERGENCY ROOM NURSING PERSONNEL
, 1. If the ER nurse receives the call regarding a radiatien accident victim, she is responsible fbr completing the Radiation Emergency Notification Report, and notify the ; Nursing Supervisor immediately.
- 2. The Emergency Room personnel should begin preparation for receiving the victim. These preparations must include:
A. Determine that the Shower Area is clean and clear of any objects. i ' i B. The valve for the nuclear waste water holding tank is to be opened. (Notify Engineering), i. j C. The air conditioning return duct is to be closed to shut off the air circulation system to prevent spread of contamination. 1 D. Under direction of Radiation Control Office, prepare area for receiving radiation accident victim. Sup-plies are located in locker in ER.
, E. The floor area leading from lthe entrance of the i
Emergency Room into the decontamination room must . be covered. (Notify Engineering) . F. The Cast Room must be prpeared to receive the victim. j The cast care and other movable equipment are to be
-i moved from the room to avoid contamination.
G. Supplies needed for the care of the victim are to be taken to this area in order to provide optimum treat-
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6 ment without creating excess traf fic, (i.e. BP Cuffs,
-stethoscope, surgical instruments, wound care materials).
H. Have available containers needed for collecting bioassay j samples, (i.e. contaminated tissue, hair, blood, 4x4 gauze l . pads, or other contaminated supplies) .
, I. Set up containers in the contamination room for collection vand control of contaminated or potentially contaminated articles. Have tags available for the proper labelling
. . of these articles.
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' J. Read dosimeters and/or film badges before patient arrival.
Personnel must wear dosimeters and/or film badges. ., a.u. s - E~ ~ '"
- 3. The Emergency Room nurse must follow the same procedures for .
. care of the contaminated victim as outlined under the '
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; 4. The E=crgency Rcen nurca trill handle the cente=inated patient and wound as ene would a surgical procedure (i.e. ge'.:n, gleves, cap, raks, etc.).
i .: 5. Tne nurse in the Energency Rect role can be of tremendcus aid in preventing fear and hysteria. Her cale, assured, friendly greeting, attitude and conversations with the a patient are rest important psycholegically.
- 6. The nurse will assist the physician and the Radiation Centrol Tea: in the cor.tain=ent of contaminated materials.
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i VI. ADMINISTRATION 4 4 j The Adr.inistrator will meet with representatives of the j Nuclear P2:nc c:d ascure the reopensibility for all i news releases if indicated. VII. SECI;RITY 7 t
- Security will report to the Emergency Roem Entrance to t.aintain traffic control.
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.i -i - RADIATION EMERCENCY NOTIFICATICN REPORT L* (To be used by Supervisor to enter available data tehen a notificatien is re-ceived of the i=pending admission of a radiation accident victic.) h.i 3, 1 i -4 A. Person Makine Notificatien ,
- 1
.' Na=e Date Ti=e Title Affiliation i
i , Address Telephone i j
- 3. Patients to be Admitted:
j Check Accrocriste Colu=n(s) l , Name (if available) Injury but no Radiation i Internal External Conta=in-1 l radiation or exposure conta=- contam- sted
, contaminntion inntien ination tecunds 4 ,
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! C. Will natients be: surveyed for contamination? Decontaminated? D. Nature of accident: Type radiation source 1i t ..
- f Other Details q
n I ! j .. 1 E. Person in charge of radiation evaluation: il 4 F. Expected time of arrival at llospital: Notification taken by: ,i , 'l. a ,- i ,).(.. f't m, o .
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. ADDCNDt.'M 3 REEF CASUALITY *1 ADIATION RE07.T 4
DATE RECEIVED Tnts i i
! PATIENT'S NAME falautATo3y i.
CHAla f ST3 ETCHER J i, RADIATION SL".tV'Y RESULTS ( SU2 FACE ) i i i j, 1 eps . crad/hr i 4 l e trad/hr N
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o reading at 1 meter: Crad/hr
. .t t LOCATIONS OF HIGHEST READING AREAS i -
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i i i 6 J i INSTRUMENTATION USED FOR i ACCIDENT DETECTION 1 i 4 b 6 5
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; INSTRUMENTS FOR ACCIDENT DETECTION i
l RANGE
] INSTRUMENTS UNIT 1 UNIT 2 i RCS pressure 0-1600/ 0-1600/
, 1500-2500 psia 1500-2500 psia
.j l RCS temperature
{ hot leg (control channel) 515 - 615*F 515 - 615*F 4 hot leg (safety channel) 515 - 665*F 515 - 665 F
; cold leg (control cnannel) 515 - 615 F 515 - 615 F cold leg (safety channel) 465 - 615*F 465 - 615"F i j cold leg (wide range) N/A 0 - 600*F i
j Incore thercoccuples 50 - 2250*F To be determined Subcooling margin monitors 212 - 705*F To ce detennined i
} Nuclear Instrumentation Power range 1
Intermediate range (wide range) 08 10- -Ig0%
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1] Source range 0.1 - 10 cps 2 1 x- 105 - 2001. 10 cps 1 Pressurizer pressure 0-1600/ 0-1600/ 1500-2500 psia 1500-2500 psia i Pressurizer level j 0 - 100% 0 - 100% Steam Generator pressure 0 - 1200 psia 0 - 1000 psia 4 Steam Generator level 0 - 100% 0 - 100% 1
] Main steam pressure 0 - 1200 psia 0 - 1200 psia ECCS header isolation valve lights on/off on/off
[j ' ~ ECCS pumps 0 - 75 amps 0 - 75 amps l' ] Containment pressure 0 - 50 psig 0 - 15 psig (ES FAS) l 0 - 175 psig 0 - 60 psig (wide range) l 'd Earthquake monitor 0-1g N/A l4
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! UNANNOUNCED NOTIFICATION DRILLS
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}' Quarterly conmunications drills will be conducted with the FPL Offsite Emergency Organization. At least one drill per year will be unannounced. This unannounced drill will include notification to all
} primary offsite response agencies (i.e. BDP, DHRS, County Disaster Preparedness agencies) and those FPL emergency response personnel required to be notified based upon the drill scenario.
j As indicated in Annex L of the State Plan, the State conducts communications drills at least annually. >> l The State Field Operations Center is one of the facilities which is l involved in all exercises. Annex i indicates the equipment tested in ,, these exercises.
- As indicated in Section VI of Annex L. " communications between the nuclear facility, state and local emergency operation centers and field 4
a assessment teams will be tested (annually)..."
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q 7.1.5 Evaluation Ouring drills and exercises, observers will make on-the-spot corrections ij j to actions taken by drill participants that might affect the planned j outcome (objective) of the drill. Minor errors in procedures or techniques will be noted and discussed during the post-drill evaluation. L Following an exercise, the Emergency Planning Supervisor, plant
.,' management, FPL observers, and principal participants in the exercise j, will meet to discuss and evaluate the exercise.
g The evaluation should be based on tha ability of participants to follow 3 emergency procedures, the adequacy of emergency procedures, and the j- adequacy of emergency equipment and supplies. Plant management will be I responsible for any necessary changes in the Plant Emergency Procedures j and for reconmending changes in the Emergency Plan to the Emergency Planning Supervisor. Reconmended changes in the Emergency Plan will be !. submitted to the Emergency Plan Supervisor. y H 7-7 L St. Lucie
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