ML20099J129

Applicant Exhibit A-EP-46,consisting of Forwarding Rev 2 to Protective Action Implementation Plan & Sheltering Floor Plan for Review.One Oversize Drawing Encl. Aperture Card Available in PDR

ML20099J129
Person / Time
Site:	Shoreham File:Long Island Lighting Company icon.png
Issue date:	06/09/1984
From:	Ryan E LONG ISLAND LIGHTING CO.
To:	Ecroyd R CENTRAL SUFFOLK HOSP., RIVERHEAD, NY
References
OL-3-A-EP-046, OL-3-A-EP-46, NUDOCS 8411280524
Download: ML20099J129 (36)

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Mr. Robert F. Ecroyd.,i Reporter:

Executive Vice Presiden lTM '

g Central Suffolk Hospital 1300 Roanoke Avenue Riverhead, NY 11901

Dear Mr. Ecroyd:

Enclosed for your review is Revision 2 to the Protective Action Implementation Plan for Central Suffolk and Revision 2 to the sheltering floor plan.

The changes suggested by you and your staff at our March 21 meeting have been incor-porated.

If you have any further modifications or questions on this material, please call me at 733-4884.

Very truly yours, M.

M Eileen M. Ryan Local Emergency Response Implementing Organization EMR/kv l

cc: Mr. G. Dinizio bec:

Messrs. J. A. Weismantle-C. A. Daverio J. N. Christman

- H&W S. M. Dudar J. O. Yedvab Ms. E. D. Robinson K. E. B. McCleskey - H&W R. Falzone

- H&W LERO File l

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CENTRAL SUFFOLK HOSPITAL PROTECTIVE ACTION IMPLEMENTATION PLAN IN THE EVENT OF A RADIOLOGICAL EMERGENCY AT THE SHOREHAM NUCLEAR POWER STATION (SNPS)

DRAFT Revision 2

TABLE OF CONTENTS A.. Glossary "B-Concept of Operations-C.

Protective Action Implementation Procedure- - Map Illustrating EPZ - Hospital Call List - Sheltering Instructions - Floor Plan of Sheltering Areas - KI Distribution Instructions - Evacuation Instructions - Emergency Tag 4

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A.

GLOSSARY:

The terms listed below are used in these procedures or may be

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used infthe' Emergency. Broadcast System (EBS) messages.which-you-may hearfon your tone: alert radio in-the event of:a radiological emergency.at the.Shoreham Nuclear Power Station.

Underlined words: cited in the definitions'are cross-indexed.

' ALERT Ansalert-would be declared if'there:were an actual or potential safety' problem at'the plant. LA release of radiation may have occurred, but.the amount would not have been significant..-At this level, LERO would make emergency personnel. ready and available to respond iftthe problem became more serious.

CONTAMINATION The presence of radioactive material in undesirable. locations.-

DECONTAMINATION The reduction or removal of radioactive contaminants from an object, person or area, as by cleaning or washing with water or-detergents.

t DOSE.

A quantity of, energy absorbed from ionization per unit mass of.

tissue.

The rem is a unit of absorbed dose.

' EMERGENCY OPERATIONS CENTER (EOC)

The command, coordination, and. communication center operated by LERO which-will be activated to evaluate the radiological emergency and make and coordinate protective action recommendations along with other efforts that may be implemented for emergency response.

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EMERGENCY PLANNING ZONE-(EPZ)

The area about a nuclear power plant for which planning is accomplished to' assure that promat and' effective actions can be taken to protect the public in t3e event of a radiological' emergency.

The plume exposure EPZ is an area n

.approximately 10 miles in radius around a nuclear power plant.

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EVACUATION..

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i The protective action that entails the actual movement of-people-out of the affected area..

EXERCISE Al preplanned event that tests a major portion. of all. of the basic elements within the radiological emergency response plan.

This event tests-the capability of the emergency preparedness:

organization to successfully respond to a. radiological emergency Lthat-could' result in offsite consequences.

GENERAL EMERGENCY A General Emergency would be declared if the situation involved

~

actual;or expected. core damage and radiation releases were expected to exceed the government limits for areas beyond the immediate site. ;At this level,~LERO officials would decide-whether preplanned protective actions such as sheltering or:

evacuation were necessary.

Continuing information would be provided to the public.

-LERO Local Emergency Response Organization MILLIREM (MREM)

One-thousandth (1/1,000) of a rem.

-MONITORING, RADIOLOGICAL

-The. operation of locating and measuring radioactivity by means of survey instruments that can detect and-measure (as dose rates) ionizing radiation.

~ NUCLEAR POWER PLANT A. commercial nuclear electric power generating facility.

. NUCLEAR REACTOR A device in which a' fission chain reaction can.be initiated, maintained, and controlled.

Its essential component is a core-with fissionable fuel.

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F OFFSITE The area beyond the property boundary line of a nuclear power plant.

ONSITE The area-including and around the nuclear po'wer plant enclosed by the_ property boundary line.

PROTECTIVE ACTION GUIDELINES Projected radiological doses to individuals in the general population and emergency workers, that warrant protective actions following a release of. radioactive naterial.

PROTECTIVE ACTIONS The measures taken in anticipation of, during, or after-a

-release of radioactive material.

The purpose is to reduce the radiological doses to persons that would be likely to occur if

.the actions were not taken.

RADIATION The emission or propagation of waves or particles such ar light, sound, radiant heat, or particles or waves emitted by radioactivity including any or all of the following:

alpha

. particles, beta particles, gamma rays, X-rays, neutrons,

.high-speed electrons, high-speed protons and other atomic particles.

RADIOLOGICAL EMERGENCY Any event involving actual or potential radiation exposure or radiological contamination to the environment.

RELEASE Escape of radioactive materials into the environment.

REM A measure of radiation's biological affect, similar to the way degrees measure temperature or inches measure distance. Revision 2

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SHELTERING The protective action consisting of going indoors, closing-doors and windows, and turning off ventilation systems._

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~ SITE ~ AREA EMERGENCY.

4 A Site Area Emergency: would be declared _ if there-were actual or -

- potential major failures of plant systems needed for public protection.

Releases of radiation may_be involved, but_beyond the site. boundary, they would not be expected to exceed. safe limits past.which the_-government requires protective action.

At-this level, LERO would staff emergency positions, radiation survey teams would-be dispatched, and the public.would be notified through the' news media.

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-UNUSUAL EVENT

-An Unusual Event would be declared if there were~ potential for a

safety. problem, but there had-been no release of radiation from the plant.

If this classification is declared, offsite officials ~

are notified about the potential problem.

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CONCEPT OF' OPERATIONS 1I.

INTRODUCTION The primary protective action rc<ommendation for Central jSuffolk Hospital-in=the event of a radiological emergency at

-the Shoreham'Nucl~ ear Power Station (SNPS) will be:to shelter the -patients and employees.

'Under the Shoreham. Plan,. emergencies are to be classified

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r using four categories of increasing seriousness:

. Unusual

. nly O

Event, Alert,-Site Area Emergency, and General-Emergency.

at a General Emergency would there bc-the possibility that a release of radioactivity would be of sufficient. magnitude to y

potentially: exceed, in the plume Emergency Planning Zone (EPZ), the Environmental Protection: Agency a Protective Action Guideline dose levels.

Your hospital _will be. notified initially of. any -emergency.at.

Shoreham requiring protective. actions by anyone in-the-EPZlby the tone alert radio provided to the hospital by LERO.-

Your tone alert. radio may be activated at the Alert Classification-although there will be no need for hospitals.to take;any.

protective actions-at that emergency classification.

If at a higher classification protective' actions are' recommended for the -general public, your. tone ~ alert radio would broadcast. the Emergency Broadcast System (EBS) message.

If it is necessary for the hospital to take protective actions, LERO would. contact your hospital by telephone to verify that you' received the protective. action recommendation and are implementing these L

procedures.

Protective actions'of sheltering or evacuation are recommended based upon the projected ' radiation doses that may be received in particular areas of the plume EPZ, and the amount of time available in which=to' respond relative to the amount of. time necessary to implement a-response.

While it is unlikely that.

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an emergency resulting in a release would occur at Shoreham,.it is more unlikely that a release would occur that would make it necessary to take protective actions out'to the 10-mile boundary.

II.

SHELTERING ll.

In sheltering Central Suffolk patients during a release radioactivity fron'Shoreham,.the patients are'being prote ced from two kinds of exposure

-(1) external exposure to radiation from an overhead-plume and (2) internal exposure from inhaling i

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radioactive ~particulates from the plume.

Adequate shelterin can be provided by'your building. :The sheltering areas are g

~1ndicated 'on the : floor plantin Attachment 4.

The primaryLsheltering areas are the cafeteria and: corridors on the first floor.

These areas' have ruf outside-walls and are twellfbelow.the roof, and thus-provide ~ maximum sheltering

. protection.

The ventilation system in these areas ~can be isolated protecting the patients and staff from radioactive

-particulates that could be inhaled.>

Hospital staff should be instructed to move portable life-support. equipment and medication to the sheltering areas.

All' patients should be sheltered in~the special' areas except those patients in the-intensive care unit, the coronary care.

unit, isolation and the prison. unit.

The following individuals should be sent home if they do not live in an affected

-(evacuated / sheltered) area:

patients-who are in the hospital for elective surgery patients who were due to have been discharged the day of the emergency is announced any other persons, which from the etandpoint.of their health, the hospital considers safe to release.

III.

EVACUATION It.is possible to postulate a highly unlikely accident scenario that would result in the~ conclusion that it would be

necessary.to evacuate Central Suffolk Hospital.~

However, Central Suffolk Hospital is located on the edge of the plume EPZ and in most accident scenarios, a radioactive release from Shoreham would.not present the hospital with an immediate-emergency (as would, for example,~a fire), giving-the hospital ample time to implement protective actions.

In addition,.

government studies indicate that the' probability of large radiation doses, even from a worse-case accident at the plant, drops'off substantially.at about 10 miles from.the teactor (NUREG 0396, Pg. I-37).'

IV.

WHY WILL LERO RECOMMEND SHELTERING OVER EVACUATION AS THEL PRIMARY PROTECTIVE ACTION 7 LERO will recommend sheltering rather than evacuation as the primary protection-action based on the high level of radiation-shielding provided by your hospital, your distance from Shoreham, and the greater possibility.of risk to patients ~by relocating rather than' sheltering.them.

There is federal guidance which acknowledges the need to apply different criteria in. establishing'the appropriate protective-7_

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. action for saecial' groups (e.g., hospital patients). 'As written in t'ae Environmental Protection Agency's Manual of

' Protection Action Guides-and Protective Actions for Nuclear Incidents, "..... some persons are involuntarily included under different criteria because the risk of taking action is different than for the general population.

This involuntarily _

selected population may-include bedridden and critically.ill patients, patients in intensive care units, prisoners, etc."

(EPA-520/1-75-001, pg.-1.14).

V.

SUMMATION In the event of a radiological emergency at the Shoreham Nuclear Power Station, LERO's primary protective action recommendation to Central Suffolk Hospital will be to shelter. -

Patients in-ICU, CCU, isolation and the prison unit should not be moved.,

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C.

PROTECTIVE ACTION IMPLEMENTATION' PROCEDURE 1.0- PURPOSE

-This-procedure provides guidance'for.the implementation of.

. sheltering _and evacuation efforts for the CentralLSuffolk

-Hospital in the event of a radiological emergency at the-Shoreham Nuclear-Power Station (SNPS).

2.0 RESPONSIBILITY The Hospital-Administrator or his designee is responsible for implementing this procedure.

3.0 PRECAUTIONS You may be notified at the Alert level and.will be notified at

'all higher emergency classifications that there is an emergency-situation at the.SNPS by the Emergency Broadcast System (EBS)-

message broadcast over your tone alert radio..

Protective Action recommendations will not be made until a Site Area or General Emergency is declared.

4.0 PREREQUISITES lin Alert, Site Area Emergency or General Emergency condition'is

in progress and has'been verified.

5.0 ACTIONS 5.l' Hospital Administrator or his designee do the following:

5E.1.1 Upon notification of an Alert or higher. emergency classification via the tone alert. radio,~ note that your hospital is' located in Zone P (see Attachment 1 for map illustrating the EPZ).

All EBS messages-which require protective actione are keyed to 19 zone letters, A-through S.

s5.1.2 Continue to listen to your tone alert radio for further EBS messages.

5.1.3 If sheltering or evacuation is recommended by the EBS message for zone P, go to Section 6.0 and implement the sheltering procedure. Revision 2 L'

5.1. 4.

If evacuation is recommended for. Central Suffolk-Hospital, the LERO Health Facilities Coordinator will' contact-you via commercial phone.

Implement

.the evacuation procedures in Section 7.0.

6.0- SHELTERING PROCEDURE 6.1. Call in-any^ additional staff that may be required for the implementation of the sheltering protective action by using the'-Hospital-Call List in Attachment'2..

6.2 Upon.a. recommendation of a protective action from LERO,

. prepare your patients for sheltering.

The following activities must be considered:

o Keep all employees and patients indoors.

o Close all doors and windows.

o Turn oft'all ventilation systems.

o Have everyone, except ICU/CCU, isolation, and any prisoners go to a special sheltering area (see Attachments 3 and'4).

o Cancel any elective surgery.

~o If possible, do not start Renal Dialysis.

o Move all patients on oxygen and respirators-(not

-ICU/CCU) to the cafeteria.

o If your facility has decided to use Potassium Iodide (KI) administer it to the patients and/or employees as soon as possible (see Attachment 5 for KI distribution instructions).

6.3 Keep in contact with the LERO Health Facilities Coordinator located at the EOC (xxx'- xxxx).

The EOC should.be contacted:

o If the mounted dosimeter indicates a 1.0 REM reading and again if it incidates.a 3.5 REM reading o

When the sheltering protective action is completed o

To tell'the'EOC~how many patients will not be sheltered-in the special sheltering areas 6.4 Brief your key personnel on the status of the emergency.

Review their procedures with them:

Nursing - Section 6.4.1 Maintenance - Section 6.4.2 Dietary - Section 6.4.3 Housekeeping - Section 6.4.4 Social Services - Section 6.4.5 Administration - Section 6.4.6 Security - Section 6.4.7 Revision 2 a

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E6.4.1; U1on notification of sheltering from.the person in.

ciarge, the Nursing Supervisor will do the' a

following:

l6.4.1.1 Hold a' separate. briefing with your' staff,

including inhalation therapy, ICU, CCU,'and' emergency room and implement the following-steps:-

A.

Identify'those patients who.should v,c' be. moved.to the sheltering area (e g.

patients in'the intensive-care

-unit / coronary care unit, the r.ison unit, and isolation should

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. moved).

B.

Provide' instruct 4

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where the-

. sheltering area located and how-patients are to be moved to the~

sheltering areas (see Attachments 3.and 4).

The cafeteria will be used for patients requiring suction and oxygen since sufficient. emergency power exists.

in the cafeteria to handle the suction.

machines in the eventiof a simultaneous-power failure.

C.

Provide instructions on moving-medications and charts to the sheltering area..

D.. Discharge any patients considered safe to release if they do not live in an affected area.

E.

If your facility has dec'ided to'use Potassium Iodide-(KI), administer the KI to the patients and/or employees ASAP ~(see Attachment 5 for KI distribution' instructions).

6.4.1.2 Call in any additional nurses and support staff that may be' required to implement the-protective action recommendation.

, Revision 2

'6.4.2 Upon notification'of sheltering from the person in

charge,-the Maintenance Supervisor will do:t'a following:

6.4.2.1 Hold a' separate briefing with your staff and implement the following ateps:

A.

Prepare the sheltering area for the arrival of the patients. -Move any-furniture and movable equipment (start with'the cafeteria).

Review the floor plan illustrating the sheltering area (Attachment 4).

B.

Turn off all outside ventilation.

Close and lock doors-and windows.- The two main entrance' doors should be sealed with tape, towels, blankets, or sheets.

Shield windows in lobby.

C..

Read the mounted dosimeter every 30

' minutes.

6.4.3 Upon notification of sheltering from the person in-

~ harge, the Dietary Supervisor will do the c

following:

6.4~.3.1 Hold a separate briefing with your staff and implement the following steps:

A.

Check with nursing about food for tube

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feeders to accompany-patients to the special sheltering areas.

B.

Prepare's small amount of food and drink.

Avoid spending more than twenty minutes preparing the food and drink.

C.

.Stop all cooking activities.

Turn.off-all ranges, ovens, and disconnect all

. electrical equipment (except those providing1 refrigeration).

D.

After steps A, B, and C are complete,-

have all members of the dietary staff report to the personnel pool area lLn radiology. Revision 2 L

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'6.4.4.Upon. notification of-sheltering from the: person in.

~

charge, the Housekeeping Staff Supervisor.will do

.the following:

16.4.4.1 -Hold a separate 1 briefing with your staff-and implement thr following. steps:

A.H.Close all windows inipatients and.

B other rooms.

B.

Upon the: completion of.the above step,-

-report to the personnel pool:in-

' radiology.

6.4.5 Upon notification of sheltering from the~ person in charge, the' Social Services Staff Supervisor will do the following:

i 6.4.5.1 Hold a separate briefing with your~ staff and implement the'following steps:.

A.

Notify' relatives;and~ friends about the.

sheltering of the patients.

Inform then that they will be. notified again

) -'

when the emergency is terminated.

B.

Upon-the completion of the above step, report to the personnel pool in l

radiology.

6.4.6 Upon notification from the person in charge, the Administration Supervisor will doLthe following.

4 I

6.4.6.1 Hold a separate briefing'with your staff:

and implement the following step:

A.

Instruct all members of the administration staff to report.to the personnel-pool in radiology.

6.4.7 Upon notification from the person in charge, the Security Supervisor will do the following.

J 6.4.7.1 Hold a separate briefing with your staff andLimplement the following steps:

A.

Set up-Security at the-main entrance and emergency room entrance. Revision 2 L

B.. Direct all non-injured potentiallyl.

contaminated. evacuees (who may come to-

-the hospital) to the nearest-decontamination center for monitoring _

and, if necessary, decontamination'.

f 1 Revision 2

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7.0: EVACUATION ~ PROCEDURE-7.1 When the LERO Health Facilities Coordinator calls with-g evacuation instructions,. provide him'with the number of

patients that will require an ambulette/ van or. ambulance L

and the' number of patients that are ambulatory and can be

evacuated in a-bus.

r 7.2 If the projected dose is expected to reach 1-5 REM inside the hospital, the LERO Health Facilities Coordinator will call the Hospital Administrator or his designee and-

}

recommend evacuation of all pregnant women (patients, staff, and visitore).and children under the age of 12.

If the projected dose within the hospital is expected to exceed 5 REM, LERO may recommend that the remaining hospital population be evacuated.

7.3 Call in any additional staff that may be required for the implementation of the evacuation protective action by using i

the Hospital Call List'in Attachment 2.

Advise. remaining staff members to report to reception hospital as directed.

7.4 Upon a recommend-tion of evacuation from LERO, prepare your patients for evacuation.

The following activities must be considered:

h o Radiosensitive patients (e.g. maternity and pediatrics) and pregnant statt and visitors should be evacuated first.

o LERO will provide transportation (ambulances, ambulette/ vans,-buses) for the evacuation of patients.

1 o LERO will work with you in identifying reception hospitals.

7.5 Keep in contact with the LERO Health Facilities

('

Coordinato* located at the EOC (XXX-XXXX).

The EOC should be contacted:

o If the mounted dosimeter indicates a 1.0 rem reading and again at a 3.5 REM reading, o If difficulties arise with transportation during the evacuation, o To inform the EOC when evacuation is completed.

7.6-Brief your key personal on the status of emergency.

Review their procedure with them:

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Nursing - Section 7.6.1 Maintenance - Section 7.6.2 Revision 2 u

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u Dietary - Section 7.6.3

. Housekeeping

Section 7.6.4

. Social Services - Section 7.6.5 Administration - Section 7.6.6-Security Section 7.6.7

, Revision 2

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7.6.1 Upon notification of evacuation _from the person in charge, the Nursing' Supervisor will do the-tollowing:

7.6.1.1 Hold'a separate briefing with your. staff, including inhalation therapy, ICU, CCU, and~

emergency room staff and implement the following steps:

A.

Identify.those patients who will require ambulance, ambulette/ van orLbus transporation to be evacuated.

B.

Provide instructions on which patients should be evacuated first and how the evacuation will be implemented (see

' ).

C.

Insure.that emergency tags (see attachment 7) accompany the patients to the reception hospital.

D..

Discuss the transfer of medications to the reception hospital.

E.

Provide each patient with adequate and proper clothing, including outerwear.

7.6.1.2 Call in any additional nurses and support staff that.may be required to implement the protective action recommendation.

7.6.1.3 Inform the person in charge of the number.

of patients who are ambulatory, the number of patients who will require ambulances,

~

the number of patients who will required-ambulette/ vans.

7.6.1.4 Record the name of the reception hospital that each~ evacuated patient was sent to on the emergency tags and provide the list to the Gocial Services Department (the Social Services Department will call relatives to inform them of the evacuation).

+ Revision 2

"7..6.2 Uaon notification of evacuation from the person;in~

charge,:the Maintenance Supervisor will do:the following:

~

7.6.2[1= Ho1d a. separate briefing with your. staff and implement the following. steps:

A.

Makeisure' boilers are kept running in:

freezing weather.

B.

Prepare the. building for.the evacuation.-

C.-

Secure.all entrances after evacuation-of~the building;by locking, chaining, etc.

7.6.3 Uaon notification of evacuation from the person in charge, the Dietary Staff Supervisory will do the following:

'7.6.3.1 Hold a separate briefing'with your staff and-implement the following steps:

A.

Check with' nursing about food;for tube feeders to accompany patients to the reception hospital (s).

B.

Stop all! cooking activities.. Turn off all ranges, disconnect all1 electrical equipment (except those units providing-refrigeration).

C.

After steps A:and.B are complete, all dietary staff members will report to theLpersonnel pool in radiology.

. Revision 2

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. 7.6,.4. Upon notification of evacuation from ths-person in charge, the Housekeeping Staff Supervisor will,do

~ he following:

t 7.6.4.1 Hold a separate briefing with your staff and implem2nt the following steps:

L A'.

Close all windows in patients' and; other: rooms.

B.

Upon the completion of the above step, report to the personnel pool in

radiology.

7.6.5 Upon notification of evacuation from the person in charge, the Social Services Staff Supervisor will d.o the following:

-7.6.5.1 Hold a separate briefing with'your staff-and implement.the.following steps:

A.

Notify relatives and friends about relocation of patients.and convey their.

new-location and telephone numbers.

7.6.6 Upon notification of evacuation from.the person in charge, the Administration Department will assist.

the personnel pool in radiology.

7.6.7 'Upon. notification.of evacuation trom the person in charge, the Security Department will' set up security around the hospital until the evacuation efforts have been completed.

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ATTACHENT 2 HOSPITAL CALL' LIST (to be provided)

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ATTACHMENT 3 SHELTERING INSTRUCTIONS-k 1

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-ATTACHMENT 3

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SHELTERING' INSTRUCTIONS Step-Common ' sense and' good judgement must take precedence.

1 All elevators.an'd staircases will'be used.to move the

-2 patients to.the'special' sheltering areas.

3 LPatients will be. moved starting from the third floor andi.

then the second floor to the first floor,special sheltering _

n areas.

g Review floor plan (Attachment 4) and note where patients 4

will be moved.

Each head nurse will determine which of their patients can 5

Inn moved in wheelchairs and which patients must be moved in stretchers.or beds.

All head nurses will then report to the Nursing 6

Administrator on the third floor to start the' movement of-the patients toLthe first floor.

All other nurses will stay with their patients until they 7

are moved.

Maternity will be moved first.- If possible, maternity

~8 patients should be given their babies and releasedLfrom the hospital.

Maternity patients may use the stairs.

l 9

After all patients from maternity have been moved ~,

determine which patients from pediatrics can be moved in wheelchairs and which must be moved in stretchers or beds.

NOTE:. If any parents are present, release'the children into the care.of their parents, if possible.

Move the wheelchair pediatric patients first using 10 elevators 1 or 2.

Then move the patients in stretchers or beds using elevators 1 or 2.

After all pediatric patients are moved to the first floor 11

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sheltering area, move-the-patients located in 3 SOUTH using elevator 4.

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ATTACHMENT'3 SHELTERING INSTRUCTIONS;(CONT'D.)

Step After all. patients on third floor have been moved' start-12 moving the patients on 2 EAST.

Use elevators 1 or 2.

Move the patients on 2 SOUTH using elevator 4.

13.

14 After patients on 2 SOUTH-have been~ moved, move the patients on the'first floor over to the sheltering areas using the hallways.

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ATTACIIMENT 4 -

FLOOR PLAN OF ShlELTERING: AREAS r-

-( see enclosures-)

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Revision 2 E

e 4 ATTACHMENT 5 KI DISTRIBUTION INSTRUCTIONS Revision 2

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l ATTACHMENT '.5 Potassium Iodide (KI) Distribution Instructions

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' General Background on KI:

1 KI blocks'radioiodine, which might be ingested or inhaled by an exposed person, from entering the thyroid gland by c'

saturating-the gland with nonradioactive iodine.

If-y radioiodine exposure has occurred or is anticipated, the Administrator or her designee can recommend the use of KI as a protective action, in conjunction with sheltering..

Because KI works by saturating the thyroid gland with nonradioactive iodine before radioiodine reaches'the thyroid, it'is very important to take KI shortly before or

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soon after any exposure to radioiodine.

The concept is e

illustrated by the fact that KI is over 95 percent effective when taken at the time of exposure to i

radioiodine and is only 50 percent effective when taken 3-4 hours after exposure.

It is ig ortant to remember that KI protects only the thyroid gland and does not-

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protect the rest of the body from radiation exposure..

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Decision Authority:

i LERO will not make a recommendation for the use of KI as a i-protective action.

The decision to recommend KI willibe made by the Administrator or her designee.

'III.

Recommended Dese and Frequency:

The recommended dosage is one (1) 130 mg. tablet per day 1

(equivalent to 100 mg. of iodine) to all individuals over-i one year of age and one-half (%) of a 130 mg.' tablet per day (equivalent to 50 mg. of iodine) to infants under one (1) year of age.

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KI will not be required after ten (10) days if other l.

protective measures are taken.

These protective measures could include interruption of contaminated milk supplies l

or evacuation.

Radioiodine already present in the body but blocked from

-entering the thyroid gland by KI will continue to

. circulate for up to 48 hours5.555556e-4 days <br />0.0133 hours <br />7.936508e-5 weeks <br />1.8264e-5 months <br /> after cessation of exposure.

Thus, it takes the body two (2) days to eliminate radioiodine by renal excretion.

H e thyroid gland must be l-protected for this 48 hour5.555556e-4 days <br />0.0133 hours <br />7.936508e-5 weeks <br />1.8264e-5 months <br /> period to prevent uptake of l

radioiodine'from other parts of the body.

Continued use of KI is, therefore, required for two (2) additional days after cessation of exposure.

The minimum dossge of KI is

'three (3)' days.

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i IV.

Side Effects:

Read the manufacturer's brochure for possible side effects to KI.

IF the side effects are severe or if a person has an allergic reaction, they should contact a doctor.

V.

Storage:

There are no s7ecial storage requirements for this ty KI, provided t2at each bottle remains tightly close. pe of It is recommended, however, that all KI be kept under lock and key to ensure against possible misuse.

Revision 2

ATTACHMENT 6 EVACUATION INSTRUCTIONS Revision 2

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ATTACHMENT 6

' EVACUATION INSTRUCTIONS

' Step 1

Common sense -and good judgement must take precedence.

2 Alt elevators and staircases will be used to move the patients out of.the hospital.

3 The main lobby area and cafeteria will be used as a staging area for the patients.

4 All patients will be evacuated through the main lobby.

5 Pediatrics and maternity should be evacuated first.

6 Record the name of the reception hospital that each evacuated patient was sent to on the emergency tags.

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ATTACIIMENT 7 EMERGENCY TAG 4

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