ML20134P888

Forwards Portions of State of Oh & Ashtabula,Geauga & Lake Counties Emergency Plans,Confirming List of Medical Facilities Available in Case of Emergency

ML20134P888
Person / Time
Site:	Perry
Issue date:	08/29/1985
From:	Krimm R Federal Emergency Management Agency
To:	Jordan E NRC OFFICE OF INSPECTION & ENFORCEMENT (IE)
References
NUDOCS 8509090086
Download: ML20134P888 (30)

Text

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$ Federal Emergency Management Agency 1 / Washington, D.C. 20472

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MEMORANDlN FOR: Edward L. Jordan Director, Division of Emergency Preparedness and Engineering Response Of fice of Inspection and Enforcenent U.S. Nuclear Regulatory Commission

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FROM:

Assistant Associate Director Of fice of Natural and Technological Hazartfs Programs

SUBJECT:

Medical Services Infonnation for the Perry Nuclear Power Plant Attached are copies of the following: Part 1, Medical and Public Health Support, State of Ohio, Plan for Response to Radiation Emergencies at Licensed Maclear Facilities; Section L, Medical and Public Health Support, Ashtabula County Ohio Radiological Emergency Preparedness Plan; Section L, Medical and Public Health, Geauga County Radiological Emergency Response Plan; and, r;. ; L, Medical and Public Health Support, Lake County Disaster Services Ao-1. /. This infonnation is confinnation that a list of medical facilities N - been identified for use in case of an emergency at the Perry Nuclear Power Plant. Other related and supporting arrangenents and services are al so identified.

Attactrnents As Stated 8509090006 850829 PDR F ADOCM 05000440 PDR f

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, . Jhi.0.: 'B' 1E:EE fem REGICW4 V BATTLE CREEF 1 P.(M SOURCE: STATE OF 01110

• 4 . ** PLAN FOR RESPCNSE 'IO RADIATICN EMERGENCIES

• AT LICENSED NUCLEAR FACILITIES seCTIDs II - 233gIu33 PART 1 - MEDICAL AND PUBLIC NEALTN SUPPORT l

1. Purpose The purpose of this section to to esaure that errengemente are j made for m edise t se rvices for co ntesina ted individuale l fot Lening a radiological incident et e nucteer peu se p tent.

8. Scope:

This portion of the p Len addresses thoes functions to be l

performed at the state Level. Detet ted information with rega rd to specific sites uit L be found in the pa rticuter county easrgency plan appended to this plan.

'3 geckground Dates The Dhte Depa rtm ent of HesLth (DDH) is charged with W cccrdinating Lccet heelth department planning for . edi a tio n

. energencies et Licensed nucteer facilitiee. With regard to the p roviete n for medient services for contesinated individua t e, the DDH is resp o nsible for accom p lishing the fellowings

a. Coordinate the p rovision of se ergency medicat supp Lies and health servicae to the effected ersee.

b. Develop plane or maintain e Li e ti n." fo r: j (1) Hospitate and other mediceL factLities with a respo nse sepobility in radiation incidente.

4 A s su m p tio ne

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Mi. 0.: 'e51E:29 FEr% REGICe4 V U,TTLE CRED.1 P.07

. c. On-site first aid capability attL be provided by the

. operator,

b. Local government e n ti ti s e wilL errenge for transportetton of co ntaminated individue Le to app ropriate m edice L fact Lities using Loos L resources, and witL request esetatence from the state onty shoo their resources have been exhausted or are deseed inadequate.

a. Medics L resourose of contiguous states wilL be eve 1Lebte for use se required.

d. The ODH v1LL not exercise direct co ntrol over Laos L health department e or P ne tth p Le nning organizatio ne in Ohio.

e. The Ohio Otsester Services Agency (QDSA) stLL be in co nsta nt com mu nica tio ne eith the ODN.

5 Medical Facilities \

e. M edice L Care - Nacice L facilities or institutions having emergency roome end nucLese medical depa rtm ents (se indicated in Figures II-L-1 to 5 and Map II-L-1 to 3, depicting Locations) era capsble of receiving and ca ri n g for aset radic t ogicd L' accido n t c e s s e.

(1) S p eci fic Lettere ef agress ant for services bets een designated medicsL facilities and cou n tie s mitL be inserted in op p ropriate county Level plane.

(2) A L L accredited hos pita te witL have en extended dieseter p Len to include p rovisions for peacetime radiological e m e r g e n ci e s.

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b. Monitoring of Contaminated Individua te -

(1) Ci n ci n n e tt Generet Hospital and Monsanto Mound Laboratory have the only facilities in the state i

espeble of shole body counting. ,

l (R) Medioet facilities in the state which have diagnostic 7

and/or therapeutic radioisotope factLities are specifice t t y identified by a p lus (+1. These f acilities have the capability of monitoring radiatio n esposure to the thy roid.

c. Additio nal Su pport -

(1) Additional assistance asy be obtained through M AP/IR AP and other agencies, and by special co ntract with the power facilities. (See 8sette n II, Part Il 5 Transportattent

a. Victime of radiologiceL accidente mitL be transported to medical facilities by the most accessible Leoal means, as predetermined in the sounty plan. In the event it is determined that Local resources ca nnot adequataly respond to this requirem ans, as sistance wilL be requested feca the state,

b. If the assistance of the state to requested and directed, the Ohio Na tio nal Sue rd (CN S) witL be p repared to furnteh up to 85 asbutances for transportetton of contaminated

! individua t e to ap p rop rieta m edical facilities. Designa ted l

-II-L- 0 3-i

a. . _ . _- - __ . - __ .-_- - -- - _. ..-.

, M4.04 'E! 16:30 FEr9 REGICW4 V EATTLE CPID: 1 p,c3 units w1L L furnish embulances with two drivere per vehicle ,

for this purpose. Unit personnel vill be activated, en arder, in the p riorities listed, and as needed.

Coseanders of asterisked unite wit L be the designated of fice ra in cha rge. (See Pa rt J Figu re II-J-il .

7. Trainings

a. Radiological training for medical and medlest support personnet sheL L be provided through the services of coneutting firm e se ntract ed by Liceneses within the State of Ohio. (See Seatto n II, Part M - Radiological Em e rg e nc y Response Training)

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FIGURE II-L-t OMID DIRECTORY OF NEDICAL PACILITIES NAVING EMER8ENCY ROGR8 (PERRY PLANNING AREA)

&SHYABMkA-BRMNTY l 1 ASMTABULA SENERAL HOSPITAL, 2420 Lake Ave. , ASHTABULA, 44004, (ais) ses-3111 - .

i

2.

• BROWN MEMORIAL HOSPITAL,158 W. Mai n Rd. , CONNEAUT, 44030, (218) 803-1131 3 MEMORIAL HOSPITAL OF GENEVA, 370 W. Hein St., OENEVA, 44041, (216) 4E E-1141 ,

REYAMAR.A-99MRH i 91 . CLEVELAND CLINIC HOSPITAL, 8500 EucLtd Ave., CLEVELAND, 44108, (218) 444-2200 R. CLEVELAND METROPOLITAN GENERAL HOSPITAL, 3395 Eccenten Rd.,

CLEVELAND , 44109, [215) 388-8000 3 HIGHLAND VIEW HOSPITAL, 3301 Iretend Dr., CLEVELANO, 44122, 4

tais) 4s4-es00

}/ 04 DEA 00NESE McEPITAL OF CLEVELAND, ette PeerL Rd., CLEVELAND, r

44109, (21 6) 358-4141

5. PAIRVIEW GENERAL HOSPITAL, 18101 Lorain Ave., CLEVELANO, 44111 (216) 852-1222

8. GRACE HCSPITAL, 33 07 W.14th St. , CLEVELAN D , 44113, (218) 887-1500

+7. HURON ROAD HOSPITAL, 13951 Terrace Rd., CLEVELAND, 44112, '

i (215) O!1-7000 i

• 0. KAISER POUNDATION HOSPITAL, 2475 E. Seuleve rd, CLEVELAND, 44120, (21 8) 795-8000

• 0 LUTHERAN MEDICAL CENTER, 2609 Franklin BLyd., CLEVELAND,

44113, (ats) 885-4300 e

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- --. .- - - - - . - - . - - . - - - . - - -- -l

. - Jui.N *E" 2E:32 FEMI, FIC,IOf 4 V EdiTTLE CFID: 1 p 1; l

& +10. HT. SANAI HOSPITAL OF CLEVELAND, University Ci rcle,  !

CLEVELAND , 44108, [ 21 8] 785-8000

11. POLYCLINIC HOSPITAL, 8808 Ce regt e Ave., CLEVELAND, 44103, (21 8) 431-8433

12. RICHNOND HEIGHTS SENERAL HOSPITAL, 27100 Charden Rd.,

CLEVELANO , 44148, (216) 885-5500

18. SHAKER HEDICAL CENTER HOSPITAL, 1171O Shaker SLvd.,

44120, (21 8) 821-1800

+ 1 4 ST. ALEXIS HOSPITAL, 5183 Broadway Ave., CLEVELAND , 44127,

_ (2181 841-3300

+18. ST. John HOSPITAL, 7811 De t roi t Ave. , CLEVELANO, 44102 (8181 851-7000

' +18.

' ST. LUKE'S HOSPITAL OF THE UNITED HETH00IST CHURCH,11811 Shaker SLvd., CLEVELAND, 44101, (218) 888-7000 0 +17 87. VINCENT CHARITY HOSPITAL, 2381 E. Stnd St., CLEVELAND, 44115, (218) 881-8200

, +18. UNIVERSITY HOSPITALS OF CLEVELAND (includes Abington House, Henne House, Hanna Pavilion, Lakeside HospiteL MacDonaLd House, Children's HospiteL) 2085 AdaLbert Rd., CLEVELAND, 44108, (218) 444-1000

}+18. EUCLIO SENERAL HOSPITAL, E.185th St. & Lake Erie. EUCLID, 44118, (218) 531-8000

• +20. HILLCREST HOSPITAL, 8780 Heyfteld Rd., MAYFIELO HEIGHTS, 44124, (218] 448-4500 i

+21 SRENTWOOD HOSPITAL, 4110 WarrenovilLe Center Rd.,

WARRENSVILLE HEISHTE, 44182, (218) 782-2700

22. SUBURBAN COHHUNITY HOSPITAL, 4180 Warrenevil Le Center Rd. ,

WARRENSVILLE HEISHT8, 44133, [218) 481-8000 23 SEOFCRD MUNICIPAL HOSPITAL, 44 BLeine St., BE0 FORD , 44148, (218) 438-2000

' +24. MARYHOUND HOSPITAL, 12300 McCracken Rd., SARFIELD HEIGHTS, i 44125, (218) 581-0500 l

1. +25. KAISER FOUNDATION HOSPITAL,12301 8nos Rd., PARMA, 44130, (21 8 ) 382-2000

. . Juri.04 'ES 16:32 FEr% PIGIOr4 ' BATTLE CREE 1 P.12

[CEE. PARMA COMMUNITY GENERAL HOSPITAL, 7007 Pcwore Blvd., PARMA, 44125, (2181 888-1800 I

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\ c27 SOUTHWEST SENERAL HOSPITAL,19697 E. Beg Ley Rd., M700LEBURGH HEIGHTS (formerty BEREA), (210) 828-4000 28 LAKEWOOD HOSPITAL, 14518 Detroit Ave., LAKEWOOD, 44107, (215) 821-4200 s

'^ +25.

SAY VIEW HOSPITAL, 28200 Lake Rd., BAY VILLAGE, 44140, (215) 331-2500 j BIAWSA-CREETY

'.' 01 . SEAUSA COMMUNITY HOSPITAL, 13207 Revenne Rd., CHAR 00N, 44024,

( Ei s ) Ess-sisi ,

h LARE-90H1YY '

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1. NORTHEASTERN OHIO SENERAL HOSPITAL, 2041 Hubbard Rd.,

MA0Z$0N, 44057, [21 6) 428-2121 t

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, +2. LAKE COUNTY MEMORIAL HOSPITAL, 71 E. High St., PAINESVILLE,

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44077, (216) 551-9700 LaRAIM-98HNTY

+1. LORAIN COMMUNITY HOSPITAL, 3700 Kathe Rd., LORAIN, 44053, (210) 282-9121

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+2. ET. JOSEPH HOSPITAL, 20 5 W. 20th St., LORAIN, 44052, (2181 245-8851

3. AMHERST HOSPITAL, 254 Cleveland Ave., ANHERST, 44002, (2181 988-2831

( [ +4.

ALLEN MEMORIAL HOSPITAL, 200 W. Lorain St., OBERLIN, 44074, (218) 775-1211

+5. ELYRIA MEMORIAL HOSPITAL, 830 River St., ELYRIA, 44036, (21 8) 223-3211

08. WELLINGTON COMMUNITY HOSPITAL, Dixon St., WELLINGTON, 44090, (2*S) 847-2345

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'8" 16:22 FEN REGION V E#,TTLE CRED' 1 F.12 RE9tMA-SOURTY 40 +1. LODI COMMUNITY HOSPITAL, 225 Elyris St., LODI , 4 42 54, A (21 8) 948-1222 q' +1. ME0!NA COMMUNITY HOSPITAL, 980 E. Washington St., ME0!NA, c 44858, (218) 723-3231

,,; +3 . WADSWORTH-RITTMAN HOSPITAL,135 Weds = orth Rd. , WAOSWORTH,

. 44281, [218) 334-1504 78RYASE-90HEYY a' +1. ROBINSCN MEMORIAL HOSPITAL, 6847 N. Chestnut St., RAVENNA, I 44285, ( Ri g ) 8B7-0811 P

BUMMI_Y-90WNYY .

+1 . CUYAH09A FALLE GENERAL HOSPITAL, 1800 23rd St., CUYAHOGA 0)Pg FALLS, 44223, (11 8) 829-8301

+2. AKRON CITY HOSPITAL, 525 E. Market St., AKRON, 44309, (218) 375-3000

+3. AKRON GENERAL MEDICAL CENTER, 400 Webash Ave., AKRON, 44307, (215] 384-8550

,'I + 4 . CHILORENS HOSPITAL MEDICAL CENTER OF AKRON, 281

. Locust St., AKRON, 44308, (21 8 ) 379-8200

+5. ST. THOMAS HOSPITAL ME0! CAL CENTER, 444 N. Main St., AKRON, 44310, [216) 378-1111

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+5 BAR8ERTON CITIZENS HOSPITAL,155 Ft f th St. N.E., BARBERTON, 44203, (2181 745-1811 YRWW9Wkt-GEBM7Y M* +1. ST. JOSEPH'S RIVERSIDE HOSPITAL,1400 Tod Ave. M.W., WARREN,

', 44485, (216) 841-4000

+2. TRUNSULL MEMORIAL HOSPITAL, 1350 E. Markat St., WARREN, 44482, (21 8) 841-9011

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,3. WARREN GENERAL HOSPITAL, 887 Eastland Ave., WARREN, 44484, (21 8) 399-7541

, . tJ4. 04 'E515:M FD% REGICr4 V MTTLE CRED: 1 e,,

0 = burn ca re unit 0 diagnostic and/or therapeutic radioisotops feet t t sy 1

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$~W RADIOLOGICAL EMERGENCY PREPAREDNESS PLAN o u l

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( CONTROLLED COPY NO. os^-223 5/10/84

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L - MEDICAL AND PUBLIC HEALTH SUPPORT j

,7' L.1 Purpose To describe the arrangements made to provide medical services for treating contaminated injured individuals and for evaluating radiation exposure and radioactive material uptakes.

l L.2 Treating Contaminated injured Individuals Arrangements have been made with the Ashtabula County Medical Center to provide medical treatment for injured individuals who are contaminated with radioactive material. These arrangements are evidenced by the letter of agreement in Appendixj L.3 Evaluation of Radiation Exposure and Radioactive Material Uptakes Arrangements have been made with the Ashtabula County Medical Center to

( provide diagnostic evaluation services for individuals with an uptake of radio-active materials. These arrangements are evidenced by the letter of agreement in Appendix 8. ,

L.4 Transportation of Contaminated Injured Individuals Arrangements have been made to transport contaminated injured individuals to hospitals in fire department vehicles and ambulance service vehicles. These arrangements are evidenced by the letters of agreement in Appendix 8. U The operators of these transport vehicles will be trained in the handling of contaminated injured individuals.

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GEALGA COL.NTY RADIOLOGICAL EMERGENCY RES3ONSE PLAN i M[

%ilIlli l ss l Geauga County

Disaster Services Agency l

December 1983 l

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i L. MEDICAL AND PUBLIC HEALTH

[ L-1. Purpose i

To describe the arrangements made to provide medical services for treating conteminated injured individuals, and for evaluating radiation exposure and radioactive material uptakes.

L-2. Treating Contaminated Injured Individuals Arrangements have been made with Geauga Community HosplEl to" provide #

medical treatment for injured Individuals who are contaminated with radioactive material. This hospital is prepared to handle contaminated individuals on a limited basis. Cases beyond the capability of Geauga Community Hospital will be referred to the University Hospitals or other hospitals listed in the Hospital's Disaster Manual (see Tab 1, Appendix 7). These hospitals are adequately prepared to treat injured contaminated individuals.

j L-3. Evaluation of Radiation Exposure and Radioactive Material Uptakes

! /

1 Geauga Community Hospital will provide diagnostic evaluation services for

)

individuals with an. uptake (or suspected uptake) of radioactive materials. The University Hospitals and other hospitals listed in the Hospital's Disaster Manual (see Tab 1, Appendix 7) w111 serve as backup hospitals.

i L-4. Transportation of Contaminated Injured Individuals Injured persons who are suspected or known to be contaminated (either by survey <:

or imowledge of the conditions where an Individual is picked up) will be transported in fire department rescue vehicles and private ambulance service j vehicles.

l The crews of these vehicles will be trained in the handling of injured persons who are contaminated. Following delivery of each injured contaminated person, the /

crew and vehicle will report to the Hambden Fire Station where they will be monitored and, if necessary, decontaminated.

t L-1 1

Change 2, July 1984 l

I

I L-5. Letttrs cf Agreem:nt The arrangements outlined in paragraphs L-2 through L-4 are evidenced by the letter of agreement, with attachments, in Tab 1, Appendix 7. Arrangements with fire departments and private ambulance services are further described in l

the SOPS for these organizations, b

L-2 )

'[ - Appendix 7. Letters of Agreement Tab Title / Agency '

1- Geauga Community Hospital 2- Thompson United Methodist Church 3- Berry's World 4- Trask Ambulance Service 5- Greater Cleveland Chapter of the American Red Cross /Chardon School District 6- Chardon Local School District 7

7- West Geauga Local School District 8- Geauga Ambulance Service ,

9- Ledgemont Local School District

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r GENUGA COMMUNITY HOSPIThl.

THE GEAUGA HOSPIT AL A S SOCI Allo N INC.

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Paul C. Jacoes ,

President February 9, 1984 Mr. Dale B. Wedge, Director Geauga County Disaster Services Agency 13281 Ravenna Road.

Chardon, Ohio 44024

Dear Mr. Wedge:

This serves as a letter of agreement to confirm that the Geauga Community Hospital is (1) Aware that it might be called upon to provide medical support for contaminated injured individuals in the event of a radaological accident at the Perry Nuclear Power Plant.

(2) Willing to provide such services, albeit on a limited basas (up to about 10 victims). Capabilities of the Hospital are described in the attached extracts from the Hospital's D2saster Manual (pages 12, 13 and 16-19).

If an incident should occur at Perry, the Hospital would implement its disaster plan by recalling key hospital personnel and medical staff. Pro-cedures for recall are described in pages 4.2,9, and 10 of the Disaster Manual (attached). Any cases beyond the Hospital's capabilities (either because of types of injuries or numbers of victims) will be transferred to other hospitals in accordance with existing protocols, as described in pages 10 and 11 of the Manual, also attached hereto.

1 If we can be of further assistance, please contact Clif ford E. Harmon.

Sincerely,

= ,

Paul C .aco* , President cc: Clifford K. Harmon,lVice President, Institutional Services Richard J. Frenenie, Executive Vice President

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A Non Prof. Orgemaet.on Accredited By The Joint Comens.ca On Acc estat.oe Of Moso. eis 7g y

E. Notifientica rnd Ricell of M:dieni and Hespitnl Parsonn91 A. Tha Dissster Chiof or d:signnte shcIl actify th2 Medical

( Commander or his designate prior to activation.

3. The Telephone Operator shall call Department Heads.

F. Reception and' Flow Of Casualties

1. Recertion

a. All disaster victims shall be checked at the hospital's circular drive, at which time they shall be screened (if appropriate) for radiation contamination except during ,

inclement weather when the emergency entrance shall be used.

b. If radiation contacination is detected, such victims are to be directed to the " Decontamination Area" OPD-2 except as otherwise directed by the Triage Area.

c Upon arrival of casualties in the Emergency area, ALL shall be examined by the E.R. physician and disposition made to specific treatment areas.

d. All victi=s shall be identified and tagged by Triage personnel.

r- The Disaster Envelope and Emergency Room Report vill be the only patient record until a patient is adzitted as an inpatient and/or undergoes surgery. Each envelope vill contain:

1. ER Chart

2. Valuables envelope

3. Plastic. patient clothing bag 4 ER na:e band / allergy band

. 5. Disaster tag - preprinted and color coded

6. Easic ree.uisitions; cocplete blood count, bleed rype and cress catch, urine and x-ray, Che: 12 & 1, A3G's

7. Patient progress notes

8. Order sheets

9. Cic:hing list

10. Transfer check list Tif ty (50) pre-nu=bered Disaster Envelopes to be kept in E.R.

Each item contained in the envelope shall be pre-numbered and catch the nu=ber en the cutside of the envelope.

e. All discster envelopes are pre-nu:bered. Personnel filling out the na t band =ust be sure that the number on the band is clear, legible -and agrees with the envelope.

f. On c::p'c:icn

. of the na:e band, place on the vrist or ankle of the victis. On the cc: side of the envelope there vill be brief ins: rue:1cns

( for persennel =aking out requisition to indicate on the requisition

the location of patient (cast room x-ray lobby, etc.)

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9-l F4v. 4 /5 3 c/53 TAB 1

2. Flev i -

8 :; .

kha 'dispositisu cf diccster victims is dapsud nt upon th2 nunbartof

.?;}i cnticipated casualtiss. Generally, if casualtiss era expected to )

~" exceed 10 in number, the following vill be in effect:

a. URGENT - To Triage Area (Emergency Room) including respiratory obstruction or depression, hemorrhages. .

b. LESS URGENT - (First-Aid) Radiology Lobby.

Obvious admission vill be routed to the

c. FRACTURE CASUALTIES Fracture Room for treabsent. . Clinical fractures, bet questionable admissions, splint and hold in long hallway with adequate supe rvision. ,

BURNS AND SHOCK - To be routed to Recovery-Room.

d.

a. D.O.A.'s, - To Morgue.

. f. RADIOACTIVE CASUALTIES - To Decontamination Area - OPD-2 .

g. EMERGENCT MEDICAL TRANSPORTATION - Refer to procedures in Appendix - See also section III.

3. Transferal Of Disaster Casualties To Other Health Care Facilities

- Upon complete medical assessment of disaster casualties, should it be deemed medically essential, appropriately involved victims shall be

~ r~ transferred to other health care facilities for expanded and scre definitive care.

The following referral hospitals in proximity of Ceauga Ecspital shall be utilized to accommodate transferred casualties based on the level and degree of trauma:

University Hospitals Head Trauma (444-1000) , inf ant and . Pediatric Irau=a Huron Road Respital Head Trau=a (761-3300)

Metropolitan General Ecepital Burn Trauca/ Radiation Trana (398-6000)

St. Lukes tEospital Head Trauma I

(3f8-7000) General Trauma Hillcrest Hospital General Trau=a *

(449-4500)

Lake County Hospitals General Tratca -

(East and West) Radiation Trau=a

(?54-2400) (953-9500) .

Transportation of casusicies s'.-all be primarily by land utili:ing local.

EMI and Paramedic squads. The decision to transfer shall be made. by the '

Physician Triage Officer and coordinated through the Triage Center. Rhere L" < land transportation is not feasib'e, the Life Flight (Air Helicop er'Anbulan:e) shall be used as cutlined per Life Flight transportation procedures.

3 t-Rev. E/E3' i 9/33 TAB 1 w - - - -

y - - . w ws- 4 s-. __q+,wg ,%per -ug-u- ,

. F. Receptien nnd Flcv ef Cesunitics (Csntinued)

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7._.

4. Parson 11 Effcets end Vnlu;bles

1. Removal of clothing and personal effects to be handled as follows:

a. Place belongings into a plastic bag. Small personal effects to be placed in " valuable's envelope" and itemized carefully. .

b. Identify the bags with your name, patient's name, and include disaster tag number. .

. c. Deliver clothing and valuable's bag to Business Office by runner to be locked in safe.

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Rev. 9/E3 TAB 1 l -

W. IMRretRv7 (chsuaXtv bbcontam8natin l i

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1. Decontr~dnntient i

..Tj[- Principles: The radioactive injured patient may be a primary radioactive injury casualty or a multiple injury victim whose radiation trauma is complicated by surgical wounds. In the latter case, the most important lesion should be treated first, predicated on the judgement of the surgeon. The administration of the '

radioactive trauma involves three premises which should be adhered to in both types of cases: (1) Containment, (2) Decontamination, (3) Nkasurements.

2. Recommended Procedures:

a. Rescue Squads: In event of an accident which generates a radio-

. active injured patient, with or without associated injury,

. proceed to call Geauga County Sheriffs Department, Chardon Rescue Squads and Geauga County Disaster Agency.

b. Decontanination Area An emergency area which can be converted expediently into use for the administration of a radioactive injured patient. OPD-2 to be the designated temporary Radioactive Room.

1. Easy access to outdoors, preferably with doors opening to the ground outdoors lessening the chance of contaminating the

._ 'dospital corridors with radioactive soil.

2. Adequate water drain.

3. Floor - rs:ce== ended asphalt .

4. Walls smooth.

5. Water outlets - one or more since deconta=1 nation involves abundant amounts of running water. To these outlets hoses can be connected to conduct water to the room and to the patient. The runof f will be into a flow drain.

6. Air Exhaust - some radioactive soil is in the fern of dust.

All pressuri:ed air outlets from the room to be properly filtered to prevent air conta=ination.

7. Deterrents: For the purpose of removing radioactive soils use ,

detergent preferred to soap. One of the more neutral (PR7) ,

is desirable.

5. Protective Clothing: All persons entering the Decentanination Room with the patient is to wear protective clothing:

- Disposable shoe covers

- Double surgical nask

- Surgical gloves t

Rev. 1/30 c/E3 TAB 1

t. . MWremv7 6nruaAty fbcontare nach (Cort 6nued)

! 2.

, , Recourn7nded Pracrdurest (C:ntinutd)'

• 9.

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Deecateminnting h eariels:

- Plastic squeeze bottles containing detergent 1

- Handbrushes l

- Absorbent swabs *

- Gause sponges 7 gallon plastic trash containers to hold supplies and to contain them af ter use. (Ob tain trash containers from CSR) , .

- Paper runners in room for floor covering B. Expansion of Hospital Services

1. Admitting Office

a. Count the number of available beds. *

b. Cancel all reservations and elective admissions

c. Maintain a list-of emergency admissions and list of individuals received or treated during disaster.

Maintain communication with all treatment areas.

d. Utilize disaster tag number as Hospital nu=ber on all pa tients. The regular number to be assigned at a later ti=e.

e. Maintain a list of D.O.A. 's

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f. Assist the Director of Consnunity Relations, or designate in the release of information as follows:

-1. Na:ne and address

2. Dispositicc:

a. If admitted, reveal " serious cendition" and nothing more.

b. " Treated or Released"

c. " Receiving Treatment"

g. Recall Admitting Office Personnel as needed.

2. Business office

a. Receive and hold securely patient belongings.

b. Notify relatives of disaster patients to be discharged and advise them to proceed to the Assembly Roon entrance for pick-up. i

c. Tabulate discharges and keep Admitting apprised.

3. Nursing Department

a. Nurse in charge of Nursing Depart =ent shall act as Disaster Chief in the event the Disaster Chief is not en the scene.

As Disaster Chief, call Chief Executive Of ficer er designs.:e and notify Medical Co==ander.

• 2- TAB 1

E, Expansi"n rf Hospital S rvices (Ctatinued)

[ 3. Nursing Department (Continued)

'( LICENSED PRACTICAL NURSES - NURSINC ASSISTANTS

1. Maintain regular verk assignments, unless otherwise directed. .

. DIVISION SECRETARIES (Disaster Area) ,

1. Their primary responsibility is to record information as soon as the patient arrives at the treatment area.

2. Notify Information Center preferably in writing and utilizing a runner of the following:

a. Name of the Patient.

b. Geauga Community Hrspital disaster identification number. .

c. Condition.

d. Treatment area location.

3. During a disaster, the hospital's Com= unity Relations Director vill man the Information Center located in the Board Room, Extension 6103. .

4 Notify the Infor:ation Center regardir.g final disposition of

" all casualties.

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5. To11cv any other instructions or perform any other duties which may be assigned by the Nurse-in-charge.

6. Do not leave the assigned area unless authorited by the Nurse-in-charge.

4 Radieleev

s. Cancel all scheduled exa:s, unless in extremely critical cases.

b. Recall personnel as needed.

c. Request transportation to transpert casualties from X-Ray when dispositen is made by the physician. Contact Personnel Fool in Radiology Lounge, Extension 6991 for transporters. *

d. Use the disaster identification nc=ber as the film number on all disaster victims. Do not use regular film nu-ber as it vill be assigned later.

e. Fatients to be noved out of X-Ray as soon as dispositten of X-Ray is made by the physician.

Rev. 9'33 TAB 1

- - R. Exp nsi*n of Borpital S rvices (Cortinued)

4. Radielrav (Cratinund)  ;

e r_ j

~C " Specific Instructions

f. .

1. There vill be a central control to segregate patients on arrival according to the severity of the injuries. .

a. Radioactive contaminated patients will have been detected, per plan, and samt directly to the decontamination area. located in Outpatient Department-2.

b. Simple extremity injuries will be sent to the ER Cast Room for splinting.

2 At least one surgeon to be stationed in the Radiology Department to evaluate findings and conditions of 1 patients on consultation with the Radiologist to properly dispose of the case to Surgery or elsewhere as indicated.

3 All X-Ray film to be inserted in an envelope, identified with patient's name, number, etc. Keep films with patient or attach to his clothing if ambulatory.

h. Radiological i=pressions are written on the envelope by the Radiologist and initialed. X-Ray filma vill go with the patient

• =-

to eliminate anj search for records or unnecessary confusion.

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i. Care of The Radiologically Contaminated Victim:

S ta te=ent : The only radiologically contaminated patients seen at Geauga Co== unity Hospital should be patients so badly injured that ceconta ination is not possible at the scene or at a field station. Uninjured persons sh:cid NOT be brought to Geauga Community Hospital purely for decontamination purposes.

Equissent Needed for Decontamination

1. Complete isolation cart .

2. Multiple plastic bags and sealing devices

3. Geiger counter and radiation film badges 4 Koll of 5' vide absorbent paper l

Rev 9/83 17 TAB 1

R. Exp nsion of Hrspitel $9rvices (Csnticund)

.' 4 Radiologv (Crntinued)

E4 Personnel - Upon Notification Of An Impending Arrival

( 1. The Radiation Officer, Nuclear Med Tech and the Nursing Supervisor vill be notified. .

2. Nurses of non-child bearing age vill be assembled for  !

treatment of the victim.

3. Dosimeters will be issued by Radiology and worn by ALL personnel.

l Procedure - Arrival

1. OPD-2 (Outpatient Department-2) vill be stripped of all items not needed for treatment or decontamination, including drapes and cart.

2. Upon arrival, , the patient will be completely undressed in the ambulance and the clothing sealed in a plastic bag. - -

3. The patient, ambulance and attendants vill be surveyed with a geiger counter to determine the degree of contamination.

4. If the transport cart is contaminated, then the patient will be transferred to OPD-2 over a 5' vide absorbent paper.

The paper vill then be plac,ed and sealed in a plastic bag.

5. If attendants are contacinated, they vill be co=pletely undressed in the a=bulance, dress in surgical scrubs and taken to the doctors shower room for decontamination.

6. The ambulance vill be closed and parked away from the Emergency Room entrance..

Patient Care

. 1. Until de:er.ta=1:ation is co:plete, attending personnel vill be rotated each ten minutes.

2. All personnel having contact with the patient vill be in surgical scrub gowns, gloves, masks, caps and shoe covers. *

3. All used material vill be placed and sealed in plastic bacs.

4 Each person leaving the conta:inated area vill be checked with a geiger counter for contamination.

5. Any needed medical treatment of a lifesaving nature vill be , ,

administered regardless of the state of conta ination. If possible, t

=edical treatment and decontacination vill be done concurrently.

6. The patient will be continually and repeatedly vashed down until '

all surface contamination hcs been re oved.

. __ 7. The vash water, as used, vill be dispesed of devn the sink of C?D-2.

p

?.ev. 9/93 TAB 1

H. Exp nsirn cf B: spital Servic e s (Co2tinu;d)

4. Radiology (Centinu;d)

. a.:

.g.. Patient Care k - 8. Internal cont ==4na tion that cannot be removed by washing or during the normal course ,of wound treatment or lavaging vill -

not be addressed.

9. Once completely decontaminated, the patient will be treated as usual for any further medical or surgical problems.

l Referral '

11 A victim having been exposed to a severe dose of radiation or who cannot be decontaminated dur to internal contamination vill be medically stabilized, decontaminated to what extent possible, and transferred to Metropolitan General Hospital.

Disposition of Ares and Materials

1. All materials used vill be double bagged and sealed in plastic bags and placed in a secure area outside of the hospital building for fiani disposition.

, 2. All nondisposable equipment vili be washed until all evidence of

__. conta=ination is removed and then cleaned and processed in the

, usual manner.

3. All liquids used vill be disposed of into the hospital septic systen for dilution and degrading. p.

4 OPD-2 vill be washed down completely until all evidence of contamination is removed.

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5. All dosi=eter badges will be turned over to the radiation officer.

5. Laberatory

a. Dismiss outpatients through the Assembly Room.

b. Continue routi=e inpatient procedures as required. .

c. Staff and recall:

i

1. A list of na:es, addresses and telephone numbers of all Laboratory personnel to be available in the Laboratory.

i 2. The medital technologist on duty shall be responsible for l notification of other Laboratory personnel as the situation i( demands.

Rev, c/S3 -

19 -

TAB 1

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EMERGENCY RESPONSE PLAN FOR THE PERRY NUCLEAR POWER PLANT (PNPP)

Part F Technological Emergency / Disaster Operations

,- Radiological -

.(

l l

Lake County Disaster Services Agency 1

-- - - - . , - . - - . . - . - - . - - . .- - - . - - - - , - - . . . - - - . . - - - - - - , - - - - ~ . - , - - - - , - - - - - - - - - - - - -

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PART L. MEDICAL AND PUBLIC HEALTH SUPPORT L-01 INTRODUCTION The medical and public health function during a radiological emergency involves:

1. Continuation of medical care for County residents

2. Detection and treatment of persons with radiological contamination

3. Evacuation of hospitals and nursing homes.

L-02 RESPONSIBILITIES FOR MEDICAL AND PUBLIC HEALTH SUPPORT The Lake County Health District will have primary responsibility for providing nursing and EMT services at reception centers. The District will also assure sanitary conditions at the reception centers.

The Lake County Health District will coordinate the activities of local fire departments in the radiological screening / decontamination of evacuees at reception centers.

The Emergency Services Medical Coordinator of the Lake County Memorial Hospitals has the primary responsibility for the coordination of physician services at the reception centers.

Nursing homes and the two hospitals within the 10-mile EPZ - Lake County Memorial Hospital (East) and Northeastern Ohio General Hospital have the primary responsibility for the evacuation of their patients from their facility. Hospitals and nursing homes will receive transportation support from the EOC, who will by directing available vehicles (buses and ambulances), support the evacuation of patients and nursing home residents.

k l

148

• Rev. 2 06-13-84 l

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Local fire departments throughout the County will conduct the screening and decontamination of evacuees at reception centers (Attachment 3-9).

Local rescue squads throughout the County will continue their normal rescue and emergency medical functions during an emergency at PNPP. In addition, local rescue squads throughout the County will be capable of transporting injured, radiologically exposed persons.

L-03 MEDICAL AND PUBLIC HEALTH SUPPORT ACTIVITIES

1. Activate Hosoltal Disaster Plans - At the declaration of a " Site Emergency" or more serious emergency at PNPP, the hospital will begin the operation of their internal disaster plans. These plans will cover the discharge of patients, suspension of admissions, and preparation for evacuation of patients.

2. Assure Sanitary Conditions at Reception Centers - The Lake County Health District will inspect reception center operations for

proper sanitation. This activity willbegin with the activation of the reception centers, following declaration of a " General Emergency" at PNPP.

3. Provide Nurses, EMT's at Reception Centers - The Lake County Health District will provide nurses to the reception centers, upon declaration of " General Emergency" at PNPP.

4. Provide E M T's and Physicians at Reception Centers - The Emergency Medical Coordinator of the Lake County DSA will

coordinate physicians and EMT's for emergency service at the reception centers as needed. These physicians will be deployed fo!!owing the activation of reception centers, upon declaration of a

" General Emergency" at PNPP.

5. Screen Evacuees for Contamination - Local fire departments, under the coordination of the Lake County Health District, will screen evacuees and their vehicles for radiological contamination. .

This screening activity will be done at reception centers.

6. Decontaminate Evacuees and Vehicles - Local fire departments ,

will decontaminate vehicles and evacuees. This activity will be performed at decontamination stations located at reception centers.

7. Transport Persons with Suspected Contamination - Injured persons who are suspected to be contaminated will be transported to hospitals in fire department rescue vehicles and ambulances.

Rescue vehicle operators will be trained in the handling of injured persons who are contaminated. Injured persons from within the PNPP site will be transported in accordance with instructions from PNPP staff.

1 149

• Rev. 2: 06-15-84

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s. ..  !.

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8. Diagnose Exposure injuries - Persons requiring diagnostic services /

for exposure to radiation will be transported to Lake County Memorial Hospital (East or West). In the event of an evacuation effecting Lake County Memorial Hospital (East), all persons requiring diagnostic services for exposure to radiation will be.

transported to Lake County Memorial Hospital (West). Both

• V hospitals have the capability for evaluation of radiation exposure or uptake.

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6 i

L, 150

• Rev. 2: 06-15-84

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