ML12179A231

Byron Station - After Action Report/ Improvement Plan, Radiological Emergency Preparedness (REP) Program, Drill Date - April 10, 2012

ML12179A231
Person / Time
Site:	Byron
Issue date:	05/17/2012
From:	Velasquez A US Dept of Homeland Security, Federal Emergency Management Agency
To:	Document Control Desk, Office of Nuclear Reactor Regulation
References
Download: ML12179A231 (38)

Text

U.S. Department of Homeland Security Region V 536 South Clark Street, Floor 6 Chicago, IL 60605#FEMA ND S#NRC Headquarters Document Control Desk U.S. Nuclear Regulatory Commission Washington, DC 20555-0001 To Whom It May Concern: Enclosed is a copy of the Final After Action Report / Improvement Plan for the April 10, 2012, Radiological Emergency Preparedness Medical Services Drill for the Byron Station.No Deficiencies, Areas Requiring Corrective Action (ARCA), or Planning Issues were identified during this drill.Copies of this report were transmitted to the DHS/FEMA Headquarters, the Nuclear Regulatory Commission Region III Office, and the State of Illinois.If you have any questions, please contact William King, Chairman, Regional Assistance Committee, DHS/FEMA, Region V, at (312) 408-5575 or Daniel Kanakares, Technological Hazards Program Specialist, DHS/FEMA, Region V at (312) 408-5332.Sincerely, Andrew Velasquez III Regional Administrator Enclosure (1)::1ý7X4 (?jil-t-www.fema.gov Byron Station After Action Report/Improvement Plan Drill Date -April 10, 2012 Radiological Emergency Preparedness (REP) Program (UFEMA Published May 17, 2012 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station Byron Station After Action Report/Improvement Plan Published May 17, 2012 Contents Executive Summary 3 Section 1: Exercise Overview 8 1.1 Exercise.

Details 8 1.2 Exercise Planning Team Leadership 8 1.3 Participating Organizations 10 Section 2: Exercise Design Summary 11 2.1 Exercise Purpose and Design 11 2.2 Exercise Objectives, Capabilities and Activities 11 2.3 Scenario Summary 11 Section 3: Analysis of Capabilities 12 3.1 Drill Evaluation and Results 12 3.2 Summary Results of Drill Evaluation 12 3.3 Criteria Evaluation Summaries 15 3.3.1 Illinois Jurisdictions 15 3.3.1.1 State of Illinois -OSF St. Anthony's Medical Center 15-Medical Service -Facility 3.3.1.2 State of Illinois -Lifeline Ambulance

-Medical 16 Service -Transportation Section 4: Conclusion 17 Appendix A: Drill Evaluators and Team Leaders 18 Appendix B: Acronyms arid Abbreviations 19 Appendix C: Exercise Plan 20 Appendix D: Scenario Summary 25 1 I Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station This page is intentionally blank.2 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station EXECUTIVE

SUMMARY

On April 10, 2012, the U.S. Department of Homeland Security's (DHS)/Federal Emergency Management Agency (FEMA), Region V, evaluated a Medical Services drill (MS-1) in the 10-mile plume exposure pathway Emergency Planning Zone (EPZ) around the Byron Station. The purpose of the medical services drill was to assess the:ability of offsite agencies to respond to a medical emergency involving a potentially radiologically contaminated member of the public.The medical services drill was held in accordance with DHS/FEMA's policies and guidance concerning the exercise of State and local radiological emergency response plans.DHS/FEMA wishes to acknowledge the efforts of the personnel from the Illinois Emergency Management Agency, Byron Station, Lifeline Ambulance and The Order of Saiikt Francis (OSF)Saint Anthony's Medical Center who participated in the medical services drill.The following criteria, which are part of the six Exercise Evaluation Areas described in the FEMA Radiological Emergency Preparedness Program Manual, dated October 2011, which supercedes the Federal Register Notice, Vol. 67, No. 80, dated April 25, 2002, were evaluated during the medical services drill.Criterion 1 .d. 1 -At least two communication systems are available, at least one operates properly, and communication links are established and maintained with appropriate locations.

Communications capabilities are managed in support of emergency operations.

Criterion 1 .e. 1 -Equipment, maps, displays, dosimetry, potassium iodide (KI), and other supplies are sufficient to support emergency operations.

Criterion 3.a. 1 -The OROs issue appropriate dosimetry and procedures, and manage radiological exposure to emergency workers in accordance with the plans and procedures.

Emergency workers periodically and at the end of each mission read their dosimeters and record the readings on the appropriate record or chart.Criterion 6.d. 1 -The facility/ORO has the appropriate space, adequate resources, and trained personnel to provide transport, monitoring, decontamination, and medical services to contaminated injured individuals.

3 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station The County and local organizations demonstrated knowledge of and adequately implemented organizational emergency response plans and procedures.

There were no Deficiencies identified as a result of this drill.. There were no Areas Requiring Corrective Action (ARCAs) identified during this drill. There were no previous Deficiencies or ARCAs to be corrected during this drill.INTRODUCTION

-EXERCISE BASIS On December 7, 1979, the President directed FEMA to assume the lead responsibility for all offsite nuclear planning and response.

DHS/FEMA activities are conducted pursuant to Title 44 Code of Federal Regulations (CFR) Parts 350, 351 and 352. These regulations are a key element in the Radiological Emergency Preparedness (REP) Program that was established following the U Three Mile Island Nuclear Station accident in March 1979.The Federal Code, 44 CFR 350 establishes the policies and procedures for DHS/FEMA initial and continued approval of State and local governments' radiological emergency planning and preparedness for commercial nuclear power plants. This approval is contingent, in part, on State and local governments' participation in joint exercises with licensees.

DHS/FEMA responsibilities in radiological emergency planning for fixed nuclear facilities include the following:

• • Taking the lead in offsite emergency planning and, in the review and evaluation of RERPs and procedures developed by State and local governments;

• Determining whether such plans and procedures can be implemented on the basis of observation and evaluation of exercises of the plans and procedures conducted by State and local governments; I* Responding to requests by the U.S. Nuclear Regulatory Commission (NRC) pursuant to the, Memorandum of Understanding between the NRC and FEMA dated June 17, 1993 (Federal Register, Vol. 58, No. 176, September 14, 1993); and 4 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station* Coordinating the activities of Federal agencies with responsibilities in the radiological emergency planning process:-U.S. Nuclear Regulatory Commission,-U.S. Environmental Protection Agency,-U.S. Department of Energy,-U.S. Department of Health and Human Services,-U.S. Department of Transportation,-U.S. Department of Agriculture,-*U.S. Department of the Interior, and-U.S. Food and Drug Administration.

Representatives of these agencies serve on the DHS/FEMA Regional Assistance Committee (RAC), which is chaired by DHS/FEMA.Formal submission of the RERPs for the Byron Station to FEMA Region V by the State of Illinois and involved local jurisdictions occurred on March 28, 1982. Formal approval of these RERPs was granted by FEMA on September 12, 1984, under 44 CFR 350.A Medical Services Drill (MS-l) was conducted on April 10, 2012, by DHS/FEMA to assess the capabilities of State and local emergency preparedness organizations in implementing their RERPs and procedures to protect the public health and safety during a radiological emergency involving the Bryon Station. The purpose of this drill report is to present the drill. results and findings on the performance of the offsite response organizations (ORO) during a simulated radiological emergency.

The findings presented in this report are based on the evaluations of the Federal Evaluation Team, with final determinations made by the DHS/FEMA Region V RAC Chairman, and approved by DHS/FEMA Headquarters.

The criteria utilized in the DHS/FEMA evaluation process are contained in:* NUREG-0654/FEMA-REP-1, Rev. 1, "Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants," November 1980;5 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station-FEMA-REP-14, "Radiological Emergency Preparedness Exercise Manual," September 1991; and-FEMA "Radiological Emergency Preparedness Program Guidance and Assessment Area Methodology," as described in the FEMA REP Program Manual, dated October 2011, which supercedes the Federal Register Notice, Vol. 67, No. 80, dated April 25, 2002.Section 2 of this report, entitled "Exercise Overview," presents basic information and data relevant to the exercise.

This section of the report contains a description of the plume pathway i EPZ, and a listing of all participating jurisdictions and functional entities that were evaluated.

Section 3 of this report, entitled "Analysis of Capabilities," presents detailed information on the demonstration of applicable drill. criteria at each jurisdiction or functional entity evaluated in a jurisdiction-based, issues-only format. This section also contains:

(1) descriptions of all Deficiencies and ARCAs assessed during this exercise, recommended corrective actions, and (2) descriptions of resolved ARCAs assessed during 3 previous drills and the status of the OROs efforts to resolve them.Section 4 of this report, entitled "Conclusion" presents the DHS/FEMA summary of overall exercise conduct and results as evaluated against the requirements of 44 CFR 350.Emergency Planning Zone (EPZ) -Description The Byron Station, Units 1 and 2, is located on a 1,288-acre site in Rockville Township, approximately

3.7 miles

south-southwest of the City of Byron and 2.2 miles east of the Rock 3 River in Ogle County, Illinois.

The site is situated approximately in the center of the county in a predominantly agricultural area, with cash grain crops of corn and soybeans.

3 The plume pathway EPZ consists of a circle with the Byron Station as the center point. The EPZ extends approximately 10 miles outward in all directions from the Byron Station. In the event of i a serious incident at the Byron Station, the plume exposure EPZ will be the area in which intensive efforts will be made to notify and protect residents and transient populations from exposure to radiation.

This EPZ includes Ogle County, a small portion of Winnebago County and the following municipalities:

Byron, Oregon, Stillman Valley, Leaf River, Mount Morris, and Davis Junction.6 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station The population distribution in the 10-mile EPZ surrounding the Byron Station is relatively low.Based on the 2010 census, the City of Byron has a population of 3,753, Oregon has a population of 3,721, Stillman Valley has a population of 1,120, Leaf River has a population of 443, Mount Morris has a population of 2,998, and Davis Junction has a population of 2,773; for a total of 14,408 residents.

The 10 Sub-Areas (Numbered:

10, 12, 14, 17, 23, 25, 27, 28, 39 and 40)located in the Byron Station EPZ have a total population of 29,282 per the 2010 census.Recreational facilities outside the municipalities include the 273-acre Lowden Memorial State Park located three and one-half miles southwest of the Byron Station. This park has facilities for hiking, camping, picnicking, boating and fishing. The 1,800-acre Castle Rock State Park and Nature Preserve is located seven miles south-southwest of the Byron Station. This park has facilities for picnicking, fishing, boating, and hiking along the 600-acre Nature Preserve.

The 2,225-acre Lowden-Miller State Forest is approximately six and one-half miles southwest of the Byron Station. This facility has trails for hiking (year-round), skiing (seasonal) and hunting (October to December; 40 hunters per day).Major transportation facilities in the Byron Station EPZ are limited to Illinois Route 72, three and one-half miles north of the station, Illinois Route 2, two and one-half miles west of the station, and Illinois Route 64, four and one-half miles south of the station. Three rail lines also run through the Byron Station EPZ: the Illinois and Missouri (I & M) Rail Link line is four and one-half miles north of the station, the Burlington Northern and Santa Fe Railway Company line is five and one-half miles south of the station, and the Illinois Railnet line is nine and one-half miles east of the station.7 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station I SECTION 1: EXERCISE OVERVIEW 1.1 Exercise Details Exercise Name Byron Station Type of Exercise Drill Exercise Date April 10, 2012 1 Program Department of Homeland Security/FEMA Radiological Emergency Preparedness Program Scenario Type Radiological Emergency 1.2 Exercise Planning Team Leadership William King Exercise RAC Chairman DHS/FEMA Radiological Assistance Committee, Chairman 536 South Clark Street Chicago, Illinois, 60605 312-408-5575 William.King@dhs.gov Dwaine Warren Exercise Director DHS/FEMA Supervisory REP Team Leader I 536 South Clark Street 8 I Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station Chicago, Illinois, 60605 312-408-5342 Dwaine.Warren@dhs.gov Daniel Kanakares Site Specialist DHS/FEMA Technological Hazards Program Specialist 536 South Clark Street Chicago, Illinois, 60605 312-408-5332 Daniel.kanakares@dhs.gov Joni Estabrook State Controller Illinois Emergency Management Agency.Nuclear Safety Emergency Response Coordinator 1035 Outer Park Drive Springfield, Illinois, 62704 217-524-0888 Joni.Estabrook@illinois.gov Kathy Allen State Controller Illinois Emergency Management Agency Manager, HazMat Section 1035 Outer Park Drive Springfield, Illinois, 62704 217-524-0888 Kathy.Allen@illinois.gov 9

Unclassified U Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station 1.3 Participating Organizations Agencies and organizations of the following jurisdictions participated in the Byron Station drill: State Jurisdictions Illinois Emergency Management Agency OSF St. Anthony's Hospital*Lifeline Ambulance I I I I I I I I I I 10 II I Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station SECTION 2: EXERCISE DESIGN

SUMMARY

2.1 Exercise

Purpose and Design On April 10, 2012, the DHS/FEMA Region V Office'evaluated a medical services drill for the Byron Station. The purpose of the medical services drill was to assess the ability of offsite agencies to respond to a medical emergency involving a potentially radiologically contaminated, member of the public. The medical services drill was held in accordance with DHS/FEMA's policies and guidance concerning the exercise of State and local radiological emergency response plans.2.2 Exercise Objectives, Capabilities and Activities Exercise objectives and identified Capabilities/REP Criteria selected to be demonstrated are discussed in Appendix B "Exercise Plan".2.3 Scenario Summary Appendix C "Scenario Details", contains a summary of the Exercise Scenario, a simulated sequence of events that was used as a basis for invoking emergency response actions by Offsite Response Organizations (OROs) in the Medical Services Drill.During the exercise, controllers from the State of Illinois provided "inject messages" containing scenario events and/or relevant data to those persons or locations who would normally receive notification of such events. These inject messages were the method used for invoking addtional specific response actions by OROs.11 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station SECTION 3: ANALYSIS OF CAPABILITIES

3.1 Drill

Evaluation and Results Contained in this section are the results and findings of the evaluation of all jurisdictions and I functional entities that participated in the April 10, 2012, medical services drill (MS-i)conducted to test the offsite emergency response capabilities of State and local governments in I the EPZ surrounding the Byron Station.Each jurisdiction and functional entity was evaluated based on its demonstration of exercise criteria delineated in the FEMA REP Program Manual, dated October 2011, which supercede I's the Federal Register Notice, Vol. 67, No. 80, dated April 25, 2002. Detailed information on the exercise criteria and the extent-of-play agreements used in this exercise are found in Appendix B"Exercise Plan" of this report.3.2 Summary Results of Drill Evaluation The matrix presented in Table 3.1, on the following page(s) presents the status of all exercise criteria from the FEMA REPProgram Manual, dated October 2011, which supercedes the Federal Register Notice, Vol. 67, No. 80, dated April 25, 2002, which were scheduled for demonstration during this drill by all participating jurisdictions and functional entities.

Exercise criteria are listed by number and the demonstration status of those criteria is indicated by the use of the following letters. ." M -Met (No Deficiency or ARCAs)" D -Deficiency assessed*" A -ARCA(s) assessed or unresolved ARCA(s) from prior exercise(s)

I" N -Not Demonstrated" Blank -Not scheduled for demonstration I I 12 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station Table 3.1 -Summary of Drill Evaluation QI-DATE: 2012-04-10 SITE: Byron Station, IL 0 2 M: Met, A: ARCA, D: Deficiency, P: Plan Issue, N: Not Demonstrated Mobilization lal Facilities 1 b1 Direction and Control Ic1 Communications Equipment idl M M Equipment and Supplies to Support Operations lel M EW Exposure Control Decisions 2al PARs' 2b I PADs 2b2 PADs for Disabled/Functional Needs 2cl Ingestion PADs 2d1 RRR Decisions 2el EW Exposure Control Implementation 3al M M KI Public/Institutionalized 3b 1 PAD Implementation Disabled/Functional Needs 3d PAD Implementation Schools 3c2 TACP Establishment*

3dl Impediments 3d2 Implement Ingestion PADs 3el Coordination of RRR Decisions 3e2 Coordination of RRR Decisions 3f1 FildMeasuremenit and Analysis .3,> < --RESERVED 4al Field Team Management 4a2 Field Team Operations 4a3 Field Team Sampling 4bl Laboratory Operations 4c1 Emergeficy Notification and Public Info>, Initial Alert & Notification 5al RESERVED 5a2 Backup Alert & Notification 5a3 Exception Area Alerting 5a4 Subsequent Information

& Instructions 5bl support Ope;rations/Faýcjltles

-,,,, Reception Center Operations 6al EW Monitoring

& Decontamination 6bl Congregate Care 6c0 13 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station I Contaminated Injured Transport

& Care 16dl I M IM I I 14 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station 3.3 Criteria Evaluation Summaries 3.3.1 Illinois Jurisdictions 3.3.1.1 State of Illinois -OSF St. Anthony's Medical Center -Medical Service -Facility The State of Illinois (OSF St. Anthony's Medical Center) demonstrated the Target Capability that there was proper space, resources, including communication equipment, and trained personnel to monitor decontaminate and provide medical services to contaminated injured individuals.

The State of Illinois demonstrated the availability and use of the 800 MHz radio system and the use of cellular telephones for communication between the medical center and the ambulance.

Upon arrival to the medical center, the OSF St. Anthony's Medical Center staff aligned the ambulance gurney aside a hospital gurney. The patient was carefully transferred across the control line to the hospital gurney. Procedures to avoid cross-contamination were followed in conjunction with patient care being the priority.

The patient was wheeled into the treatment room at the hospital.The ability to issue appropriate dosimetry and manage radiological exposure to emergency workers was demonstrated.

The Illinois Emergency Management Agency (IEMA) Medical Radiation Technician (MRT) stated that he would monitor the ambulance, ambulance bay and ambulance crew. He notified medical center staff when all of the outside monitoring activities were complete.

The availability of dosimetry and potassium iodide (KI) for hospital personnel was not demonstrated during this drill.In summary, the status of DHS/FEMA criteria for this location is as follows: a. MET: 1.d.1, 1.e. 1, 3.a.1, 6.d.1.b. AREAS REQUIRING CORRECTIVE ACTION: None 1c. DEFICIENCY:

None d. PLAN ISSUES: None e. NOT DEMONSTRATED:

None f. PRIOR ISSUES -RESOLVED:

None 15 Unclassifled Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station 3 g. PRIOR ISSUES -UNRESOLVED:

None i 3.3.1.2 State of Illinois -Lifeline Ambulance

-Medical Service -Transportation The State of Illinois and the Lifeline Ambulance Service demonstrated the Target Capability that they had the appropriate space, adequate resources, including communication systems, and trained personnel to provide transport, monitoring, decontamination, and medical services to contaminated injured individuals.

Lifeline Ambulance Service demonstrated the capability to transport and provide initial medical care to a contaminated, injured individual.

Lifeline Ambulance Service transported a possibly contaminated injured individual to the OSF St. Anthony's Medical Center. Lifeline Ambulance Service used cellular telephones to communicate to the medical center to keep the 800 MHz radio system open for emergency radio communication.

The medical attention to the injured individual was priority over the possibility of contamination; however, contamination controls were in place and observed by the ambulance crew. i In summary, the status of DHS/FEMA criteria for this location is as follows: 5 a. MET: L.d.1,3.a.1,6.d.l.

b. AREAS REQUIRING CORRECTIVE ACTION: None c. DEFICIENCY:

None d. PLAN ISSUES: None e. NOT DEMONSTRATED:

None.f. PRIOR ISSUES 7 RESOLVED:

None g. PRIOR ISSUES -UNRESOLVED:

None i 16 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station SECTION 4: CONCLUSION There were no Deficiencies, ARCAs, or Plan Issues identified for the State of Illinois.17 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station I APPENDIX A: DRILL EVALUATORS AND TEAM LEADERS DATE: 2012-04-10, SITE: Byron Station, IL I I~ In,: I 18 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station APPENDIX B: ACRONYMS AND ABBREVIATIONS BP Blood Pressure DHS Department of Homeland Security ED Emergency Department EPZ Emergency Planning Zone FEMA Federal Emergency Management Agency KVO Keep Vein Open LD. Luminescent Dosimeter NRC Nuclear Regulatory Commission RAC Regional Assistance Committee REA Radiation Exposure Area REP Radiological Emergency Preparedness VHF Very High Frequency 19 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station APPENDIX C: EXERCISE PLAN 20 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station Offsite Medical Drill Extent of Play OSF St. Anthony's Hospital Rockford, Illinois April 10, 2012 Start time 10:00 a.m.21 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station Extent of Play Agreement Medical Services Exercise April 10, 2012 Location:

OSF St. Anthony's Rockford 5666 East.State Street Rockford, Illinois 61108-2472 Transportation Provider:

Lifeline Ambulance 318 RoxburyAvenue Participant Roster: Victim: Walking Well/Victim Family Member: Lead Controller:

IEMA Ambulance Controller:

Joni Estabrook Hospital Controller:

Kathy Allen MRT: TBD MRT: TBD Criteria that can be re-demonstrated immediately for credit at the discretion of the evaluator, include the following:

For Transportation:

1.dl, 3.a.1 and 6.d.1; for the Hospital 1.dl, 1.e.1, 3.a.1 and 6.d.1. Criteria may be re-demonstrated, as agreed by the Lead Controller and FEMA.EVALUATION AREA 1 -EMERGENCY OPERATIONS MANAGEMENT Criterion U.d.1: At least two communication systems are available, at least one operated properly, and communication links are established and maintained with appropriate locations.

The Lifeline Ambulance will use 2-way radios to communicate with St. Anthony's.

Other communication systems that be used include commercial telephone or cell phones.Criterion 1.e.1: Equipment, maps, displays, dosimetry, potassium iodide (KI) and other supplies are sufficient to support emergency operations.

St. Anthony's will adequately demonstrate the ability to support operations, with adequate resources.

The availability of dosimetry and KI for hospital personnel WILL NOT be demonstrated during this exercise, however IEMA staff will be issued dosimetry and KI as field team members.22 Unclassified Radiological Emergency PreparednessProgram (REP)After Action Report/Improvement Plan Byron Station EVALUATION AREA 3 -PORTECTIVE ACTION IMPLEMENTATION, Criterion 3.a.1: The ORO's issue appropriate dosimetry and procedures, and manage radiological exposure to emergency workers in accordance with the plan and procedures.

Emergency workers periodically and at the end of each mission read their dosimeters and record the readings on the appropriate exposure record or chart.EVULAUTION AREA 6.d -TRANSPORTATION AND TREATMENT OF CONTAMINATED INJURED INVIDUALS Criterion 6.d.1:. The facility/ORO has the appropriate space, adequate resources, and trained personnel to provide transport, monitoring, decontamination, and medical services to contaminated injured individuals.

EXTENT OF PLAY FOR OSF ST. ANTHONY'S HOSPITAL MEDICAL DRILL

Introduction:

An offsite medical drill will be conducted to demonstrate the State of Illinois' concept of operations of handling contaminated injured individuals.

The drill is structured to address MS-1 Hospital and Transportation Criteria.Extent of Play: The Byron Nuclear Power Station has declared a general emergency.

The emergency alert sirens have sounded, the public has been directed to evacuated affected areas and to report to reception centers set up in the local area. The scenario is based on a local resident who has reported to the reception center from a rural area and spent an extended time in the Byron EPZ. He/She reports to the local Rockford Reception center as directed by radio announcement.

While in line for contamination monitoring she is having difficulty breathing and becomes panicked.

The reception center supervisor is.notified and EMS is called.Hospital and Transportation:

The hospital will demonstrate procedures for limiting exposure to hospital staff, decontaminating a patient, and restricting access to the area where the patient is being treated and monitored.

Lifeline Ambulance will demonstrate the capability to transport a contaminated, injured individual to St. Anthony's Hospital in Rockford.

The ambulance crew will pick up a contaminated injured patient near St. Anthony's Hospital.

The ambulance crew will pick up a contaminated injured patient near the hospital at a simulated reception center.IEMA MRT staff will accompany the ambulance staff during the transportation portion of the drill.23 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station Lifeline Ambulance will call in the information regarding the patient to St.Anthony's Hospital so they can prepare the receipt of a contaminated patient. St.Anthony's will implement their plan for receipt, isolation and treatment of an injured contaminated patient. Medical personnel will utilize universal precautions good housekeeping practices to minimize the spread contamination, and will focus on treating the patient's medical condition.

Simple decontamination efforts will be demonstrated after the patient has been medically stabilized.

The hospital will -demonstrate procedures for limiting exposure to hospital staff, decontaminated a patient, and restricting access to the area where the patient is being treated and monitored.

Hospital'personnel will demonstrate their knowledge of who to call beyond IEMA for assistance in Radiological Accidents, e.g., REAC/TS.For purposes of this exercise, an IEMA staff member will be dispatched to St. Anthony's with radiation detection and measurement equipment to survey out ambulance staff.The purpose of having an IEMA MRT available is to facilitate monitoring the ambulance staff and ambulance itself so they can be put back into service as soon as possible.The drill will conclude with the hospital representative supervising the removal of protective clothing and surveying of the emergency room and hospital personnel.

IEMA will also advise on the-proper procedure for release or disposal of contaminated material.24 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station APPENDIX D: SCENARIO

SUMMARY

Offsite Medical Drill Within the EPZ (Summary and Injects)OSF St. Anthony's Hospital Rockford, Illinois April 10, 2012 Start time 10:00 a.m.25 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station Objectives:

1. Demonstrate the ability of EMS personnel to transport a contaminated injured patient.2. Demonstrate the ability of hospital personnel to treat a contaminated injured patient.3. Demonstrate the ability of personnel to exercise proper radiological controls.4. Demonstrate the proper techniques of personnel decontamination.

5. Demonstrate good communication between medical personnel and IEMA staff: 6. Demonstrate proper use of radiation detectors.

IEMA Players and Controllers Injured Victim Walking Well Family Member IEMA Ambulance MRT IEMA Hospital MRT IEMA Ambulance Controller IEMA Hospital Controller Lead Controller IEMA 26 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station Extent of Play for OSF St. Anthony's Medical Center Byron Nuclear Power Station has declared a general emergency.

The emergency alert sirens have sounded, the public has been directed to evacuate affected areas and to report to receptions set up in the local area. The scenario is based on a local resident who had stayed behind to take care of livestock when a release had occurred.

The resident reports to a local reception center where he/she begins to experiernce difficulty breathing.

IEMA staff assist the resident through the portal monitor to a seat and call EMS.This drill will originate near the hospital at a simulated reception center [Radiation monitoring and, if necessary, decontamination, of evacuees is provided for at these facilities by staff from IEMA under the Illinois Plan for Radiological Accidents (IPRA).]1. An ambulance and EMS staff will be used to demonstrate loading, transporting and unloading the victim. EMS personnel will pick up the patient at a staged location close to the hospital.

The patient will be pre-staged for the ambulance arrival. IEMA staff will be present for the reception center and transportation portion of the drill.2. The ambulance crew will communicate with the receiving hospital regarding the medical status of the patient and any additional precautions taken to prevent spread of contamination.

3. IEMA MRT and hospital nuclear medicine staff will be providing radiological exposure control and monitoring of EMS and hospital personnel.

4. Decontamination is determinant on ambulance protocols and injury that the patient presents.5. Hospital nuclear medicine personnel will be responsible for any patient and staff radiological monitoring and contamination control activities until an IEMA MRT arrives on scene.6. The IEMA MRT will supervise the ingress and egress of radiological control areas. Monitoring will be performed prior to personnel leaving the potentially contaminated patient treatment area. Protective clothing used by hospital personnel will be similar to that used for a chemical or biological agent in accordance with hospital protocol.

Multiple methods of decontamination, including dry, damp or wet, may be utilized for the removal of contamination.

7. Hospital nuclear medicine will be the primary radiological advisor for contamination control and any patient and staff radiological monitoring and contamination control activities unless no nuclear medicine staff is available to assume responsibility.

IEMA will be present to advise and assist as needed.8. The medical facility will demonstrate or describe their procedures for the medical treatment and necessary decontamination of a contaminated injured individual.

Multiple methods of decontamination, including dry, damp or wet, may be utilized for the removal of contamination.

IEMA/hospital nuclear medicine personnel will survey the hospital REA and medical personnel to maintain contamination control. These methods will include taking swipes of floors and surfaces so that the hospital and ambulance can be cleared for normal operations.

27 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station 9. The hospital may need to contact REAC/TS to determine appropriate

ýamples needed to assess internal contamination.

Any samples collected will be sent to REAC/TS for analyzing, IEMA does not process biological samples.10. Emergency medical personnel will be able to maintain their exposure below the. limits specified in 10 CFR Part 20 because for the exercise, the dose rate from the patient is below 2 mr/hr.11 .After the Hospital is notified, hospital personnel will prepare the area to receive the patient in accordance with their procedures and provide security as necessary.

IEMA as a general practice would, if necessary, post radiation signs in accordance with the requirements as set forth in 10 CFR Part 20. Hospital security will control the area in accordance with the same policies and procedures used to provide isolation in the treatment of a chemical or biological agent.12. Regardless of specific written hospital procedures for addressing radiation contamination, the supervision and advice provided by IEMA personnel should be the governing guidance for determining whether the patient's 3 contamination situation is appropriately addressed.

13. Hospital personnel will need to address a walking well family member and determine whether he/she is contaminated.

This portion of the medical drill will evaluate hospital procedures and policies only and not be evaluated against the FEMA criteria.I The drill terminated when the controller verifies that the criteria under Evaluation Area 6, Sub-element 6.d and Evaluation Area 3, Sub-element 3.a.1, have been satisfied.

3 28 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station TIME: Pre t = 0 Victim Instructions MESSAGE FORM 0 Controller (X) Player ( ).Contingency Drill/Exercise Type: St. Anthony's Medical Center Medical Drill Message for: Victim and EMS staff MESSAGE The Byron Nuclear Station has issued a public broadcast that a radioactive release has occurred and that resident's and those working in the Byron EPZ area are being evacuated.

You then report to the Reception Center.Before reporting to the reception center you tend to livestock as well as the neighbor who was out of town. The extended time spent in the EPZ delays you in reporting to the reception center and you are therefore exposed and contaminated with low levels of radioactive materials.

FOR CONTROLLERS USE ONLY The information would be available to the hospital as they received preliminary notification information from outbound ambulance calls.29 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station I I TIME: Time 0 MESSAGE: Initial Conditions MESSAGE FORM (X) Controller (X) Player Drill/Exercise Type: St. Anthony's Medical Center Medical Drill Message for: Hospital Personnel MESSAGE Initial Conditions:

The Datient initially is a little panicked and is wheezina.( ) Contingency I Contamination Initial survey First Decon Second Third Decon Levels: Reading Decon Right hand 1000 cpm 500 cpm 300 cpm 75 cpm Left hand 1100 cpm 600 cpm 60 cpm Neck clavicle area 500cpm 200 cpm 40 cpm Hairline right 400 cpm 80 cpm temple Shoes (should be 1200 cpm 0 should be removed) removed*Pant/shoes should be removed and bagged.**Contamination would likely be spread from hand to other parts of the patient's skin or clothing.Current Medical Conditions:

Currently wheezing and having difficulty breathing.

Note: See last page for contamination locations and levels.FOR CONTROLLERS USE ONLY Contamination levels have not been established at this time.30 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station TO: First Responders/EMS FROM: EMS Controller NOTE: Do not provide the data to players unless the means to obtain it are demonstrated.

THIS IS A DRILL DO NOT initiate actions affecting safe operations Message: EMS Arrival Enroute to In REA After on Scene Hospital Treatment Level of consciousness:

ResponsiveX3 ResponsiveX3 ResponsiveX3 ResponsiveX3 Respirations:

28 32 22 18 Pulse: 78 80 78 50 Skin: Damp/sweaty Damp/sweaty Dry Dry Blood Prsue 152/92 150/89 138/80 120/68 Pressure: Patient is Patient is Patient has Patient is panicked and wheezing improved and Visual: panicked and wheezing returned to wheezing normal breathing rate.Note: Patient is allergic to sulfa drugs.Pulse oximeter is reading 93% on air Expected Action: Follow local protocols or standing orders.THIS IS A DRILL DO NOT initiate actions affecting safe operations 31 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station TIME: 0 + 5 min.MESSAGE: MESSAGE FORM (X) Controller (X) Player 0 Contingency Drill/Exercise Type: St. Anthony's Medical Center Drill Message for: Hospital Personnel MESSAGE When the Hospital is notified that a potentially contaminated patient will be arriving, the Hospital should make preparations to receive patient in accordance with hospital procedures.

IEMA staff will be dispatched to the hospital in advance of the receipt of the patient for purposes of this exercise.I I i I I I 1 1 I I FOR CONTROLLERS USE ONLY Issue the message only if ambulance departure from reception center was to occur after 1020. Realistically it would take 20 minutes after the initial call for the ambulance to respond and depart with the patient.32 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station TIME: After patient arrival at hospital MESSAGE: Decontamination Activities MESSAGE FORM (X) Controller 0 Player ()Contingency Drill/Exercise Type: St. Anthony's Medical Center Drill Message for: IEMA RAD Controllers MESSAGE If proper radiological controls are in place no contamination is found in the ambulance.

All areas of the hospital and path from ambulance to treatment room will be surveyed and read as background.

The controller may adjust contamination levels based on actions of the players.The patient has contamination on right palm, left palm, forehead at hairline, chest/clavicle area and on both pant cuffs and bottom and toes of shoes.IT DOES NOT MATTER IF THE CLOTHING IS REMOVED BY THE AMBULANCE OR HOSPITAL PERSONNEL.

Clothing should be bagged and labeled.FOR CONTROLLERS USE ONLY 33 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station I TIME: After patient arrival at hospital MESSAGE: Decontamination Activities MESSAGE FORM (X) Controller 0 Player Drill/Exercise Type: St. Anthony's Medical Center Drill Message for: IEMA RAD Controller MESSAGE Decontamination efforts are as follows: Once clothing is carefully removed, all outer contami clothing reads 700 cpm.()Contingency nation is removed. Bagged Contamination Initial survey First Decon Second Third Decon Levels: Reading Decon Right hand 1000 cpm 500 cpm 300 cpm 75 cpm Left hand 1100 cpm 600 cpm 60 cpm Neck clavicle area 500cpm 200 cpm 40 cpm Hairline right 400 cpm 80 cpm temple Shoes (should be 1200 cpm 0 should be removed) removed*Pants and shoes should be removed and bagged.**Contamination would likely be spread from hand to injured arm either on patient's skin or clothing.Note: Controllers may adjust levels based on player actions.FOR CONTROLLERS USE ONLY 34 Unclassified Radiological Emergency Preparedness Program (REP)After Action Report/Improvement Plan Byron Station TIME: After EMS Staff Survey MESSAGE: Final Activities MESSAGE FORM (X) Controller 0 Player () Contingency Drill/Exercise Type: St. Anthony's Medical Center Drill Message for: Hospital Personnel MESSAGE A member of the public walks into the ED area and inquires about a family member that was brought to this medical facility.

He/she tells hospital staff that a friend saw his/her husband being transported by ambulance and then called family.35 Unclassified Radiological Emergency Preparedness Program (REP)After'Action Report/Improvement Plan Byron Station I I I I This page is intentionally blank.I 36