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| number = ML15138A223
| number = ML15138A223
| issue date = 04/16/2015
| issue date = 04/16/2015
| title = Farley, Units 1 and 2 - Emergency Plan, Revision 64, Part 2 of 3
| title = Emergency Plan, Revision 64, Part 2 of 3
| author name = Gayheart C A
| author name = Gayheart C A
| author affiliation = Southern Co, Southern Nuclear Operating Co, Inc
| author affiliation = Southern Co, Southern Nuclear Operating Co, Inc
Line 15: Line 15:
| page count = 24
| page count = 24
}}
}}
=Text=
{{#Wiki_filter:EMERGENCY PLAN Part II  MEDICAL PLAN
Rev. 64 Page 1 of 2 Rev. 64 INDEX OF EFFECTIVE PAGES PART II - MEDICAL PLAN PAGE REV. NO. PAGE REV. NO. PAGE REV. NO.      i 24 B-20b DEL C-35 52 ii 24 B-20c DEL C-36 52 iii 7 B-21 DEL C-37 52 1 7 B-22 DEL C-38 52 2 30 B-23 DEL C-39 52 3 52 B-24 DEL C-40 52 4 24 B-25 DEL C-41 52 5 24 B-26 DEL C-42 52 6 30 B-27 DEL C-43 52 7 52 B-28 DEL C-44 52 8 24 B-29A DEL C-45 52 9 27 B-29B DEL C-46 52 10 39 B-30 DEL C-47 52 11 27 B-31 DEL C-48 52 12 24 B-32 DEL C-49 52 13 64 B-33 DEL C-50 52 14 27 APPENDIX C C-51 52 15 19 C-1 52 C-52 52 16 27 C-2 52 C-53 52 17 52 C-3 52 C-54 52 18 7 C-4 52 C-55 52 APPENDIX A C-5 52 C-56 52 A-1 47 C-6 52 C-57 52  C-7 52 C-58 52 APPENDIX B C-8 52 C-59 52  C-9 52 C-60 52 B-i DEL C-10 52 C-61 52 B-1 64 C-11 52 C-62 52 B-2 DEL C-12 52 C-63 52 B-3 DEL C-13 52  B-4 DEL C-14 52  B-5 DEL C-15 52 APPENDIX D B-6 DEL C-16 52 D-1 DEL B-7 DEL C-17 52 D-2 DEL B-8 DEL C-18 52 D-3 DEL B-9 DEL C-19 52 D-4 DEL B-10 DEL C-20 52 D-5 DEL B-10a DEL C-21 52 D-6 DEL B-10b DEL C-22 52 D-7 DEL B-10c DEL C-23 52 D-8 DEL B-11 DEL C-24 52 D-9 DEL B-12 DEL C-25 52 D-10 DEL B-13 DEL C-26 52 D-11 DEL B-14 DEL C-27 52 D-12 DEL B-15 DEL C-28 52 D-13 DEL B-16 DEL C-29 52 D-14 DEL B-17 DEL C-30 52 D-15 DEL B-18 DEL C-31 52 D-16 DEL B-19 DEL C-32 52 D-17 DEL B-20 DEL C-33 52 D-18 DEL B-20a DEL C-34 52 D-19 DEL
Page 2 of 2 Rev. 48 INDEX OF EFFECTIVE PAGES PART II - MEDICAL PLAN PAGE REV. NO. PAGE REV. NO. PAGE  REV. NO.      APPENDIX D (CONT'D) D-68 16  D-20 DEL D-69 16  D-21 DEL D-70 16  D-22 DEL D-71 16  D-23 DEL D-72 16  D-24 DEL D-73 16  D-25 DEL D-74 16  D-26 DEL D-75 16  D-27 DEL D-76 16  D-28 DEL D-77 16  D-29 DEL D-78 16  D-30 DEL D-79 16  D-31 DEL D-80 16  D-32 DEL D-81 16  D-33 DEL D-82 16  D-34 DEL D-83 16  D-35 DEL D-84 16  D-36 DEL D-85 16  D-37 DEL D-86 16  D-38 DEL D-87 16  D-39 16 D-88 16  D-40 16 D-89 16  D-41 16 D-90 16  D-42 16 D-91 16  D-43 16 APPENDIX E  D-44 16 E-1 7  D-45 16 E-2 7  D-46 16 APPENDIX F  D-47 16 F-1 49  D-48 16    D-49 16    D-50 16    D-51 16    D-52 16    D-53 16    D-54 16    D-55 16    D-56 16    D-57 16    D-58 16    D-59 16    D-60 16    D-61 16    D-62 16    D-63 16    D-64 16    D-65 16    D-66 16    D-67 16   
RADIATION EMERGENCY MEDICAL PLAN
I. INTRODUCTION
A. PURPOSE
It is the objective of the Radiation Emergency Medical Plan to provide for the selection and delivery of appropriate medical care
for personnel who may have been exposed to serious radioactive
contamination or radiation injury, possibly concomitant with other
injuries, at the Joseph M. Farley Nuclear Plant. In the event of an
accident, to ensure a smooth flow of action from initial evaluation
and treatment through final disposition, knowledgeable decision
making regarding medical priorities is required. Adequate
arrangements for transportation of injured personnel and assurance
that proper facilities as well as expert professional and paramedical
services are immediately available are necessary. Through careful
planning, training and practice, this objective will be accomplished.
B. SCOPE
The plan provides for onsite medical support and offsite medical support at three levels:  primary care, definitive care, and back-up
definitive care. A description of casualty flow to these facilities
including action levels, transportation available and notification
procedures, is given.
Provisions are made for training at the local level of support to minimize the chance of an accident and to ensure that, in the event
of an accident, affected personnel onsite and offsite respond
appropriately without compounding the medical or radiological
problems present.
II. MEDICAL SUPPORT AND FACILITIES
A. PLANT SITE
: 1. General Onsite emergency medical activities are performed by trained and qualified persons immediately available under the direction
of the Emergency Director and will consist of:
: a. Removal of personnel from hazardous area (high radiation level or contamination levels)
: b. First aid for severe physical injuries
: c. Personnel decontamination
: d. Evaluation of radiation exposure
Rev. 7 
: e. Triage of personnel An aerial view of the plant site is shown in FIGURE 1.
: 2. Facilities The health physics and decontamination facility is located at
elevation 155 of the Auxiliary Building as shown in FIGURE 2 and
FIGURE 3.
This facility is located near potentially contaminated and high
radiation areas so that health physics support, first aid, and
personnel decontamination can be effectively administered. A
Health Physics technician will normally be available at this
facility.
In the event of a Site Area or General Emergency when the health
physics and decontamination facility might become untenable, the
Nursing Station (FIGURE 4) at the Training/Visitor's Center will
normally become the center for personnel first aid and
decontamination activity. The necessary first aid and
decontamination supplies for these facilities are listed in
APPENDIX A.
B. SOUTHEAST ALABAMA MEDICAL CENTER (SAMC)
The Southeast Alabama Medical Center (SAMC) of Dothan, Alabama, has
agreed to accept injured, contaminated and/or irradiated casualties (APPENDIX B). This hospital is a 400 bed general hospital fully
accredited by the State Hospital Association and Joint Commission for
Accreditation of Hospitals and Organizations. It has a modern fully
equipped emergency room of sixteen suites with provisions to perform
all necessary procedures; complete laboratory and diagnostic x-ray
capabilities; and 13 major and 1 minor surgical suites. There are
approximately 100+ members on the active staff, the majority board
certified or qualified representing all major medical specialties.
Space (FIGURE 5) at the hospital provides a receiving area for
potentially contaminated and/or irradiated patients and has a separate
entrance from the normally used emergency entrance. This facility is
adequate for:
: 1. Personnel decontamination
: 2. Emergency treatment
: 3. Storage of emergency equipment and supplies A permanent helipad exists for air evacuation of injured or irradiated
personnel via helicopter. Communications can be established by FNP
with SAMC through the hospital's switchboard or directly with the
hospital emergency room.
Rev. 30 
FIGURE 1  Aerial view of plant site Rev. 52 Alabama 95  County 42 Contracto rParking Lot Fabrication Shop  Training Center Parking Lo t Unit 1Cooling Towers Unit 2Cooling Towers Wate r TreatmentPlant Utility Building A ux ili ar yBuilding Di ese lBuilding N O u t age Support Building  T ur bi ne Building S erv i ceBuilding Protecte d A rea Detail A Switch House See Detail A CSC Parking Lot HighVoltage Switchyard Warehouse Control Room OSC a n d T SC 
FIGURE 2                                                  Gen. Rev. 24
FIGURE 3                                                      Gen. Rev. 24
FITNESS FOR DUTY/NURSE'S STATION Figure 4 
Gen. Rev. 30 
C. THE UNIVERSITY OF ALABAMA HOSPITAL (RCTF)
The University of Alabama Hospital in Birmingham, Alabama, has agreed to admit and provide on a priority basis definitive care for
contaminated and/or irradiated casualties (APPENDIX B). This
hospital is a 639 bed teaching institution affiliated with the
University of Alabama in Birmingham School of Medicine. It is
accredited by the Joint Commission on Accreditation of Hospitals and
Organizations and is licensed by the Alabama State Board of Health. 
It is a member of the American Hospital Association, the Council of
Teaching Hospitals and the Alabama Hospital Association. Its
specialists in oncology, hematology, infectious disease, endocrinology, gastroenterology, nuclear medicine, radiology, and  the surgical specialties render it fully capable of providing effective medical care. Already in existence are portable and        fixed isolation units capable of maintaining a sterile environment.                                                       
Facilities for the care of radiation emergency casualties have been developed to provide a Radiation Casualty Treatment Facility (RCTF).
The RCTF consists of a nine bed unit, a nursing station, utility
room, storage room, and a treatment and examination room.
D. OAK RIDGE Institute of Science and Education (ORISE)               
Oak Ridge Associated Universities operates a Radiation Emergency Assistance Center Training Site in Oak Ridge, Tennessee. Its
specialized facilities and staff are available for the care and
treatment of possible radiation casualties from the Joseph M. Farley Nuclear Plant of Alabama Power Company in Dothan, Alabama (APPENDIX B). The ORISE-REAC/TS can accommodate approximately 20      patients who are contaminated or have received external radiation.
A laminar flow facility with two sterile rooms is available for patients requiring isolation. Sophisticated whole-body counting equipment, probes for locating radioactive particles in wounds, and
computer-based monitoring services are also available. The staff      of the ORISE-REAC/TS has considerable experience in total-body irradiation and several have participated in the handling of previous radiation accident casualties. The nursing staff, aides and orderlies, likewise, are experienced in handling patients who have been treated with or accidentally exposed to both external and
internal radiation. Full diagnostic laboratory and radiographic
back-up facilities are available. A description of their facilities
is given in APPENDIX E.
III. RADIATION CASUALTY HANDLING PROCEDURE
A. NOTIFICATION
A general order of notification in the event of an incident at the Farley Nuclear Plant is given in PART I, FIGURE 24. Detailed lines
of notification and communication concerning medical support are
given in FIGURE 6 of this plan.
Rev. 24
B. ONSITE RESPONSIVE ACTION
Actual or suspected radiation casualties, with or without concomitant trauma, will be moved to the primary onsite decontamination area as
shown in FIGURE 2 and FIGURE 3. If this primary onsite
decontamination area is unavailable as a result of the emergency, the
casualties will be moved to the secondary onsite decontamination area
as shown in FIGURE 4. The priority order of onsite medical emergency
action will then be:
: 1) First aid of life-threatening or severe physical injury;
: 2) Personnel decontamination, to the extent that trauma is aggravated;
: 3) Evaluation of radiation exposure, external and internal, with concomitant first aid of other injuries.
The actual or suspected casualties may be grouped into three classes for triage considerations.                                 
Class I
Criteria
: 1) Estimated radiation dose greater than applicable 10CFR20 limits but less than 5 rem to whole body (including eyes, gonads, and
blood-forming organs); or
: 2) Estimated radiation dose to the skin of the whole body greater than the 10CFR20 limit but less than 30 rem; or
: 3) Estimated radiation dose to the feet, ankles, hands, or forearms greater than the 10CFR20 limit but less than 75 rem.
ACTION 
: 1) Without trauma - Send to Southeast Alabama Medical Center (SAMC) for evaluation after clearance by Health Physics for
contamination.
: 2) With trauma - Apply appropriate first aid then send to SAMC for evaluation. Monitoring for contamination is desirable prior to
sending the casualty to SAMC.
Class II
Criteria
: 1) Estimated radiation dose to the whole body (including eyes, gonads, and blood-forming organs) greater than 5 rem but less
than 25 rem, or 
Rev. 27
MEDICAL NOTIFICATION ORDER
FIGURE 6 - MEDICAL NOTIFICATION ORDER
Gen. Rev. 39
* If injury involves contamination, excessive exposure or if it is anticipated that injured will be admitted to the hospital for observation or treatm ent in excess of 48 hours duration.
SHIFT SUPERVISO A MBULANCE SAM SURGEON RCTF EMERGENCDIRECTO EO MANAGEMEDICAL ADVISO R SNC PROJECMEDICALDIRECTO STATE OF A LABAM A ORISE-NRC*
: 2) Estimated radiation dose to the skin of the whole body greater than 30 rem but less than 150 rem; or
: 3) Estimated radiation dose to the feet, ankles, hands, or forearms greater than 75 rem but less than 375 rem.
Action 
: 1) Without trauma send to SAMC for evaluation after clearance by Health Physics for contamination.
: 2) With trauma apply appropriate first aid, then send to SAMC for evaluation. Monitoring for contamination is desirable prior to
sending the casualty to SAMC.
Class III
Criteria
: 1) Estimated radiation dose to the whole body (including eyes, gonads, and blood-forming organs) of 25 rem or more; or 
: 2) Estimated radiation dose to the skin of the whole body of 150 rem or more; or
: 3) Estimated radiation dose to the feet, ankles, hands, or forearms of 375 rem or more.
: 4) Internal radiation exposure estimated to be significant.
Action 
: 1) Without trauma - after proper decontamination by Health Physics, send to SAMC for evaluation and potential                transfer to the Radiation Casualty Treatment Facility (RCTF) in Birmingham or to ORISE-REAC/TS in Oak Ridge,Tennessee.
: 2) With trauma - appropriate first aid, decontamination, and send to SAMC for treatment and potential transfer to RCTF or REAC/TS.
The above estimates of external and internal radiation exposures will be performed by the Health Physics staff on the basis of all
available information, including dosimeters, area monitors, air
monitors, and survey instruments.
Contaminated casualties sent to SAMC, RCTF, or REAC/TS will be accompanied by a person who is qualified in radiological monitoring
and will stay in attendance and maintain radiological control until
decontamination is complete. Contaminated casualties will be covered
with suitable protective clothing or plastic sheets so as to prevent
or minimize the spread of radioactive material. Radiation exposure
to the vehicle operator and any attendant personnel will be
Rev. 27 minimized to the extent possible, and shadow shields may be used.
Inhalation of airborne radioactive material may be minimized through
the use of respiratory protective devices.
Each casualty will be identified before leaving the plant with a nonremovable hospital type wristband showing his name and an
identification number for use for reference purposes in all
communications, to avoid possible confusion in reporting estimates of
radiation dose and similar matters.
C. SAMC RESPONSIVE ACTION
All casualties sent to SAMC will enter the Radiation Casualty/Decon-tamination area and be surveyed by qualified personnel assigned for
that purpose. Emergency medical care will be provided if required
together with further decontamination.
: 1) Criteria
Those casualties with estimated radiation doses less than 25 rem to the whole body (including eyes, gonads, and blood-
forming organs) and estimated from bioassay measurements and
other reasons not to be bearing significant quantities of
internal emitters.
Action
Hospitalize if necessary for continued treatment of trauma or illness; otherwise continue minor treatment, observation and
evaluation on out-patient basis, after release by Health
Physics personnel. Observation and evaluation will include
hematological surveys, bioassays of urine and feces, and
general physical condition, including opthalmological and
dermatological examinations. If evaluation so indicates (e.g.,
leukopenia), transfer to RCTF or REAC/TS.
: 2) Criteria
Those casualties with estimated radiation doses of greater than 25 rem to whole body, or thought from bioassay measurements and
other reasons to be bearing significant quantities of internal
emitters.
Action
Transfer to RCTF or REAC/TS (after emergency treatment of trauma or illness).
In the event of mass casualties, a decision will be made as to which casualties will be sent from SAMC to RCTF, or directly to ORISE REAC/TS. This decision will be made by the Medical Director of the Southern Nuclear Operating Company or his designated alternate, with the advise of staff and consultants.
Rev. 24 Contaminated and/or irradiated casualties sent from SAMC to RCTF, ORISE-REAC/TS or elsewhere, will be accompanied by    a person qualified in radiological monitoring. This person will stay in attendance and maintain radiological control until the patient is transferred to a similarly
qualified person at the receiving institution.
All rooms, equipment, and supplies used to treat contaminated personnel will be made controlled areas and considered to be
contaminated until released by the Health Physics staff.
D. RCTF RESPONSIVE ACTION
Casualties sent to RCTF will be met outside the building by an individual qualified in radiological monitoring, will enter through
the appropriate emergency room entrance of the University of Alabama
Hospital, be surveyed and then transported directly to the RCTF. 
The staff of the RCTF will have been previously notified and will be
ready to accept the patients.
IV. TRANSPORTATION
A. SERVICES AVAILABLE
: 1. Local Rescue Squads Ashford Rescue Squad Columbia Rescue Squad
: 2. Dothan Ambulance Service (Pilchers Ambulance Service), Inc.
Dothan Ambulance Service, Inc. has agreed to transport potentially contaminated and/or irradiated casualties from    the plant site to SAMC and on to the University of Alabama Hospital in Birmingham, Alabama or Radiation Emergency
Assistance Center Training Site (REAC/TS) of Oak Ridge
Institute for Science and Education (ORISE) in    Oak Ridge, Tennessee ORISE-REAC/TS. Their ambulances are equipped with radios so they can be in communication through SAMC with the Control Room.
Rev. 64
B. ROUTES
: 1. Plant Site to SAMC (Figure 7, 8)
Normally, emergency vehicles will proceed west on County Road 42 to County Road 33; southwest on County Road 33 to County Road 55; south on County Road 55 to U.S. 84, west on U.S. 84, until its junction with State Highway 210 (Ross Clark Circle)
at which point the Medical Center is located.
If the normal route is unavailable then an alternate route will be directed by the control room. Two such alternate routes are shown on Figure 7.                                 
: 2. Plant Site or SAMC to the University of Alabama Hospital (FIGURE 9)
As in 1 above, to State Highway 210 (Ross Clark Circle); then north on 210 to its junction with U.S. Highway 231; Highway 231
north to Montgomery and junction with Interstate 65 then north
on Interstate 65 to Birmingham. Exit Interstate 65 at 8th
Avenue South; east to 19th Street; north to 6th Avenue South;
east to University Hospital Emergency Room.
: 3. SAMC to Oak Ridge, Tennessee (FIGURE 9)
As in 2 above on Interstate 65 to Interstate 59 north to Chattanooga, Tennessee; north on Interstate 75 to    Interstate 40; west on Interstate 40 to State Highway 95; north on State Highway 95 to Oak Ridge, Tennessee, then north on New York Avenue to West Tennessee Avenue; east to ORISE-REAC/TS.                                             
V. DRILLS
Radiation emergency practice drills will be conducted annually to maintain the proficiency of the organization and personnel at the plant, SAMC and at
the RCTF and to verify the arrangements made with other groups. Drills
will be arranged so as to provide quantitative data on response times for
each communication, decision and action element of the overall Radiation
Emergency Medical Plan. These response times will be used to predict the
effectiveness of the Plan and to disclose areas where improvement in
training, equipment or organization is needed. Management review of
critique comments obtained from drill monitors will be conducted. 
Identified, necessary, or required alterations in training or for the
Emergency Plan/EIPs will be implemented in a timely manner.
VI. TRAINING
A. OPERATIONS AND MAINTENANCE PERSONNEL
Permanently assigned personnel will undergo radiation protection
training, the extent of which will depend on the nature of the 
Rev. 27
specific job. Each employee will be required as part of his training to be familiar with radiation protection practices, facilities and
equipment at the plant as described in the Health Physics Manual. At
least one person on each shift will be qualified to perform first
aid.
B. HEALTH PHYSICS PERSONNEL
All Health Physics Technicians will be thoroughly trained in the principles of radiation protection including personnel dosimetry, decontamination and monitoring.
C. PHYSICIANS
Several physicians in the Houston County area have been retrained to provide care for injured, contaminated, and/or irradiated victims. These physicians are encouraged to attend a training seminar on the care of radiation injuries. The Medical Director      for the Southern Nuclear Operating Company has also attended this seminar.                                                           
D. PARAMEDICAL PERSONNEL
Ambulance attendants, nurses and hospital technicians will be encouraged to attend annual training sessions. These sessions will
be conducted under the direction of the Training Director. Training
will include a description of the facility, its health physics
program, the spectrum of possible accidents with emphasis on
potential resulting casualties and procedures for implementing the
Radiation Emergency Medical Plan.
VII. RADIATION EXPOSURE GUIDELINES
The following guidelines are given for the exposure of hospital and ambulance service personnel:
A. 3 REM
If there is an adequate number of attendants such that rotation  may
be accomplished without further endangering the patient(s).
B. 5 REM
If the number of attendants is limited such that personnel cannot be rotated.
C. 25 REM
To save a life.
The above guideline numbers refer to whole body penetrating radiation.
When careful monitoring is provided, the extremities dose may be up to 5
times the value given and the skin dose may be up to 2 times the value
given.                    Rev. 19 
Major Route to SAMC FIGURE 7 
Rev. 27 
Figure 9. Major Routes to Birmingham and Oak Ridge, Tennessee Rev. 7 APPENDIX A EMERGENCY EQUIPMENT AND SUPPLIES
I. HP OFFICE 
Blankets First Aid Supplies Protective Clothing and Supplies Decontamination Supplies Wristbands Survey Meter
II. NURSING STATION
Audiometric Testing Equipment Pulmonary Testing Equipment Vision Testing Equipment Physical Examination Equipment First Aid Supplies
III. PEV DELETED
IV. AMBULANCE KIT
Protective Clothing Lead Covering Material Blankets Signs and Labels Wristbands Dosimetry Devices
V. SOUTHEAST ALABAMA MEDICAL CENTER
Survey Meters and Supplies Dosimetry Devices Signs and Labels Protective Clothing Surgical Clothing Decontamination Supplies Specimen Containers Disposable Cartons Logbook and Pencil
A-1                                Rev. 47 APPENDIX B Letters of Agreement on File
Listing of letters can be found in Appendix 2 (B) Index of Part I of the Farley Emergency Plan.
B-1                                Rev. 64
APPENDIX F
ROSTER OF MEDICAL CONSULTANTS
I. SOUTHERN NUCLEAR MEDICAL DIRECTOR C. Calvert Dodson, III, M.D.
II. SNC CONTRACT PHYSICIANS (FAIRVIEW CLINIC, DOTHAN)
Earl F. Mazyck, M.D. James A. Robeson, Jr. M.D.
J. Ryan Conner, M.D.
Christopher L. Miller, M.D.
III. SAMC STAFF James C. Jones, D.O., Director, Emergency Room
IV. UNIVERSITY OF ALABAMA MEDICAL CENTER STAFF Chris Roskoe, M.D., Medical Director, Emergency Room
F-1                                Rev. 49}}

Latest revision as of 04:19, 17 March 2019

Emergency Plan, Revision 64, Part 2 of 3
ML15138A223
Person / Time
Site: Farley  Southern Nuclear icon.png
Issue date: 04/16/2015
From: Gayheart C A
Southern Co, Southern Nuclear Operating Co
To:
Document Control Desk, Office of Nuclear Reactor Regulation
Shared Package
ML15138A238 List:
References
NL-15-0820
Download: ML15138A223 (24)


Text

EMERGENCY PLAN Part II MEDICAL PLAN

Rev. 64 Page 1 of 2 Rev. 64 INDEX OF EFFECTIVE PAGES PART II - MEDICAL PLAN PAGE REV. NO. PAGE REV. NO. PAGE REV. NO. i 24 B-20b DEL C-35 52 ii 24 B-20c DEL C-36 52 iii 7 B-21 DEL C-37 52 1 7 B-22 DEL C-38 52 2 30 B-23 DEL C-39 52 3 52 B-24 DEL C-40 52 4 24 B-25 DEL C-41 52 5 24 B-26 DEL C-42 52 6 30 B-27 DEL C-43 52 7 52 B-28 DEL C-44 52 8 24 B-29A DEL C-45 52 9 27 B-29B DEL C-46 52 10 39 B-30 DEL C-47 52 11 27 B-31 DEL C-48 52 12 24 B-32 DEL C-49 52 13 64 B-33 DEL C-50 52 14 27 APPENDIX C C-51 52 15 19 C-1 52 C-52 52 16 27 C-2 52 C-53 52 17 52 C-3 52 C-54 52 18 7 C-4 52 C-55 52 APPENDIX A C-5 52 C-56 52 A-1 47 C-6 52 C-57 52 C-7 52 C-58 52 APPENDIX B C-8 52 C-59 52 C-9 52 C-60 52 B-i DEL C-10 52 C-61 52 B-1 64 C-11 52 C-62 52 B-2 DEL C-12 52 C-63 52 B-3 DEL C-13 52 B-4 DEL C-14 52 B-5 DEL C-15 52 APPENDIX D B-6 DEL C-16 52 D-1 DEL B-7 DEL C-17 52 D-2 DEL B-8 DEL C-18 52 D-3 DEL B-9 DEL C-19 52 D-4 DEL B-10 DEL C-20 52 D-5 DEL B-10a DEL C-21 52 D-6 DEL B-10b DEL C-22 52 D-7 DEL B-10c DEL C-23 52 D-8 DEL B-11 DEL C-24 52 D-9 DEL B-12 DEL C-25 52 D-10 DEL B-13 DEL C-26 52 D-11 DEL B-14 DEL C-27 52 D-12 DEL B-15 DEL C-28 52 D-13 DEL B-16 DEL C-29 52 D-14 DEL B-17 DEL C-30 52 D-15 DEL B-18 DEL C-31 52 D-16 DEL B-19 DEL C-32 52 D-17 DEL B-20 DEL C-33 52 D-18 DEL B-20a DEL C-34 52 D-19 DEL

Page 2 of 2 Rev. 48 INDEX OF EFFECTIVE PAGES PART II - MEDICAL PLAN PAGE REV. NO. PAGE REV. NO. PAGE REV. NO. APPENDIX D (CONT'D) D-68 16 D-20 DEL D-69 16 D-21 DEL D-70 16 D-22 DEL D-71 16 D-23 DEL D-72 16 D-24 DEL D-73 16 D-25 DEL D-74 16 D-26 DEL D-75 16 D-27 DEL D-76 16 D-28 DEL D-77 16 D-29 DEL D-78 16 D-30 DEL D-79 16 D-31 DEL D-80 16 D-32 DEL D-81 16 D-33 DEL D-82 16 D-34 DEL D-83 16 D-35 DEL D-84 16 D-36 DEL D-85 16 D-37 DEL D-86 16 D-38 DEL D-87 16 D-39 16 D-88 16 D-40 16 D-89 16 D-41 16 D-90 16 D-42 16 D-91 16 D-43 16 APPENDIX E D-44 16 E-1 7 D-45 16 E-2 7 D-46 16 APPENDIX F D-47 16 F-1 49 D-48 16 D-49 16 D-50 16 D-51 16 D-52 16 D-53 16 D-54 16 D-55 16 D-56 16 D-57 16 D-58 16 D-59 16 D-60 16 D-61 16 D-62 16 D-63 16 D-64 16 D-65 16 D-66 16 D-67 16

RADIATION EMERGENCY MEDICAL PLAN

I. INTRODUCTION

A. PURPOSE

It is the objective of the Radiation Emergency Medical Plan to provide for the selection and delivery of appropriate medical care

for personnel who may have been exposed to serious radioactive

contamination or radiation injury, possibly concomitant with other

injuries, at the Joseph M. Farley Nuclear Plant. In the event of an

accident, to ensure a smooth flow of action from initial evaluation

and treatment through final disposition, knowledgeable decision

making regarding medical priorities is required. Adequate

arrangements for transportation of injured personnel and assurance

that proper facilities as well as expert professional and paramedical

services are immediately available are necessary. Through careful

planning, training and practice, this objective will be accomplished.

B. SCOPE

The plan provides for onsite medical support and offsite medical support at three levels: primary care, definitive care, and back-up

definitive care. A description of casualty flow to these facilities

including action levels, transportation available and notification

procedures, is given.

Provisions are made for training at the local level of support to minimize the chance of an accident and to ensure that, in the event

of an accident, affected personnel onsite and offsite respond

appropriately without compounding the medical or radiological

problems present.

II. MEDICAL SUPPORT AND FACILITIES

A. PLANT SITE

1. General Onsite emergency medical activities are performed by trained and qualified persons immediately available under the direction

of the Emergency Director and will consist of:

a. Removal of personnel from hazardous area (high radiation level or contamination levels)
b. First aid for severe physical injuries
c. Personnel decontamination
d. Evaluation of radiation exposure

Rev. 7

e. Triage of personnel An aerial view of the plant site is shown in FIGURE 1.
2. Facilities The health physics and decontamination facility is located at

elevation 155 of the Auxiliary Building as shown in FIGURE 2 and

FIGURE 3.

This facility is located near potentially contaminated and high

radiation areas so that health physics support, first aid, and

personnel decontamination can be effectively administered. A

Health Physics technician will normally be available at this

facility.

In the event of a Site Area or General Emergency when the health

physics and decontamination facility might become untenable, the

Nursing Station (FIGURE 4) at the Training/Visitor's Center will

normally become the center for personnel first aid and

decontamination activity. The necessary first aid and

decontamination supplies for these facilities are listed in

APPENDIX A.

B. SOUTHEAST ALABAMA MEDICAL CENTER (SAMC)

The Southeast Alabama Medical Center (SAMC) of Dothan, Alabama, has

agreed to accept injured, contaminated and/or irradiated casualties (APPENDIX B). This hospital is a 400 bed general hospital fully

accredited by the State Hospital Association and Joint Commission for

Accreditation of Hospitals and Organizations. It has a modern fully

equipped emergency room of sixteen suites with provisions to perform

all necessary procedures; complete laboratory and diagnostic x-ray

capabilities; and 13 major and 1 minor surgical suites. There are

approximately 100+ members on the active staff, the majority board

certified or qualified representing all major medical specialties.

Space (FIGURE 5) at the hospital provides a receiving area for

potentially contaminated and/or irradiated patients and has a separate

entrance from the normally used emergency entrance. This facility is

adequate for:

1. Personnel decontamination
2. Emergency treatment
3. Storage of emergency equipment and supplies A permanent helipad exists for air evacuation of injured or irradiated

personnel via helicopter. Communications can be established by FNP

with SAMC through the hospital's switchboard or directly with the

hospital emergency room.

Rev. 30

FIGURE 1 Aerial view of plant site Rev. 52 Alabama 95 County 42 Contracto rParking Lot Fabrication Shop Training Center Parking Lo t Unit 1Cooling Towers Unit 2Cooling Towers Wate r TreatmentPlant Utility Building A ux ili ar yBuilding Di ese lBuilding N O u t age Support Building T ur bi ne Building S erv i ceBuilding Protecte d A rea Detail A Switch House See Detail A CSC Parking Lot HighVoltage Switchyard Warehouse Control Room OSC a n d T SC

FIGURE 2 Gen. Rev. 24

FIGURE 3 Gen. Rev. 24

FITNESS FOR DUTY/NURSE'S STATION Figure 4

Gen. Rev. 30

C. THE UNIVERSITY OF ALABAMA HOSPITAL (RCTF)

The University of Alabama Hospital in Birmingham, Alabama, has agreed to admit and provide on a priority basis definitive care for

contaminated and/or irradiated casualties (APPENDIX B). This

hospital is a 639 bed teaching institution affiliated with the

University of Alabama in Birmingham School of Medicine. It is

accredited by the Joint Commission on Accreditation of Hospitals and

Organizations and is licensed by the Alabama State Board of Health.

It is a member of the American Hospital Association, the Council of

Teaching Hospitals and the Alabama Hospital Association. Its

specialists in oncology, hematology, infectious disease, endocrinology, gastroenterology, nuclear medicine, radiology, and the surgical specialties render it fully capable of providing effective medical care. Already in existence are portable and fixed isolation units capable of maintaining a sterile environment.

Facilities for the care of radiation emergency casualties have been developed to provide a Radiation Casualty Treatment Facility (RCTF).

The RCTF consists of a nine bed unit, a nursing station, utility

room, storage room, and a treatment and examination room.

D. OAK RIDGE Institute of Science and Education (ORISE)

Oak Ridge Associated Universities operates a Radiation Emergency Assistance Center Training Site in Oak Ridge, Tennessee. Its

specialized facilities and staff are available for the care and

treatment of possible radiation casualties from the Joseph M. Farley Nuclear Plant of Alabama Power Company in Dothan, Alabama (APPENDIX B). The ORISE-REAC/TS can accommodate approximately 20 patients who are contaminated or have received external radiation.

A laminar flow facility with two sterile rooms is available for patients requiring isolation. Sophisticated whole-body counting equipment, probes for locating radioactive particles in wounds, and

computer-based monitoring services are also available. The staff of the ORISE-REAC/TS has considerable experience in total-body irradiation and several have participated in the handling of previous radiation accident casualties. The nursing staff, aides and orderlies, likewise, are experienced in handling patients who have been treated with or accidentally exposed to both external and

internal radiation. Full diagnostic laboratory and radiographic

back-up facilities are available. A description of their facilities

is given in APPENDIX E.

III. RADIATION CASUALTY HANDLING PROCEDURE

A. NOTIFICATION

A general order of notification in the event of an incident at the Farley Nuclear Plant is given in PART I, FIGURE 24. Detailed lines

of notification and communication concerning medical support are

given in FIGURE 6 of this plan.

Rev. 24

B. ONSITE RESPONSIVE ACTION

Actual or suspected radiation casualties, with or without concomitant trauma, will be moved to the primary onsite decontamination area as

shown in FIGURE 2 and FIGURE 3. If this primary onsite

decontamination area is unavailable as a result of the emergency, the

casualties will be moved to the secondary onsite decontamination area

as shown in FIGURE 4. The priority order of onsite medical emergency

action will then be:

1) First aid of life-threatening or severe physical injury;
2) Personnel decontamination, to the extent that trauma is aggravated;
3) Evaluation of radiation exposure, external and internal, with concomitant first aid of other injuries.

The actual or suspected casualties may be grouped into three classes for triage considerations.

Class I

Criteria

1) Estimated radiation dose greater than applicable 10CFR20 limits but less than 5 rem to whole body (including eyes, gonads, and

blood-forming organs); or

2) Estimated radiation dose to the skin of the whole body greater than the 10CFR20 limit but less than 30 rem; or
3) Estimated radiation dose to the feet, ankles, hands, or forearms greater than the 10CFR20 limit but less than 75 rem.

ACTION

1) Without trauma - Send to Southeast Alabama Medical Center (SAMC) for evaluation after clearance by Health Physics for

contamination.

2) With trauma - Apply appropriate first aid then send to SAMC for evaluation. Monitoring for contamination is desirable prior to

sending the casualty to SAMC.

Class II

Criteria

1) Estimated radiation dose to the whole body (including eyes, gonads, and blood-forming organs) greater than 5 rem but less

than 25 rem, or

Rev. 27

MEDICAL NOTIFICATION ORDER

FIGURE 6 - MEDICAL NOTIFICATION ORDER

Gen. Rev. 39

  • If injury involves contamination, excessive exposure or if it is anticipated that injured will be admitted to the hospital for observation or treatm ent in excess of 48 hours5.555556e-4 days <br />0.0133 hours <br />7.936508e-5 weeks <br />1.8264e-5 months <br /> duration.

SHIFT SUPERVISO A MBULANCE SAM SURGEON RCTF EMERGENCDIRECTO EO MANAGEMEDICAL ADVISO R SNC PROJECMEDICALDIRECTO STATE OF A LABAM A ORISE-NRC*

2) Estimated radiation dose to the skin of the whole body greater than 30 rem but less than 150 rem; or
3) Estimated radiation dose to the feet, ankles, hands, or forearms greater than 75 rem but less than 375 rem.

Action

1) Without trauma send to SAMC for evaluation after clearance by Health Physics for contamination.
2) With trauma apply appropriate first aid, then send to SAMC for evaluation. Monitoring for contamination is desirable prior to

sending the casualty to SAMC.

Class III

Criteria

1) Estimated radiation dose to the whole body (including eyes, gonads, and blood-forming organs) of 25 rem or more; or
2) Estimated radiation dose to the skin of the whole body of 150 rem or more; or
3) Estimated radiation dose to the feet, ankles, hands, or forearms of 375 rem or more.
4) Internal radiation exposure estimated to be significant.

Action

1) Without trauma - after proper decontamination by Health Physics, send to SAMC for evaluation and potential transfer to the Radiation Casualty Treatment Facility (RCTF) in Birmingham or to ORISE-REAC/TS in Oak Ridge,Tennessee.
2) With trauma - appropriate first aid, decontamination, and send to SAMC for treatment and potential transfer to RCTF or REAC/TS.

The above estimates of external and internal radiation exposures will be performed by the Health Physics staff on the basis of all

available information, including dosimeters, area monitors, air

monitors, and survey instruments.

Contaminated casualties sent to SAMC, RCTF, or REAC/TS will be accompanied by a person who is qualified in radiological monitoring

and will stay in attendance and maintain radiological control until

decontamination is complete. Contaminated casualties will be covered

with suitable protective clothing or plastic sheets so as to prevent

or minimize the spread of radioactive material. Radiation exposure

to the vehicle operator and any attendant personnel will be

Rev. 27 minimized to the extent possible, and shadow shields may be used.

Inhalation of airborne radioactive material may be minimized through

the use of respiratory protective devices.

Each casualty will be identified before leaving the plant with a nonremovable hospital type wristband showing his name and an

identification number for use for reference purposes in all

communications, to avoid possible confusion in reporting estimates of

radiation dose and similar matters.

C. SAMC RESPONSIVE ACTION

All casualties sent to SAMC will enter the Radiation Casualty/Decon-tamination area and be surveyed by qualified personnel assigned for

that purpose. Emergency medical care will be provided if required

together with further decontamination.

1) Criteria

Those casualties with estimated radiation doses less than 25 rem to the whole body (including eyes, gonads, and blood-

forming organs) and estimated from bioassay measurements and

other reasons not to be bearing significant quantities of

internal emitters.

Action

Hospitalize if necessary for continued treatment of trauma or illness; otherwise continue minor treatment, observation and

evaluation on out-patient basis, after release by Health

Physics personnel. Observation and evaluation will include

hematological surveys, bioassays of urine and feces, and

general physical condition, including opthalmological and

dermatological examinations. If evaluation so indicates (e.g.,

leukopenia), transfer to RCTF or REAC/TS.

2) Criteria

Those casualties with estimated radiation doses of greater than 25 rem to whole body, or thought from bioassay measurements and

other reasons to be bearing significant quantities of internal

emitters.

Action

Transfer to RCTF or REAC/TS (after emergency treatment of trauma or illness).

In the event of mass casualties, a decision will be made as to which casualties will be sent from SAMC to RCTF, or directly to ORISE REAC/TS. This decision will be made by the Medical Director of the Southern Nuclear Operating Company or his designated alternate, with the advise of staff and consultants.

Rev. 24 Contaminated and/or irradiated casualties sent from SAMC to RCTF, ORISE-REAC/TS or elsewhere, will be accompanied by a person qualified in radiological monitoring. This person will stay in attendance and maintain radiological control until the patient is transferred to a similarly

qualified person at the receiving institution.

All rooms, equipment, and supplies used to treat contaminated personnel will be made controlled areas and considered to be

contaminated until released by the Health Physics staff.

D. RCTF RESPONSIVE ACTION

Casualties sent to RCTF will be met outside the building by an individual qualified in radiological monitoring, will enter through

the appropriate emergency room entrance of the University of Alabama

Hospital, be surveyed and then transported directly to the RCTF.

The staff of the RCTF will have been previously notified and will be

ready to accept the patients.

IV. TRANSPORTATION

A. SERVICES AVAILABLE

1. Local Rescue Squads Ashford Rescue Squad Columbia Rescue Squad
2. Dothan Ambulance Service (Pilchers Ambulance Service), Inc.

Dothan Ambulance Service, Inc. has agreed to transport potentially contaminated and/or irradiated casualties from the plant site to SAMC and on to the University of Alabama Hospital in Birmingham, Alabama or Radiation Emergency

Assistance Center Training Site (REAC/TS) of Oak Ridge

Institute for Science and Education (ORISE) in Oak Ridge, Tennessee ORISE-REAC/TS. Their ambulances are equipped with radios so they can be in communication through SAMC with the Control Room.

Rev. 64

B. ROUTES

1. Plant Site to SAMC (Figure 7, 8)

Normally, emergency vehicles will proceed west on County Road 42 to County Road 33; southwest on County Road 33 to County Road 55; south on County Road 55 to U.S. 84, west on U.S. 84, until its junction with State Highway 210 (Ross Clark Circle)

at which point the Medical Center is located.

If the normal route is unavailable then an alternate route will be directed by the control room. Two such alternate routes are shown on Figure 7.

2. Plant Site or SAMC to the University of Alabama Hospital (FIGURE 9)

As in 1 above, to State Highway 210 (Ross Clark Circle); then north on 210 to its junction with U.S. Highway 231; Highway 231

north to Montgomery and junction with Interstate 65 then north

on Interstate 65 to Birmingham. Exit Interstate 65 at 8th

Avenue South; east to 19th Street; north to 6th Avenue South;

east to University Hospital Emergency Room.

3. SAMC to Oak Ridge, Tennessee (FIGURE 9)

As in 2 above on Interstate 65 to Interstate 59 north to Chattanooga, Tennessee; north on Interstate 75 to Interstate 40; west on Interstate 40 to State Highway 95; north on State Highway 95 to Oak Ridge, Tennessee, then north on New York Avenue to West Tennessee Avenue; east to ORISE-REAC/TS.

V. DRILLS

Radiation emergency practice drills will be conducted annually to maintain the proficiency of the organization and personnel at the plant, SAMC and at

the RCTF and to verify the arrangements made with other groups. Drills

will be arranged so as to provide quantitative data on response times for

each communication, decision and action element of the overall Radiation

Emergency Medical Plan. These response times will be used to predict the

effectiveness of the Plan and to disclose areas where improvement in

training, equipment or organization is needed. Management review of

critique comments obtained from drill monitors will be conducted.

Identified, necessary, or required alterations in training or for the

Emergency Plan/EIPs will be implemented in a timely manner.

VI. TRAINING

A. OPERATIONS AND MAINTENANCE PERSONNEL

Permanently assigned personnel will undergo radiation protection

training, the extent of which will depend on the nature of the

Rev. 27

specific job. Each employee will be required as part of his training to be familiar with radiation protection practices, facilities and

equipment at the plant as described in the Health Physics Manual. At

least one person on each shift will be qualified to perform first

aid.

B. HEALTH PHYSICS PERSONNEL

All Health Physics Technicians will be thoroughly trained in the principles of radiation protection including personnel dosimetry, decontamination and monitoring.

C. PHYSICIANS

Several physicians in the Houston County area have been retrained to provide care for injured, contaminated, and/or irradiated victims. These physicians are encouraged to attend a training seminar on the care of radiation injuries. The Medical Director for the Southern Nuclear Operating Company has also attended this seminar.

D. PARAMEDICAL PERSONNEL

Ambulance attendants, nurses and hospital technicians will be encouraged to attend annual training sessions. These sessions will

be conducted under the direction of the Training Director. Training

will include a description of the facility, its health physics

program, the spectrum of possible accidents with emphasis on

potential resulting casualties and procedures for implementing the

Radiation Emergency Medical Plan.

VII. RADIATION EXPOSURE GUIDELINES

The following guidelines are given for the exposure of hospital and ambulance service personnel:

A. 3 REM

If there is an adequate number of attendants such that rotation may

be accomplished without further endangering the patient(s).

B. 5 REM

If the number of attendants is limited such that personnel cannot be rotated.

C. 25 REM

To save a life.

The above guideline numbers refer to whole body penetrating radiation.

When careful monitoring is provided, the extremities dose may be up to 5

times the value given and the skin dose may be up to 2 times the value

given. Rev. 19

Major Route to SAMC FIGURE 7

Rev. 27

Figure 9. Major Routes to Birmingham and Oak Ridge, Tennessee Rev. 7 APPENDIX A EMERGENCY EQUIPMENT AND SUPPLIES

I. HP OFFICE

Blankets First Aid Supplies Protective Clothing and Supplies Decontamination Supplies Wristbands Survey Meter

II. NURSING STATION

Audiometric Testing Equipment Pulmonary Testing Equipment Vision Testing Equipment Physical Examination Equipment First Aid Supplies

III. PEV DELETED

IV. AMBULANCE KIT

Protective Clothing Lead Covering Material Blankets Signs and Labels Wristbands Dosimetry Devices

V. SOUTHEAST ALABAMA MEDICAL CENTER

Survey Meters and Supplies Dosimetry Devices Signs and Labels Protective Clothing Surgical Clothing Decontamination Supplies Specimen Containers Disposable Cartons Logbook and Pencil

A-1 Rev. 47 APPENDIX B Letters of Agreement on File

Listing of letters can be found in Appendix 2 (B) Index of Part I of the Farley Emergency Plan.

B-1 Rev. 64

APPENDIX F

ROSTER OF MEDICAL CONSULTANTS

I. SOUTHERN NUCLEAR MEDICAL DIRECTOR C. Calvert Dodson, III, M.D.

II. SNC CONTRACT PHYSICIANS (FAIRVIEW CLINIC, DOTHAN)

Earl F. Mazyck, M.D. James A. Robeson, Jr. M.D.

J. Ryan Conner, M.D.

Christopher L. Miller, M.D.

III. SAMC STAFF James C. Jones, D.O., Director, Emergency Room

IV. UNIVERSITY OF ALABAMA MEDICAL CENTER STAFF Chris Roskoe, M.D., Medical Director, Emergency Room

F-1 Rev. 49