ML032250672

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Document No. OP-1903.023, Change No. 034-02-0, Personnel Emergency.
ML032250672
Person / Time
Site: Arkansas Nuclear  Entergy icon.png
Issue date: 08/07/2003
From:
Entergy Operations
To:
Document Control Desk, Office of Nuclear Reactor Regulation
References
OP-1903.023, Change 034-02-0
Download: ML032250672 (25)
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Text

Arkansas Nuclear One - Administrative Services Document Control Thursday, August 07, 2003 Document Update Notification COPYHOLDER NO: 103 TO: ANO-NRC (EMERGENCY RESPONSE COORD.) - WASHINGTON ADDRESS: OS-DOC CNTRL DESK MAIL STOP OP1-17 WASHINGTON DC 20555-DC DOCUMENTNO: OP-1903.023 TITLE: PERSONNEL EMERGENCY CHANGE NO: 034-02-0 ADDITIONAL INFO:

[ / (If this box is checked, please sign, date, and returnwithin 5 days.

-ClANO-J Docket 50-313 This11 ANO-2 Docket 50-368 Signaure Date SIGNATURE CONFIRMS UPDATE HAS BEEN MADE RETURN TO:

ATTN: DOCUMENT CONTROL-(N-ADMIN-24)

ARKANSAS NUCLEAR ONE 1448 SR 333 RUSSELLVILLE, AR 72801 AU45

ENTERGY OPERATIONS INCORPORATED ARKANSAS NUCLEAR ONE TITLE: PERSONNEL EMERGENCY DOCUMENT NO. CHANGE NO...

1903.023 034-02-0 WpRK PLAN EXP. DATE TC EXP. DATE N/A NIA

~SET # 1 09 - : -SAFETY-RELATED IPTE

-YES ONO OYES ONO TEMP ALT DYES ONO.

When you see these TRAPS Get these TOOLS Time Pressure Effective Communication Distraction/Interruptlon Questioning Attitude Multiple Tasks Placekeeping Overconfidence Self Check Vague or Interpretive Guidance. Peer Check First Shift/Last Shift Knowledge Peer Pressure Procedures, Change/Off Normal Job Briefing Physical Environment Coaching Mental Stress (Home or Work) Turnover' VERIFIED BY, DATE TIME FORM TITLE: FORM NO. CHANGE NO.

VERIFICATION COVER SHEET 1000.006A 050-00-0 i'-4AJdAJJA~1(

kItid ti -44&Iii. 41&iut. h'L 41 AIik~ &IL,-<4~ 4,:.Iaq

.W 4 ~itILI ..-Ii IA.: 41 ukI A-lA t4-I -1 ,fi

ENTERGY OPERATIONS INCORPORATED ARKANSAS NUCLEAR ONE Pa e I TITLE:PERSONNEL EMERGENCY DOCUMENT NO, CHANGE NO.,

', . - 1903.023 034-02-0 AFFECTED UNIT: lPROCEDURE ELECTRONIC DOCUMEN SAFETY-RELATED UNIT I UNIT2 WORK PLAN, EXP. DATE - 0 YES - NO TYPE OF CHANGE:

o NEW 0 PC 0 TC 03- DELETION o REVISION 0 E EXP. DATE:_______

DOES THIS DOCUMENT:.

1. Supersede or replace another procedure? O YES iNO (If YES, complete 1000.006B for deleted procedure.) (0CAN058107)
2. Alter or delete anexsting regulatory commitment? 'AYES ONO (If YES, coordinate with Licensing before implementing.) (OCNA128509)(0CAN049803)
3. Require a50.69 revIew per LI-1 01? (See also 1000.006, Atachment 15) 0 YES 0 NO (If 50.59 evaluation, OSRC review required.)
4. Cause the MTCL to be untrue? (See Step 8.5 for details.) D.YES CD NO (If YES, complete 1000.009A) (1CAN108904, OCAN099001, OCNA128509, OCAN049803)
5. Create an Intent Change? O YES 1 NO (If YES, Standard Approval Process required.)
6. Implement or change IPTE requirements? KEYES NOC)

(If YES, complete 1000.143A. OSRC review required.)

7. Implement or change a Temporary Afteratlon? -YES ONO (If YES, then OSRC review required.)

Was the Master Electronic File used as the source document? O YES 0 NO INTERIM APPROVAL PROCESS STANDARD APPROVAL PROCESS ORIGINATOR SIGNATURE: (includes review of At. 13) DAT E:/e r.iNw otAtt 13) DATE: 7-2v-oa Print and S n name: PHONE/ PrInlt d Sian name. Roger Freeman PHONE 0:4994 SUPERVISOR APPROVAL- DA INf ENDENT REVIEYVER: DATE:

/ ~~~~ tl~e6 -?Su DATE:

SRO UNIT ONE:. A ENGINEERING:

SRO UNIT TWO:** DATE: QUAUTY: DATE:

Interim approval allowed fo V-ntt changes requiring no UNIT SURVEILLANCE COORDINATOR (DCNA049803): DATE:

50.59 evaluation that are Doppin rk Inrogress.

Standard Approval required to ntent c)es or changes SON LEAD requiring a 50.59 evaluatio If change not required t upport work in progress, QUALITY ASSURANCE: DATE:

Departrnent Head mu3sign.

'if both units are erected by change, both SRO signatures OTHER cTION 0t DA:

are required. (S signature required for safety related procedures o - ER SECTMI DATEF.,I OTHER SECTION LEADE - DATE:

/ - ~~~~~~~A/f-o OTHER SECTION LEADERS: DATE:

O" CHAIRMAN/TE oICAL REVIEWER: (OCNA049312) DATE: OTHER SECTION LEADERS: DATE:

Date:' OTHER SECTION LEADERS: DATE:

ECTIV RE~pltE E DAEL:r 7 OTHER SECTION LEADERS: DATE:

FORM TITLE: FORM NO. CHANGE NO.

PROCEDUREIWORK PLAN APPROVAL REQUEST 1000.006B 051-00-0

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ENTERGY OPERATIONS INCORPORATED ARKANSAS NUCLEAR ONE TITLE:Personnel Emergency DOCUMENT -NO. CHANGE NO.

-  : ~~~~~~~~~1903.023 g 040-0PROCEDURE [JWORK PLAN, EXP. DATE__ _ PAGE I oFi-O ELECTRONIC DOCUMENT -

TYPE OF CHANGE:

O3 NEW 0 PC. TC 0 DELETION o REViSION 0 EZ EXP. DATE:_

AFFECTED SECTION: DESCRIPTION OF CHANGE: (For each change made, Include sufficient detail to describe (Include step # if reason for the change.)

applicable)

Page 7 of 20 Deleted steps 8.2.2A and 8.2.28, changed step 8.22 to use Form 1903.023B.

Step 8.2.2 1903.023B Changed the notification process for the Emergency Medical Team during Personnel Emergencies. The changes will allow the Control Room to quit using the paging encoder and the radio-voice pagers wilt no longer be used. The plant page will alert plant personnel and some of the volunteers, but Teletouch will be used to alert the Emergency Medical Team and can provide more detailed Information of the event. The Emergency Medical Team will have Alpha Numeric pagers.

FORM TITLE: FORM NO. I CHANGE NO.

DESCRIPTION OF CHANGE 1000.006C j 050-00-0 71*k*w

TABLE OF CONTENTS SECTIONS PAGE NO.

1.0 Purpose ..:........ 2...........

2 2.0 Scope ,. ...... ......... 2 3.0 References............................................ .......... 2 4.0 Definitions ....... 3.............

3 5.0 Responsibility and Authority ............................. 4........

4 6.0 Limits and Precautions ...........................  :.

5 7.0 First Aid Supplies and Equipment ..................... 5 8.0 Instructions...................................... . 6 9.0 Reporting and Records Management........ ................ ............ 11 10.0 Attachments and Forms 10.1 Attachments 10.1.l Attachment 1 - Patient Information For'P (Example) .- ,. 13 10.2 Forms 10.2.1 Form 1903.023B - 'PersonnelEmergency Checklist (Shift Manager)".14 10.2.2 Form 1903.023C - "Emergency Medical Team Scene Leader Check Listw .18 10.2.3 Form 1903.023D - "Personnel Emergency Checklist (OSC Director) . .20

PROCJWORK PLAN NO. PROCEDURENVORK PLAN TITLE: PAGE: 2 of 21 1903.023 PERSONNEL EMERGENCY CHANGE: 034-02-0 1.0 PURPOSE The purpose of this procedure is to provide for the proper response to a personnel emergency. Guidance is provided for general ANO personnel, Operations Personnel, ANO Emergency Medical Team Personnel and Health Physics Personnel.

2.0 SCOPE This procedure outlines the general response to be taken during a personnel emergency. The emergency may be medical or contamination related medical and may require that offsite medical assistance be utilized. This procedure is not intended to give medical guidance for use during the emergency.

3.0 REFERENCES

3.1 REFERENCES

USED IN PROCEDURE PREPARATION:

3.1.1 Eme'rgency Plan 3.1.2 1012.019, "Radiological Work Permits" 3.1.3 Red Cross first Aid Instruction Pamphlets 3.1.4 NCRP Report No. 39, "Basic Radiation Protection Criteria" 3.1.5 NCRP Report No. 65, "Management of Persons Accidentally Contaminated with Radionuclides" 3.1.6 10CFR5O.72(b)(2)(v)

3.2 REFERENCES

USED IN CONJUNCTION WITH THIS PROCEDURE:

3.2.1 RP-104, "Personnel Contamination Events" (PCE) 3.2.2 1903.033, "Protective Action Guidelines for Rescue/Repair and Damage Control Teams" 3.2.3 1905.001, "Emergency Radiological Controls" 3.2.4 1000.104, "Condition Reporting Operability and Immediate Reportability Determinations" 3.2.5 LI-102, "Corrective Action Process" 3.2.6 1000.031, "Radiation Protection Manual" 3.2.7 Station Directive A6.202, "Public Communications" 3.2.8 Emergency Telephone Directory 3.3 RELATED ANO PROCEDURES:

3.3.1 1903.042, "Duties of the Emergency Medical Team" 3.3.2 1000.128, "Industrial Safety & Occupational Health"

PROCJWORK PLAN NO. PROCEDUREIWORK PLAN TITLE: PAGE: 3 of 21 1903.023 PERSONNEL EMERGENCY CHANGE: 034-02-0 3.4 REGULATORY CORRESPONDENCE CONTAINING NRC COMMITMENTSWHICH ARE IMPLEMENTED IN THIS PROCEDURE INCLUDE:lBOLDW DENOTES COMMITMENTS 3.4.1 LIC 12-74 (P-2880)

A. Form 1903.023C 3.4.2 0CAN058411 (P-9460)

A. Form 1903.023B, Section 1.0 and 2.0 3.4.3 LIC 94-226 (P-14029)

A. 8.3 Note 4.0 DEFINITIONS 4.1 EMERGENCY MEDICAL TEAM - Personnel employed at ANO who are trained to respond to personnel emergencies and provide first Aid/rescue.

4.1.1 The Emergency Medical Team (EMT) consists of two groups of employees:

A. Health Physics Technicians who respond to personnel emergencies in 'support of the volunteer EMT, and provide 24 hour2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> on-shift first aid/rescue coverage.

B. Volunteer Emergency Medical Team Members who respond to personnel emergencies when on-i4ite., and provide emergency medical support during'emergency class declarations which require emergency response organization activation.

4.2 SERIOUS INJURY - An injury that requires action specified in this procedure is defined as an injury to any person that has resulted in one or more of the following:

4.2.1 More than a momentary loss of consciousness.

4.2.2 An actual or suspected fracture.

4.2.3 A head injury.

4.2.4 An injury that may have damaged internal organs.

4.2.5 A serious burn.

4.2.6 Hemorrhaging.

4.2.7 Receipt of a large dose of radiation (i.e., greater than 50 R).

4.3 PROTECTED AREA - An area encompassed by physical barriers (i.e., the security fence) and to which access is controlled.

PROCJWORK PLAN NO. PROCEDURE/WORK PLAN TITLE: PAGE: 4 of 21 1903.023 PERSONNEL EMERGENCY CHANGE: 034-02-0 4.4 PATIENT INFORMATION FORM - A form used to record information gathered by emergency response personnel in a personnel emergency. This form shall contain as a minimum space for the following information:

4.4.1 Name of the injured person.

4.4.2 Cgmpany that the injured person works for.

4.4.3 Date and time the incident occurred.

4.4.4 Badge number of the injured person.

4.4.5 General description of the occurrence.

4.4.6 Injuries noted by the Emergency Medical Team.

4.4.7 Treatment or aid given by the Emergency Medical Team.

4.4.8 Names of Emergency Medical Personnel responding to the incident.

4.4.9 Location for recording more than one set of vital signs (pulse, blood pressure, respirations).

4.4.10 Location for recording dosimeter readings.

4.4.11 Action levels based on the amount of contamination the injured person may have sustained.

4.4.12 Signature blank for person completing form with date and time.

4.4.13 Form distribution instructions.

4.4.14 The name of the form.

4.5 FIRST AID/RESCUE - First Aid/Rescue is defined as those activities which involve assessment of patient condition, and treatment for those conditions. This includes actions taken to stabilize the patient, determine if additional assistance is needed, and transfer the patient to the next level of care.

5.0 RESPONSIBILITY AND AUTHORITY 5.1 ANO EMPLOYEES - as described in Section 8.1 of this procedure.

5.2 SHIFT MANAGER 5.2.1 Responsible for ensuring that ANO Emergency Medical Team Members are dispatched to the scene of a medical emergency (Also dispatch additional HP Personnel, if needed, for radiological concerns).

5.2.2 Responsible for coordinating offsite medical assistance.

PROCJWORK PLAN NO.' PROCEDURE/WORK PLAN TITLE: PAGE: 5 of 21 1903.023 PERSONNEL EMERGENCY CHANGE: 034-02-0 5.3 OPERATIONAL SUPPORT CENTER DIRECTOR 5.3.1 May relieve the Shift Manager of responsibility for steps 5.2.1 and 5.2.2 above.

5.4 EMERGENCY MEDICAL TEAM - as described in procedure 1903.042, "Duties of the Emergency Medical Team".

5.5 ANO NURSE - as described in procedure 1903.042, "Duties of the Emergency Medical Team".

5.6 HEALTH PHYSICS PERSONNEL 5.6.1 Responsible for determining the level of contamination, if involved.

5.6.2 Responsible for ensuring personnel are'surveyed prior to exiting the protected area.

5.6.3 Responsible for monitoring dose rates and time in Radiologically Controlled Areas.

5.6.4 Responsible for providing radiological instructions if time did not permit Emergency Medical Team members to read and sign in on an RWP prior to entering a Radiologically Controlled Area.

6.0 LIMITS AND PRECAUTIONS 6.1 Personnel administering first aid to an injured persoft in a suspected or undefined radiation field should be joined by a Health Physics representative (in addition to any HP's on the Emergency Medical Team, if needed) with the appropriate radiation monitoring equipment as soon as possible.

6.2 Entry into evacuated or high radiation areas for the purpose of attending to injured individuals shall be in accordance with 1903.033, "Protective Action Guidelines for Rescue/Repair and Damage Control Teams".

6.3 If it is not clear that the individual can be moved without harm, he or she should not be moved until further help arrives, unless the individual would be in danger of loss of life or limb or is in a life threatening radiation field. If questions arise, contact the Health Physics Supervisor or the Shift Manager.

6.4 Individuals who have suffered any of the conditions described in Section 4.2 should receive a medical examination prior to returning to work.

7.0 FIRST AID SUPPLIES AND EQUIPMENT 7.1 First Aid Supplies are maintained in various locations within the protected area. These supplies are located so that they are readily available in an emergency situation.

7.2 To assist St. Mary's Regional Medical Center in the treatment of radiologically contaminated individuals, ANO maintains an emergency kit at St. Mary's Regional Medical Center for use in these situations.

7.3 Equipment or supplies may be provided to assist ambulance personnel.

8.0 INSTRUCTIONS 8.1 ANO PERSONNEL 8.1.1 In the event of a personnel emergency, personnel in the vicinity of the affected individual should:

A. Notify either unit's Shift Manager and provide the following information:

  • Location in plant and number of injured people.
  • Type of injury.
  • If\ radiation/contamination is involved.
  • Name(s) of injured individuals) and employer, if known.

NOTE The injured individual should only be moved by trained personnel, unless the individual is in danger of loss of life or limb or is in a known high radiation field.

B. Administer immediate first aid and attention within the limits of their training. This attention should consist of but is not limited to the following:

  • Stopping bleeding by applying pressure.
  • Using resuscitation techniques if known.
  • Keeping the individual calm and comfortable until further help arrives.

C. Remain available at the scene of the accident to provide information to the appropriate medical personnel.

8.2 OPERATIONS PERSONNEL 8.2.1 For minor and/or non-emergency situations, Operations personnel should direct any requests for medical attention to the ANO Nurse in the Nurse's Station'or ANO Medical Facility. If the ANO nurse is not available, treatment of minor injuries (nicks, cuts, etc.) should be determined by the individual and his/her supervisor.'

8.2.2 The Shift Manager shall see that emergency assistance is dispatched to seriously ill/injured individuals using the instructions in Form 1903.023B.

8.2.3 Alert plant personnel that an emergency has occurred by:

A. Momentarily pressing the page fire tone push-button, and B Making the following announcement using the plant paging system.

"ATTENTION ALL PERSONNEL, ATTENTION ALL PERSONNEL A PERSONNEL EMERGENCY HAS OCCURRED AT (give location). THE EMERGENCY MEDICAL TEAM IS RESPONDING. ALL PERSONNEL SHOULD STAY CLEAR OF THE (give location)"

8.2.4 IF the Emergency Medical Team is summoned,,

THEN the Shift Manager, or his designee, shall complete Form 1903.023B, Personnel Emergency Checklist".

8.2.5 If onsite, the ANO Nurse will respond in conjunction with the Emergency Medical Team.

8.2.6 The Shift Manager shall see that arrangements are made for treatment based upon the assessment of the emergency medical personnel at the scene. This may include:

A. Notification of Pope County Emergency Medical Services if an ambulance is needed.

B. Guidance on Excessive Radiation Dose If the injured individual or individual(s) attending to the injured individual are suspected of having received a radiation dose in excess of 50 Rem (TEDE),

arrangements should be made between the initial attending physician and ANO Management (Vice President, Operations - ANO or Shift Manager/TSC Director/EOF Director) to transport those individuals to the University of Arkansas Medical Sciences Center in Little Rock for treatment, as necessary, after examination at St. Mary's Regional Medical Center.

PROCJWORK PLAN NO. PROCEDUREIWORK PLAN TITLE: PAGE: 8 of 21 1903.023 PERSONNEL EMERGENCY CHANGE: 034-0240 8.2.7 If the injured individual will be transported to a medical facility, the Shift Manager or OSC Director shall call the appropriate medical facility and advise them of the number of individuals involved, whether or not contamination is involved and the nature of the injuries.

  • St. Mary's Regional Medical Center (include the appropriate action level - refer to Step 8.4.2)
  • University of Arkansas Medical Sciences Hospital 8.2.8 If an ambulance has been requested to come onsite, the Security Shift Commander shall be not'ified so that Security personnel will be ready to receive and escort the ambulance personnel. (Routine ambulance access point - North Gate; routine ambulance receiving area - Maintenance Facility Breezeway unless otherwise directed.)

8.2.9 An'escort, as indicated below, should accompany the injured individual(s) to an offsite hospital in order to provide any necess~ry information or assistance to the offsite medical personnel and provide periodic updates to the Shift Manager (or other individual(s), as directed).

A. If the individual is contaminated, a Health Physics representative shall accompany in the ambulance.

B.' If the individual is not contaminated, the EMT Scene Leader shall designate an Entergy employee to accompany the individual to an offsite hospital.

8.2.10 The, injured employee's supervisor should respond in accordance with Procedure 1000.128, "Industrial Safety and Occupational Health".

8.3 EMERGENCY MEDICAL PERSONNEL

[NOTE During a "Personnel Emergency the Emergency Medical Team may enter Radiologically Controlled Areas without SRDs or Alarming Dosimeters as long as an HP Technician is providing radiological instructions and is monitoring dose rates and time in the area. Prompt medical attention shall take precedence over HP procedures when an individual is seriously injured.)

8.3.1 Emergency Medical Personnel should respond per procedure 1903.042, "Duties of the Emergency Medical Team".

PROC.IWORK PLAN NO. PROCEDUREIWORK PLAN TITLE: PAGE: 9 of 21 1903.023 PERSONNEL EMERGENCY I . CHANGE: 034-02-0 I .,

8.4 HEALTH PHYSICS PERSONNEL (If radiation/contamination is known or suspected)

NOTE' Medical attention and transportation to an offsite m~edical facility take precedence over decontamination measures for seriously injured individual(s).

8.4.1 IF the injured individual is contaminated and will require transport to the hospital, THEN a Health Physics Technician shall be IMMEDIATELY dispatched to the Emergency Department at St. Mary's Regional Medical Center to assist the hospital staff in preparing to receive a contaminated patient.

8.4.2 The following action levels for St. Mary's.Regional Medical' Center shall be referenced and provided to the Shift Manager or the OSC Director.

Level of Response for St. Mary's Regional Action Medical Center Levels Contamination Control A. LEVEL I No contamination None involved B. LEVEL II Any contamination Routine sterile above ANO's ptobedures for septic release limits and situations

<1000 counts per minute above background as measured by a frisker C. LEVEL III 2lOOO counts per Full-scale response minute above background as measured by a frisker

PROCJNORK PLAN NO. PROCEDUREIWORK PLAN TITLE: PAGE: 10 of 21 1903.023 PERSONNEL EMERGENCY CHANGE: 034-02-0 8.4.3 The following precautionary measures should be taken at the scene of the accident (as allowed by the nature of the injury):

A. Take precautions (coverings, use of stretcher, etc.)

to prevent the spread of contamination during movement and transport of the individual.

B. Move the individual to a "clean" area, as allowed by step 6.3. I C. Remove contaminated clothing.

D. Survey the individual for surface contamination.

E. Decontaminate the affected areas removing as much contamination as possible per RP-104, "Personnel Contamination Events" (PCE).

F. Cover remaining areas.

8.4.4 If the sitLation requires an ambulance and Pope County Emergency Medical Service personnel must enter a potentially contaminated area, the following assistance should be provided by Health Physics personnel:

NOTE Prompt medical attention shall take precedence over HP procedures when an individual is seriously injured.

A. Assist in donning protective clothing.

B. Provide dosimetry devices (these may be obtained from the Control Room emergency kit if necessary).

C. Provide a brief description of radiological conditions they will encounter during the response.

D. Provide special information to perform the task.

E. Bag equipment (to reduce chances of contamination).

F. Provide HP escort.

G. Assist in exiting the Controlled Access Area (to include any necessary decontamination).

PROCJWORK PLAN NO. PROCEDUREIWORK PLAN TITLE: PAGE: 11 of 21 1903.023 PERSONNEL EMERGENCY

. . ~~~~CHANGE: 034-02-0 8.4.5 A Health Physics representative, in addition to the one dispatched to St. Mary's Regional Medical. Center, shall accompany an injured and contaminated patient both onsite and to offsite medical facilities. This'HP should:

A. Remain with the victim from the scene of the accident to the Emergency Department and provide advice and assistance concerning radiological controls.

B. Attempt to answer any questions-the attending physician may have concerning the victim.

C. After decontamination efforts are complete at the hospital, remove the injured person's TLD for further dose determination and coordinate, as necessary with Dosimetry and Radwaste.

8.4.6 The HP that assisted the hospital staff in the set-up of the emergency room shall ensure that the ambulance and Pope County Emergency Medical Services personnel are surveyed after the victim(s) has been transported into the emergency room.

8.4.7 Both of the HPs at the hospital should proVide assistance and offer advice concerning the clean-up and decontamination of the facilities and equipment.

8.5 Health Physics Personnel (If radiation/contaminat4,on is not suspected) 8.5.1 If a personnel injury occurs within the protected area and contamination is not suspected, Health Physics personnel shall ensure that the individual is surveyed prior to exiting the site.

8.5.2 Personnel leaving the protected area will normally exit through a portal monitor. If a portal monitor and/or frisker is not available at an exit point from the protected area, Health Physics shall provide a portal monitor or frisker for the period of time that the exit is open.

9.0 REPORTING AND RECORDS MANAGEMENT 9.1 A written report of the personnel injury or accident should be completed in accordance with procedure 1000.128, "Industrial Safety &

Occupational Health".

9.2 The "Patient Information Form" should be distributed in the following manner:

9.2.1 Forward the original to the Manager, Emergency Planning.

9.2.2 Forward a copy to the ANO Medical Department.

9.3 Form 1903.023B should be forwarded to the Manager, Emergency Planning.

9.4 Form 1903.023C should be forwarded to the Manager, Emergency Planning.

10.0 ATTACHMENTS AND FORMS 10.1 ATTACHMENTS 10.1.1 Attachment 1 - "Patient Information Form" (Example) 10.2 FORMS 10.2.1 Form 1903.023A - Deleted 10.2.2 Form 1903.023B - "Personnel Emergency Checklist - Shift Manager" 10.2.3 Form 1903.023C - "Emergency Medical Team Scene Leader Check List" 10.2.4 Form 1963.023D - "Personnel Emergency Checklist - OSC Director"

PROCRWORK PLAN NO. PROCEDUREIWORK PLAN TrTLE: PAGE: 13 of 21 1903.023 PERSONNEL EMERGENCY CHANGE: 034-02-0 ATTACHMENT 1 PATIENT INFORMATION FORM (EXAMPLE)

PATIENT INFORMATION FC

  • PATIENT'S NAME *BADGE # . .
  • PATIENT'S SUPERVISOR *COMPANY
  • DATE/TIME OF INJURY / *LOCATION
  • DESCRIPTION OF OCCURRENCE:
  • INJURIES NOTED: -

MEDICAL TEAM TREATMENT:

I....

MEDICAL PERSONNEL RESPONDING_ VITAL SIGNS Time Tim _ I B/P Pulse Resp.

Dosimeter Readinq

  • Action Level: Check appropriate box Level I No contamination involved Notify Shift Manager/OSC Director Level II Contamination above ANO's of action level. If transported release limits and <1000 to hospital, the HP escort is counts per minute above responsible for reporting background as measured by a contamination levels. For frisker.

contamination levels and decontamination records, refer to Level III 21000 counts per minute above HP Procedure 1012.023, Personnel background as measured by a Contamination Events.

frisker FORM COMPLETED BY DATE/TIME

  • Information to be provided to the Control Room.

DISTRIBUTION: Original - Emergency Planning Copy - ANO Medical Department

Page 14 of 21 Page l of 4 NOTE Emergency telephone numbers are contained in the Emergency Telephone Directory.

1.0 [Notify the Emergency Medical Team by performing the following:

1.1 Call extension 5166 (CA-1 HP Office) 1.2 Provide the following information

  • Location of injured person(s)
  • Type of emergency (if known)
  • SpeciAlaccess routes (if applicable)
  • Personnel hazards (if applicable)
  • Establish communications with the Control Room using channel 1.

2.0 Notify plant personnel by performing the following:

2.1 Momentarily press the Fire and Medical tone push-button 2.2 Make the following announcement using the plant paging system:

"ATTENTION ALL PERSONNEL. ATTENTION ALL PERSONNEL. A PERSONNEL EMERGENCY HAS OCCURRED AT (give location). THE EMERGENCY MEDICAL TEAM IS RESPONDING. ALL PERSONNEL SHOULD STAY CLEAR OF THE (give location).

FORM TITLE: FORM NO. REV.

PERSONNEL EMERGENCY CHECKLIST (SHIFT MANAGER) 1903.023B 03402-0

Page 15 of 21 Page 2 of 4 NOTE The Internet Method of notification is preferred. The Outlook Method may be delayed based upon back log of messages cued to be sent. If Internet and Outlook is unavailable, repeat Step 2.0.

3.0 Notify the Volunteer Emergency Medical Team members by activating the Alpha Numeric pagers using one of the following methods:

3.1 Internet Method

a. Access the Teletouch web page by performing one of the following:
  • Type in or select "www.teletouch.comN in the address bar of any web page
  • From the Operations Department Home page

- Select Management

- Select General

- Select Alpha/Numeric page

b. Fill out the following information
  • 10 Digit Pager Number 479-964-3333
  • Your Name (Unit Performing Page)
  • Message
1. First Line type UMEDICAL EMERGENCY"
2. Location of injured person
3. Special access routes (if applicable)
4. Personnel hazards (if applicable)
c. Send message 3.2 Outlook Method
a. Select New (message)
b. In the 'TO' field, type 479-964-3333Opageme.teletouch.com
c. In the 'Subject' field type "MEDICAL EMERGENCY
d. In the 'Message' field, provide the following:
  • Location of injured person
  • Type of injury (if known)
  • Special access routes (if applicable)
  • Personnel hazards (if applicable)]

i~ FORM TITLE: E FORM NO. REV.

PERSONNEL EMERGENCY CHECKLIST (SHIFT MANAGER) l1903.023B 034-02-0

Page 16 of 21 Page 3 of 4 NOTE Radio communication between the Control Room and the emergency scene should be done on Channel 1.

'Telephone or Gai-tronics may be also used as a back-up method of communications if needed.

4.0 Dispatch an Operator to the scene to perform the following:

  • Obtain a radio switched to Channel 1.
  • Assist the Emergency Medical Team as needed.
  • Take actions to ensure plant conditions and/or job site activities remain in a safe condition.

5.0 Has the Emergency Miedical Team requested an ambulance?

Yes (GO TO step 6.0)

No (GO TO step 11.0) 6.0 IF an ambulance is needed, EN gather the following information:

6.1 Number of injured personnel:

6.2 Nature of injuries:

6.3 Contamination level (check appropriate box):

2 Level 1 No contamination involved U Level 2 Any contamination above ANO's release limits and <

1000 counts per minute above background as measured by a frisker.

U Level 3 2 1000 counts per minute above background as measured by a frisker.

6.4 Is an Automated External Defibrillator (AED) in use?

El Yes El No 6.5 Direct the ambulance to:

6.6 Name(s) and badge number(s) of injured personnel:

Name(s) Badge(s)

FORM TITLE: FORM NO. REV.

PERSONNEL EMERGENCY CHECKLIST (SHIFT MANAGER) 1903.02313 034-02-0

Page 170f21

  • . Page 4 of 4 7.0 Notify Pope County Emergency Medical Services (use a direct commercial telephone line and dial 9-1-1). Provide the dispatcher with the information in Step 6.1 - 6.4.

8.0 Notify St. Mary's Regional Medical Center Emergency Department (968-6211),

and provide them with the information in 6.1 - 6.4.

9.0 Notify Security (3383) that an ambulance is-responding to-the site and the location to where the ambulance is to report (see 6.5)..

10.0 IF contamination is known or suspected (level 2 or 3),

AND injured personnel are to be transported offsite, THEN perform the following:

10.1 Dispatch at least one Health Physics Technician to the hospital immediately.

10.2 Ensure that one Health Physics Technician accompanies the patient onsite and to the hospital.

10.3 Notify the Health Physics Supervisor to ensure that onsite HP staffing needs are met.

10.4 Have St. Mary's Emergency Department staff (968-6211) notify a physician from Occupational Medical Consultants.

11.0 FOLLOW-UP ACTIONS 11.1 Notify the supervisor of the injured personnel.

11.2 IF injured personnel are transported to the hospital, THEN Notify the General Manager, Plant Operations (if not available, notify the Duty EOF Director).

11.3 IF circumstances surrounding the injury warrant, THEN initiate a condition report in accordance with Procedure LI-102, " Corrective Action Process."

11.4 Determine if the event is reportable in accordance with 10CFR50.72.

Signed: Date:

Shift Manager When complete, forward this form to the Manager, Emergency Planning.

FORM TrILE: FORM NO. REV.

PERSONNEL EMERGENCY CHECKLIST (SHIFT MANAGER) 1903.023B 034-02-0

Page 18 of 21

[EMERGENCY MEDICAL TEAM SCENE LEADER CHECKLIST]

Page 1 of 2 CALL OUT RESPONSE al Verify scene safe.

C3 Assign patient care responsibilities.

[] Appoint communicator. Name D Appoint an H.P. to perform radiological controls. Name El Assign one team member to complete Patient Information Form. Name a] Determine if ambulance is needed. YES El NO Q al If yes, instruct Control Room/OSC to call 9-1-1 to dispatch Pope County Emergency Medical Services. Time El Direct the Control Room/OSC to have the ambulance respond to:

El Have Communicator provide Control Room with information from the Patient Information Form.

El Request H.P. to the scene if none have arrived. Name D Assign a security officer to clear the area if necessary. Name El If the patient is contaminated and stable, Check which steps were perform the following: performed (0)

a. If the scene is safe, decon patient at scene.
b. Move patient to CA-1 for decontamination. a
c. Decon as time permits while waiting on the ambulance.

If transporting a contaminated injured patient, wrap the patient or place the patient in a body bag to contain contamination. Name FORM TITLE: FORM NO. REV.

EMERGENCY MEDICAL TEAM SCENE LEADER CHECKLIST I1903.023C 034-02-0

Page 19 of 21 Page 2 of 2 If the patient is contaminated, ensure that the patient's dosimetry remains with the patient.

Dispatch an Entergy employee to the receiving hospital to provide updates on patient status to the Shift Manager or OSC Director. Name If the patient is contaminated, notify the Radwaste Supervisor for transportation of radioactive material from the hospital back to ANO. Name Notify Control Room or OSC that patient has left ANO enroute to Hospital, and that Time Personnel Emergency is terminated. Notified Dl Confirm plant status with Control Room Normal Conditions El1 or OSC. NUE El Alert El Site Area Emergency El General Emergency El1 El Assign EMT members to restore Medical Kits to service, and complete Kit inventory form. Name El As soon as possible provide Shift Manager or OSC Director with details of incident.

NARRATIVE

SUMMARY

OF INCIDENT RESPONSE:

Name of Injured Person Badge Number_

Signature Date Scene Leader

  • When complete, forward this form to the Manager, Emergency Planning.

FORM TITLE: FORM NO. REV.

EMERGENCY MEDICAL TEAM SCENE LEADER CHECKLIST I1903.023C 034-02-0

Page 20 of 21 Page 1 of 2 5 1.0 Dispatch the Emergency Medical Team from the OSC Assembly Area.

D 2.0 Dispatch a Health Physics Technician to the scene.

[ 3.0 Dispatch an Operator to the scene with a hand held radio.

5 3.1 IF there is no operator available in the OSC, THEN have the Control Room dispatch an operatbr.

5 3.2 Instruct the Operator to switch to radio Channell.

D 3.3 Instruct the Operator to assist the Emergency Medical Team as needed.

C 3.4 Instruct the Operator to take actions to ensure plant conditions and/or job site activities remain in a safe condition.

a 4.0 Notify the ANO Medical Department.

5 4.1 ANO Duty Nurse (pager 964-3936)

E 5.0 Has the Emergency Medical Team requested an ambulance?

O Yes (GO TO step 6.0) ,

E] No (GO TO step 11.0) 5 6.0 IF an ambulance is needed, THEN gather the following information:

5 6.1 Number of injured personnel:

5 6.2 Nature of injuries:

a 6.3 Contamination level (check appropriate box):

E Level 1: No contamination involved 5 Level 2: Any contamination above ANO's release limits and

<1000 counts per minute above background as measured by a frisker.

El Level 3: 21000 counts per minute above background as measured by a frisker.

El 6.4 Is an Automated External Defibrillator (AED) in use?

E Yes 5 No 56.5 Direct the ambulance to:

FORM TITLE: E FORM NO. REV.

PERSONNEL EMERGENCY CHECKLIST (OSC DIRECTOR) 1903.023D 034-02-0

Page 21 of 21 Page 2 of 2 D 6.6 Name(s) and badge number(s) of injured personnel:

Name (s) Badge (s)

El 7.0 Notify Pope County Emergency Medical Services (dial 9,911 on the OSC Director's phone). Provide the dispatcher with the information in Steps 6.1 through 6.4.

f 8.0 Notify St. Mary's Regional Medical Center Emergency Department (968-6211),

and provide them with the information in 6.1 through 6.4.

a 9.0 Notify Security (3383) that an ambulance is responding to the site and the location to where the ambulance is to report (see 6.5).

a 10.0 IF contamination is known or suspected (level 2 or 3),

AND injured personnel are to be transported offsite, THEN perform the following:

a 10.1 Dispatch at least one Health Physics Technician to the hospital immediately.

E 10.2 Ensure that one Health Physics Technician accompanies the patient onsite and to the hospital.

E 10.3 Have St. Mary's Emergency Department staff (968-6211) notify a physician from Occupational Medical Consultants.

Q 11.0 FOLLOW-UP ACTIONS El 11.1 IF injured personnel are transported to the hospital, T-EN notify the TSC Director.

Signed: Date:

OSC Director

  • When complete, forward this form to the Manager, Emergency Planning.

FORM TITLE: FORM NO. REV.

PERSONNEL EMERGENCY CHECKLIST (OSC DIRECTOR) I1903.023D 034-02-0

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