ML20247G014
| ML20247G014 | |
| Person / Time | |
|---|---|
| Site: | Seabrook  |
| Issue date: | 04/19/1989 |
| From: | Krimm R Federal Emergency Management Agency |
| To: | Federal Emergency Management Agency |
| References | |
| OL-S-008, OL-S-8, NUDOCS 8905300253 | |
| Download: ML20247G014 (5) | |
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Washington, D.C. 20472 89 MY 22 P7 :25 FEB 9 1988 e
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MEMORANDUM FOR:
NTH Division Chiefs
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All FEMA Regions FROM:
.K Assistant Associate Director Office of Natural and Technological Hazards
SUBJECT:
Clarification of Selected Provisions of Guidance Memorandum (GM) MS-1, Medical Services On November 13,1986,.we issued GM MS-1, Medical Services.
Since that time, questions have arisen regarding some of its provisions.
The following information is provided to clarify those provisions.
Primary and BackuD Hosoitals i
GM MS-1 is silent on the issues of the location of primary and_ backup medical facilities designated to provide medical care for the offsite population.
While it would be O'^4 preferable that.both primary and backep medical facilities be located outside of the plume EPZ, this may not be feasible.
NUREG-0654/ FEMA-REP-1 evaluation criterion J.10.h. provides-that relocation centers should be located "at least 5 miles, and preferably.10 miles, bevond the boundaries of the plume.
exposure emergency' planning zone".
Relocation centers are to j
be located at least 15 miles from nuclear power plants to preclude or minimize further radiological exposure to evacuees and the need for reevaluation.
This rationale should also be applied to medical facilities.
Therefore, it is FEMA policy that at least one, either the primary or backup medical facility, should be located at least 5 miles outside the plume EPZ.
This policy should be implemented notwithstanding those situations where the primary and/or backup medical facilities are the same as utility contract hospitals.
Medical Facilitv/ Transportation Resources (Lists and Acreements)
On page 3 of GM MS-1, evaluation criterion L.3.
states that lists should be developed of the facilities within the State or contiguous States considered capable of providing medical support for any contaminated injured individual.
The
" Areas for Review and Acceptance Criteria" for this section c
states that the lists should be annotated to indicate the
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ambulatory-nonambulatory capacities for providing medical support for contaminated injured members of the general 8905300253 890419 PDR ADOCK 05000443 a,
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-(~T kJ public and any special radiological capabilities. Further, it states that this will enable State and local officials to direct members of the general public to those institutions capable of handling contaminated injured patients.
The
" Areas for Retriew and Acceptance Criteria" for A.3. ir.dicates that written agreements should be obtained for the designated primary and backup medical f acilities and tran,sportation providers.
Organizations that have responsibility for transporting contaminated injured persons should specify the types and numbers of specialized and non-specialized vehicles necessary.
If additional vehicles and other transportation resources are needed by an organization, they should be secured with letters of agreement.
Ambulatory /Non-Ambulatory CaDacity The terms " ambulatory /non-ambulatory capacities", are explained as follows:
" Ambulatory capacity" means the medical facility's capacity to treat individuals on an outpatient basis and "non-ambulatory capacity" means the facility's inpatient capacity.
The outpatient capacity is the number of individuals that the facility can handle per day during an emergency without regard to hospitalization for treatment of radiological contamination or exposure.
The inpatient capacity is the total number of available beds in a
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facility without regard to treatment of radiological contamination or exposure.
Convevance,Enr Contaminated Iniured Individuals.
Transporting contaminated injured persons is i
addressed in GM MS-1.
It provides for specialized (e.g.,
ambulance) and non-specialized (e.g.,
auto, van or bus) transportation resources.
The key factors in determining which type of vehicle is appropriate are the type and severity of the medical problems encountered and the need for trained emergency medical services personnel.
Members of the d
public who are physically injured or appear to be sick would be transported directly to medical facilities for specialized medical treatment.
Members of the public who are not physically injured or do not appear to be sick would proceed t6 relocation centers for radiological monitoring.
It is assumed that if they are determined at relocation centers to be contaminated and/or internally exposed and need further diagnosis or treatment, they would be transported to a medical facility (ies).
Bvoassina Relocation Centers As indicated above, relocation centers may be bypassed for
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members of the public who are physically injured or appear to
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be sick.
Such persons should be transported directly to a medical facility unless the injuries are minor in nature.
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This would cover those suffering from an acute radiation exposure syndrome and wo'uld not require a transportation i
provider to assess radiological contamination.
Medical Personnel On page 4 of the GM, the " Areas for Review and Acceptance criteria" states that each hospital listed under evaluation i
criteria L.L and L.3. shall have at least one doctor and one nurse who can supervise the evaluation and treatment of contaminated injured patients.
The degree to which a r
medical facility has trained personnel beyond the minimum one doctor and one nurse is a matter between the State and' local governments and that facility's management.
We ha.ve not prescribed numbers beyond the stated minimum.
Medical Emercency Drills and Exercises The demonstration of capability to provide medical services should be done in annual medical emergency drills and biennial exercises.
An annual medical emergency dti(1 involving a simulated contaminated injured individual (including one exposed to
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dangerous levels of radiation) should be conducted and i
contain provisions for participation by local services agencies (i.e., ambulance and offsite medical treatment facility).
The simulated contaminated injured person should be transported directly to either a designated primary or backup medical facility for the public.
If the medical facility is designated for both onsite and offsite use, then one drill can be used to test the facility's capabilities to handle both onsite and offsite personnel.
The drill should also include appropriate offsite emergency communications support.
Simulation of a relocation center (s) may be included although the activation of relocation centers is not required.
The offsite portions of the medical drill may be performed as part of the required biennial exercise.
When medical emergency services components are integrated into the biennial exercise, it is necessary to include the activation of relocation centers and designated medical facilities.
The scenario and exercise play will determine which relocation centers and hospitals should be activated.
This activation should include participation by primary and i
backup facilities, including appropriate support functions. A
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simulated contaminated injured individual, either from onsite or offsite areas, will be transported to each activated medical facility.
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'I glsA Annual medical emergency drills' must be evaluated by FEMA Regional staff as required in GM EX-2, Rev. 1 (Section A.3.
on page 2).
The Region's report of the evaluation of these drills should be forwarded to FEMA Headquarters.
Implementation The time frame for incorporating the provisions of GM MS-1 into a biennial exercise or an annual drill has been revised to reflect the provisions of GM EX-2 (August 11, 1987).
All plans should have been revised to incorporate the provisions of GM MS-1 by December 31, 1987.
These medical service measures should be demonstrated either at the next annual medical emergency drill or biennial exercise held in calendar '
If changes to REP plans are necessitated by the
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year 1988.
policy that at least one medical facility be located 15 miles c
from the site, the plans should be revised to reflect this l
change by December 31, 1988.
The change should be t
demonstrated in a drill or exercise during calendar year t
1989.
This memorandum has been coordinated and concurred in by the NRC staff.
If you have any questions please contact Bill McNutt at 646-2857.
<s CC:
Frank J. Congel NRC j
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