ML20058K781
| ML20058K781 | |
| Person / Time | |
|---|---|
| Site: | Seabrook  |
| Issue date: | 06/25/1990 |
| From: | Bonds J NEW HAMPSHIRE, STATE OF, PUBLIC SERVICE CO. OF NEW HAMPSHIRE |
| To: | |
| Shared Package | |
| ML20058K778 | List: |
| References | |
| LBP-90-12, OL, NUDOCS 9007110204 | |
| Download: ML20058K781 (56) | |
Text
{{#Wiki_filter:.
.o; 4 ,
i e June 25,1990 UNITED STATES OF AMERICA NUCLEAR REGULATORY COMMISSION before the ATOMIC SAFETY AND LICENSING BOARD
)
In the Matter of )
)
PUBLIC SERVICE COMPANY OF- ) Docket Nos. 50 443 OL 1 NEW HAMPSHIRE, et al. ) 50 444 OL 1
) (Offsite Emergency (Seabrook Station Units 1 and 2 ) Planning and Safety
) Issues)
)
AFFIDAVIT OF JOHN BONDS i, John Bonds, being on oath, depose and say as follows:
- 1. I am the Assistant Director for Planning of the Division of Public Health Services of the New Hampshire Department of Health and Human Services. My professional qualifications are a matter of record in this proceeding. In addition, I have testified before this Board regarding the New Hampshire Radiological Emergency Response Plan (NHRERP) and specifically with regard to protective actions utilized in that plan.
- 2. The purpose of this affidavit is to address the issues as defined by this Board in LBP 90-12,-
regarding Advanced Life Support (ALS) patients and the consideration of their preparation time for evacuation under the NHRERP.
-3. As provided in the Affidavit of Anthony M. Callendrello, the Exeter Hospital and the Portsmouth Regional Hospital accommodate Advanced Life Support (ALS) patients.
hp kb o
- i. e
- 4. The NHRERP contains provisione for special consideration of protective actions for hospitals.
Specifically, "(s)heltering in place may be the preferred protective action for institutional facilities, the nature of which require that the implementation of protectivo actions, particularly evacuation, be considered very carefully with respect to associated risks and derived benefits." (NHRERP Vclume 1, pg. 2.6-9). In making this determination, facility specific dose reduction factors are used. (Id).
- 5. The individual emergency plans for the New Hampshire EPZ hospitals currently state that if an evacuation of the facility is recommendet "At the order to evacuate, assemble patients as medically appropriate, together with patient charts, medication charts, transfer forms and other necessary medical support equipment at departure areas as practicable. . .* (Exeter Hospital Support Plan at pg. 24, attached as 'A",
and draft supplement to the Portsmouth Regional Hospital /Portsmouth Pavillon Safety Management Plan. at pg. 5). This is to maximize the number of patients available for loading when transportation arrives at the facility.
- 6. The direction on page 24 of Attachment "A" and similar language on page 5 of the Portsmouth Hospital plan is intended to be consistent with the preparation activities carried out under lower emergency classifications as directed by the hospital plans. Specifically, at a Site Area Emergency the plans direct the facility staff to:
- prioritize patients for evacuation;
- prepare patient transfer forms providing personal data, diagnosis, medications, etc.;
- assemble required special care patient transportation needs (e.g., portable oxygen apparatus, patient restraints etc.);
1
.e e
. assemble necessary medications and supplies to accompany patients. (Attachment
'A' at pp. 20 - 22; draft supplement to the Portsmouth Regional Hospital /Portsmouth Pavillon Safety Management Plan at pp. 3,4).
; 7. The emergency plans for the Exeter and Portsmouth hospitals provide for consideration of a patient's condition when determining the appropriate protective action for that patient. Specifically, the plans note that patients considered too critical for transport should be considered candidates for sheltering rather than evacuation. (See Attachment 'A*, at 21). This decision would be made i
by the hospital's administration and medical staff on a case-by case basis and be coordinated with the Division of Public Health Services of New Hampshire. The basis of these decisions will be a comparison of the medical risk of evacuation .against the radiological risk of remaining sheltered in the facility Thus, some ALS patients may not be evacuated regardless of the protective action recommenclation for the other hospital occupants.
- 8. ETEs for ALS patients are not useful since the protective action recommendations for ALS patients are made by weighing the medical risk of evacuation against the radiological risk of sheltering.
.n. O A Jo n Bonds Merrimack County, NH June 25,1990 The above-subscribed John Bonds appeared befo.e me and made oath that he had read the -
foregoing affidavit and that the statements set forth therein are true to the best of his knowledge. Before me, Me m 1yt f otary fi Public dy Commission Expires: JCANN B. Et!OS, Nov/F wie My Comm!ssion Ex;:ues Dac:r. War 16,1S02 l
.* Attachment A NH EH l' Page 1-Rev. O NEW HAMPSHIRE DERGENCY RESPONSE SUPPORT PLAN gn NH Number:- NH EH 1 Support Organization: EXETER HOSPITAL SUPPORT PLAN Revision: 0 Effective Dates- 6/21/90 s
. ...---,,-------_a
o'. v NH EH 1 Page 2 Rev. 0 CONTENTS AND REVISION STATUS CONTENTS PAGE NO. PAGE REV. COVER 1 0 CONTENTS AND REVISION STATUS 2 0
1.0 INTRODUCTION
3-8 0 2.0 BASIC PIAN DESCRIPTION 9-15 0 3.0 PROCEDURES 16-26 0 4 4.0 INSTRUCTIONS FOR ISSUING 27-40 0 DOSIMETRY AND POTASSIUM IODIDE (KI)
- 5. 0 - PLAN MAINTENANCE AND TRAINING 41 0 6.0 ATTACHMENTS Figure 1 Contact Sheet 42 0 Figure 2 Average Census / 43-44 0 Estimatad Resource Requirements Form NH EH A, Municipal Reporting 0 Form Form NH EH B, Host Facility Bed 0 Information Form NH EH C, Dosimetry KI Report 0 Form Form NH EH D, Dosimetry Log Sheet 0 Form NH EH E, Potassium Iodide O Acknowledgement Form Form NH EH F, Radiological O Equipment Inventory
NH EH 1 Page 3 Rev. O NEW HAMPSHIRE
' EMERGENCY RESPONSE SUPPORT PLAN
1.0 INTRODUCTION
1.1 Purpose This Radiological Emergency Response Plan (RERP) is designed to prepare Exeter Hospital personnel to respond appropriately in the event of an incident at Seabrook Station. This is a corking document. It is. designed to be a flexible and quickly adaptable guide for implementation _of protective actions for both patients and staff. This document conforms to applicable federal and state statutes, planning guidance and accrediting / licensing agency regulations for the safety and care of patients and employees during a radiological incident. The RERP defines the terms used therein which have applicability to radiological emergencies (e.g., Emergency Classification. Level). Section 2 of the RERP provides a basic description of the concept of operations by which hospital administrators and staff will respond to a radiological emergency, and defines the responsibilities of key hospital staff. This section describes-how the hospital _will be notified of a' radiological emergency _at Seabrook Station, and explains _the protective actions that may be recommended by the State-of New Hampshire for hospital staff and patients. The RERP provides directions for making preparations in anticipation of a protective action recommendation from the state.- It establishes the mechanism for obtaining transportation resources and for arranging for the reception of hospital patients at host facilities in the event-evacuation of the hospital is required. Section 3 of the RERP contains a set of procedures to be implemented by hospital staff based on the severity of emergency conditions, i.e'., emergency classification levels. The procedures prescribe actions for notification and mobilization of hospital staff for preparing to implement protective actions, and for actual implementation of protective actions. Forms and figures referenced in the procedures are attached to facilitate their implementation.
------------m-----um---- - -
,-- 'c .
NH EH 1 Page 4 Rev. 0 1.2 References NUREG 0654/ FEMA REP-1, Revision 1, " Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear Power Plants." (Published jointly by the U.S. Nuclear Regulatory Commission and Federal Emergency Management-Agency.) Joint Commission on Accreditation of Health Care. Organization, " Accreditation Manual for Hospitals," 1990. State of New Hampshire Radiological Emergency Response Plan. 1.3 Glossary Contamination (Radioactive) - Deposition of unwanted radioactive material on the surface of-structures,. areas, objects or personnel. Decontamination - The reduction or removal of contaminating radioactive material from a_ structure, area,-object, or person.
. Dosimeter - A portable device such as a thermoluminescent dosimeter (TLD) film badge or direct-reading ionization chamber for measuring and registering the total accumulated exposure to ionizing radiation.
Emercency Broadcast System (EBS) - Network of radio stations which provides a direct link between responsible _public officials and the public. EBS stations broadcast. instructions about what steps the public should take in the event of an emergency. Emercency Classification Level - Four emergency conditions are categorized by the U.S. Nuclear-Regulatory Commission (NRC) according to severity _of an incident. The classifications are as follows.- A. UNUSUAL EVENT - Events are in progress or have occurred that indicate a potential degradation of the level of safety of the plant. No releases of radioactive material requiring offsite response or monitoring are expected.
NH EH 1 Page 5 Rev. 0 'r B. ALERT - Events are in progress or have occurred that involve an actual, or potential, substantial degradation of the level of safety of the plant.- Any releases ese 2xpected to be limited to small fractions of Enc.ronmental Protection Agency. (EPA) Protective Action Guideline (PAG) exposure levels. SITE AREA EMERGENCY - Events are in progress or
~
C. have occurred that involve actual or likely major failures of plant functions needed for protection of the public. Any releases are not' expected to exceed EPA PAG exposure levels outside the site boundary of Seabrook Station (0.6 mile). D. GENERAL EMERGENCY - Events-are in progress or have occurred that involve actual or imminent substantial core degradation with potential for loss of containment integrity. Releases can be reasonably expected to exceed EPA PAG expcaure levels offsite for more than the immediate site area. Emeroency ODerations Centers (EOCs) - Locations designated by the State and local emergency response organizations as assembly areas for their respective staffs. These facilities are the central command and control points for their respective emergency
- response organizations.
Emeroency Plannino Zone (EPZ) - The area covered by the Radiological Emergency Response Plan. The boundary of the Plume Exposure Pathway EPZ is chosen to accommodate practical. planning considerations and to conform as closely as possible to a 10-mile. radius. The-actual EPZ boundary may be moreLor less than 10 miles from the plant. The boundary for the Ingestion Exposure Pathway EPZ is a 50-mile radius from the plant. Emeroency Response Oroanization - Utility, Federal, State, local, and private agencies and organizations designed specifically to provide capabilities to implement emergency response activities. Evacuation - The process of removing people from a hazardous or potentially hazardous area to a safe area.
- NH EH 1 Page 6 Rev. O Host Health Care Facility - A predesignated health-care facility located outside the Plume Exposure Pathway EPZ where EPZ health care facility patients will be temporarily accommodated-and their safety and well-being provided for by appropriate staff.
Millirem - See Rem. Monitorino. Radiolooical - Locating and measuring radioactive material on individuals or in an area. -; New Hamoshire Division of Public Health Services : (NHDPHS) - NHDPHS recommends protective actions for the protection of public health to-the Governor based i on accident assessment.- NMDPHS controls the- ; radiological exposure of emergency response personnel. New Hamoshire Office of Emercancy Manacement (NHOEMi-NHOEM provides command and control of emergency response operations of the State of New Hampshire.on j the Governor's behalf. NHOEM recommends protective i response measures to the Governor.- Plume - A release of airborne material that diffuses , and disperses as it moves with the air currents. l Plume Exoosure Pathway EPZ (10-Mile EPZ) - For planning purposes, the area within approximately a 10-mile radius of a nuclear plant site.- The principal exposure sources from this pathway are: ; (1) whole-body exposure to gamma radiation from the plume and from deposited-radioactive material, and (2) inhalation exposure from the~ passing radioactive plume. Public Alert and Notification System (PANS) -A system comprised of sirens, emergency broadcast systems, and other methods used to disseminate public emergency information. Radiation. Nuclear - Alpha or beta particles or gamma-rays emitted from the nucleus of an unstable atem as
- a. result of radioactive decay. Gamma radiation, radiation in the form of energy, and direct exposure to it in a passing plume is~the principle form cf radiation of concern in a radiological emergency.
Alpha or beta particles have less penetration properties, and would be of concern as a result of deposition from a passing plume.
-e ..
NH EH 1- Page 7 Rev. 0 Radiolooical Emeroency Resoonse Plan - A detailed plan that coordinates and describes the emergency response organizations, responsibilities,-and capabilities of utilities, local oristate . governments, and private organizations to ensure public health and safety during an emergency situation in which there is a potential for radiological release. Receotion Center - The location at which the state provides services for any evacuated population in need of public assistance._ Decontamination, registration, food, and shelter can be arranged by the emergency workers at a Reception Center. Reentry - The provisions for the return of'the public after evacuation, when the radiation risk has been reduced to acceptable levels. Egm - Acronym for Roentgen equivalent man. The unit of dose of any ionizing radiation that produces the same biological effect as a unit of absorbed dose of ordinary x-rays. The amount of radiation a person receives is measured in millirem. Millirem: One thousandth (1/1000) of a rem.- Exposure to very high levels of radiation - greater than 100,000 millirem - may cause observable health-problems. Extremely high levels - several hundred thousand millirem - can cause serious ~ illness or death. Most evidence shows radiation dose of 25,000 to 50,000 millirem do not cause observable health problems. However, they can.cause temporary-changes in the blood cells and they can-possibly' increase the chance of health problems later in life. . Sheltering cur evacuation would be recommended if exposure to much lower levels (a maximum of 1000 millirem for sheltering and.5000 millirem for evacuation) were possible. Roentoen - The unit of radiation exposure in air. Roentgens are the units for' quantities of x-ray or gamma radiation measured'by detection and survey meters. Mil 11 roentgen One-thousandth (1/1000) of a Roentgen. 1
i NH EH 1 Page 8 Rev. O Shelterina - Shelter-in-place is an action taken by; the public to protect against, radiation exposure by 1 remaining indoors, away from doors and windows, j during the passage of a radioactive plume. < Thyroid Blockino - The use of potassium iodide to saturate the thyroid gland with stable iodine and j thereby prevent thyroid uptake of radiciodine.. l i
'l
-I l
3 4
.i el L
L l L 1 l l L L I.
.-_-__-___._.____2_-_.____-______--____.----_-_____ . .
'NH EH 1 Page 9-Rev. 0 t
2.0- BASIC. PLAN-DESCRIPTION 2.1 Concept n'. Operations Emergency management responses are correlated to the Emergency Classification Level declared at'Seabrook' Station. Notification of the' emergency classification and of any subsequent changes in that classification will be received by Exeter Hospital from the Exeter Emergency Response Organization and over the tone-alert radio. Notification will be received and disseminated by hospital staff according. to internal protocols. If, as' prescribed under the existing emergency classification level, it is deemed appropriate for Exeter Hospital to take protective actions, such actions may include sheltering patients and staff in-place or evacuation to a facility outside the plume exposure pathway EPZ. Evacuation vehicle estimates are located in Figure 2. Actual transportation requirements of Exeter Hospital will be assigned by the Chief' Executive Officer or Administrator on call and reported to the Exeter Emergency Response Organization during the-time of an incident. Transportation to the designated Host Health Care Facilities will be provided for Exeter Hospital patients if an evacuation is recommended. The NHOEM will mobilize and direct the dispatch of necessary transportation resources to Exeter Hospital. The primary means of communication within and outside the facility will be the telephone. Exeter Hospital operates a radio system which conforms to the requirements of the NH EMS Communications Plan which allows ambulance-to-hospital radio communication. Additional radio channels allow for hospital-to-hospital communications.
~
-s' ,
' {'a.l{ #
1 NH EH 1 Page 10 ! Rev. O i ,
>* 2.2 Responsibilities
- 1. Emergency Task Force-Implementation of this radiological emergency
. response plan is the responsibility of the Emergency Task Force. This task force comprises the following individuals, with their stated responsibilities.
NOTE The positions described below are meant to refer to the position or any designated alternate. A. Chief Executive Officer or Administrator on Gall - The overall authority for the implementation and direction of.this Radiological Emergency Response Plan rests with the Chief Executive Officer or Administrator on call. Specific-responsibilities include the followings o Coordinating the emergency management response to all radiological incidents, o Designating the command post in the Central Admitting Area. o Establishing and maintaining communications with the Exeter Emergency Response' Organization and providing for internal facility communications via telephone intercom, paging or messenger. o Coordinating staff schedules with the Emergency Task Force to ensure 24-hour staffing for emergency conditions. o Coordinating the facility's emergency management response with the Exeter Emergency Response Organization and the designated host facilities, o Directing response to all internal requests for personnel and equipment support.
o 3 NH EH l' Page 11 Rev. 0-o -Determining with key staff current patient census, transportation requirements, , staffing needs and reporting unmet resource needs to the Exeter Emergency Response Organization. o Terminating the emergency response when conditions stabilize, and returning the-facility to normal operations. o Documenting the emergency. management-effort when normal operations are restored (it is advisable to maintain a l date-time log of events during incidents, see page 14). o Authorizing the procurement of all y required supplies.- . B. Vice President for Patient Care Services - The Vice President for Patient Care Services is responsible for coordinating and directing L resources to facilitate appropriate patient census reports, transport classification and all other services required to support patient care (Charge; Nurse in the Emergency Department will assume role of Vice President g L until relieved). C. Suoervisino Nurse on Duty - The Supervising Nurse on Duty is responsible for duties < p? assigned by the Director of Nursing. In the absence of the Director of Nursing, the 4 Supervising Nurse on Duty shal'l.be
' responsible for the assignment of all nursing
- service perronnel. In the absence of the j
Executive Director And the Director of L Nursing, the Supervising Nurse on Duty shall n 4 assume control of the initial emergency response. HI D. Emeroency Room Physician - The Emergency Room
+
f Physician is responsible for the assignment Pa of all physicians during the radiological emergency including the recall of medical staff as needed. The Rmergency Room Physician shall also oversee any patient discharges made in an effort to reduce census
.' o. . NH EH 1 Page 12 Rev. 0-The Emergency Room Physician will consult with attending physicians to determine which patients should be' considered candidates for-sheltering rather than evacuation. E. Facilities Director - The Facilities Director is responsible for electrical and mechanical functions necessary to maintain a safe-building environment. The Facilities Director assigns appropriate _ personnel to answer emergency calls , for -service from all areas of=the facility, controls access to the hospital complex, and maintains security and traffic flow on the premises. F. Director of Public Relations - The Director of Public Relations is responsible for dealing with all informational requests from the public and news media. G. XHS Coordinator - The EMS Coordinator is responsible for verifying that patient transportation need assessments are appropriate for the category of-patient, identifying special transportation needs, and contacting designated-host facilities to determine their capabilities. 2' 3 Notification *
- 1. Initial Notification Upon receiving information from the Exeter Emergency Response Organization that a radiological incident at Seabrook Station has been classified as~an ALERT, SITE AREA EMERGENCY or GENERAL EMERGENCY, the telephone operator immediately notifies the highest ranking staff person available within the facility, who will-immediately. notify-the Chief Executive Officer or Administrator on call. .The tone-ale';t radio serves as an additional means of no',1fication and is automatically activated as part of the Public Alert and Notification System (PAF.S).
l
.. s: .
l NH EH 1 Page 13 E Rev. 0 .; 3
- 2. Implementation 1
L The Chief Executive Officer or Administrator-on 1 L call, once notified, implements the Radiological f L Emergency Response Plan, as appropriate (refer to Section 3.0,' Procedures).
- 3. Emergency Task Force (Department Heads)
L
. Notification i.
L Upon implementation of this Radiological j Emergency Response Plan, the Telephone Operator. immediately notifies the Chief Executive Officer ' L or Administrator.on call, who will notify the L Emergency Task Force (refer to Figure 1). The l F highest. ranking staff person on duty assumes the , role of directing the response until such time as - l a higher ranking individual arrives at Exeter Hospital and assumes responsibility.
- 4. On-Duty Personnel On-duty personnel will be notified of the !
p situation by telephone or the public address system. Personnel should remain at their assigned stations unless directed elsewhere by a member of the Emergency Task Force. -Members of the Emergency Task Force should report to the ;
- . central admitting area.
- 5. Off-Duty Personnel'
+t Off-duty personnel w.11 be contacted, as needed, by the appropriate member of the Emergency Task-Force or their department head. Upon. ;
notification, off-duty personnel should proceed to Exeter Hospital and report to their appropriate department head or, in the case of those assigned to the Emergency Task Force, to the central admitting area. l. l
i
,o 1.-
i s NH EH-1 Page 14' Rev. 0 2.4 Protective Actions The Governor, or his constitutionally designated successor, has the authority _and responsibility for approving protective actions. Recommendations for. protective ections will be provided to the Governor by the New Hampshire Office of-Emergency Management (NHOEM) and the Division of Public Health Services (DPHS). NHOEM is responsible for coordination of the implementation of state recommended protective actions.
- 1. Sheltering Shelter-in-place may be the recommended
.- protective action if radiological conditions are within the limits prescribed,by the Environmental Protection Agency's Protective Action Guides.
Shelter-in-place would be in effect until the prognosis of emergency conditions-allows-the shelter-in-place recommendation to be lifted or conditions permit an evacuation of the facility.
- 2. Evacuation Evacuation is a protective action option which
- involves movement of the population from the affected area (s). It may be accomplished on a
- selective or general basis.
A. If an evacuation-of Exeter Hospital is. recommended, patients will.be transported to designated Host Health Care-Facilities (refer to Figure 1 and Form NH EH B) for medical care during the emergency. B. Transportation to the designated Host Health Care Facilitiesf(refer to Figure 2 and Form NH EH A) will be provided for patients and essential staff of Exeter Hospital. Transportation resources will'be coordinated through the Exeter Emergency Response Organization. C. Hospital-owned vehicles (ambulances, vans, buses, etc.) may be used in the event that an evacuation is recommended. i
e NH EH 1 Page 15 Rev. 0 l D. Adequate staff will be expected to accompany { patients to the designated Host Health Care ( Facilities (refer to Figures 1 and 2). Staff i should remain.with patients until relieved by host health care staff.. 2.5 Reduction of Census During incidents of extended duration and based upon the recommendations of the Emergency Room Physician, families of patients whose medical-status permits temporary discharge to family custody will-be notified . to pick up family members. ' 4 NOTE Patients requiring ambulance transportation and/ or those patients who,~1n the home setting, would l-require bus transportation from the Plume. Exposure Pathway EPZ will not be recommended for' temporary ' discharge. I
W NH EH'1 Page 16 Rev'. O' 3.0 PROCEDURES Specific emergency management responsez are dependent'upon the Emergency Classification Level declared at Seabrook , Station. Notification of the Emergency Classification ' Level, and of any subsequent changes in that classificatior.; will be given by the Exeter Emergency Response Organization. The responsible individual for each task is clearly delined + in Section 2.0, Basic Plan Description.- In the absence of an Emergency Task Force member, the senior person in charge shall assume or assign the responsibilities until off-duty < staff can be recalled. NOTE Procedures for all classifications are cumulative; that is, procedures for each emergency classification include those procedures established for all lower classifications. , 3.1 UNUSUAL EVENT No actions required. Exeter Hospital will not ; normally be notified of an UNUSUAL. EVENT. 3.2 ALERT l Upon notification of an ALERT the Executive Director l shall ensure the following are completed: NOTE TIME-l
- 1. Assemble Emergency Task Force. ..
i L l l l L l l
N' - .j r. I NH EH l' .Page:17 Rev. 0-NOTE TIME NOTE If the tone-alert radio is the first notification of an emergency 4
~
condit,on, contact the Exeter Emergency Response Organisation
, for further information and assis-tance, if required. The tone-alert radio normally serves as'an additional means of notification and is automatically activated as part of the Public Alert and Notification System (PANS).
- 2. Establish Emergency Command Post in the central admitting area.
- 3. Notify medical staff of the situation.
- 4. .The Administrator on call or Vice President of Patient Care Services-(or senior nurse on duty) directs the charge nurses to perform an immediate update-of patiet. census (refer to Form NH EH A), classifying patients according to the-following' patient groups:
A. Maternity (See following note.) B. Pediatrics C. Neonates D. Medical / Surgical E. STS Unit F. Operating Room / Recovery Room G. Intensive / Cardiac Care (ICU/CCU)
e
. c NH EH 1 Page118 Rev. 0 9
NOTE TIME. NOTE Mothers with newborns count as
. gag (1) patient.
- 5. The Vice President of Patient Care !
Services or designee based on the ! updated patient census, will- - determine patient transportation requirements (refer to Form NH EH A) .} L. according'to the following transportation classifications: j i A. Category I - Advanced. care required (ambulance) . B. Category II - Litter-dependent l (school bus with evacuation beds) l C. Category III - Non-ambulatory-(reclining seat / coach bus) ,
- 6. Code patient charts in accordance '
with transport status'(use the ' following codes): A. (A) - Ambulance B. (E) --Evacuation Bed' Bus! C. (R) - Reclining Seat:(Coach) Bus '
- 7. Notify the designated hostE health care facilities (refer to. Figure 1) that an emergency condition exists at Seabrook Station, determine.
approximate bed availability (refer to From NH EH B), and provide'a contact point for the' host facility.
- 8. Determine on-duty staff census.
- 9. Determine emergency staff needs for (a) sheltering and (b) evacuation.
1 l
E .- c-NH EM 1 -Page=19 Rev. O NOTE TIME
- 10. . Inventory and. replenish housekeeping supplies, medications,-intravenous' fluids and oxygen supplies.
- 11. Check hospital-owned-vehicles (buses, vans, ambulances, etc.) for fuel and operability.
- 12. Provide a report of the following information (refer to Forms NH-EH A and NH EH B) to the Exeter Emergency Response Organization.
A. Patient census and transportation requirements. NOTE If facility transportation resources are to be utilized, inform the Exeter Emergency _ Response Organization. B. Host facility bed availability. C. On-duty staff census. D. All unmet resource needs.
- 13. Inventorj supply of canned foods, fruits and juices, and disposable plates, cups and utensils.
- 14. Identify patients whose medical status would permit temporary discharge to family custody.
- 15. Inventory radiological equipment /KI supplies and ensure operability in accordance with Sections 4.5 and 4.6 (refer to Figure 2 and Form NH EH F).
4 f (
7__________-. i
, c.
NH EH 1 Page 20 Rev. 0-NOTE TIME 3.3. SITE AREA EMERGENCY / GENERAL EMERGENCY Upon notification of a SITE AREA EMERGENCY or GENERAL EMERGENCY the Chief Executive Officer or Administrator on call shall ensure the following are completed.
- 1. Prerequisite - PERFORM 7JL
' APPROPRIATE ACTIONS OUTLINED UNDER ALERT.
- 2. Terminate visiting hours for the-duration of the emergency.
- 3. Recall off-duty personnel, as required.
- 4. The Emergency-Room Physician will brief medical staff, discontinue elective surgery and diagnostic admissions, and consult with attending physicians to determine which patients should be considered candidates for sheltering rather than evacuation.
- 5. Restrict emergency admissions and outpatient studies (treat and release status) referrino-stabilized oatients lo hosoitaid outside the clume-exoosure cathway EPZ (hospitals other than-Portsmouth Regional,-Amesbury or Anna Jaques). Notify the Resources Coordination Center to place Exeter Hospital on divert status-for all but life-threatening emergencies.
Complete-patient census. update and determination of transportation requirements according to: Form NH EH A.
- 6. Prioritize patients for evacuation, according to the following ranking:
t NH EH 1 _Page 21 Rev. 0 , NOTE TIME A. Maternity B. Pediatrics - C. Neonates D. Medical / Surgical (See note below.) E. STS Unit F. _ Operating Room / Recovery Room ' (See note below.) 0 G. Intensive / Cardiac Care (ICU/CCU) (See note below.) i 1, !M NOTE l-Patients considered too critical for transport should be considered candidates;for i sheltering rather than evacua-tion. L , 1:
- 7. Prepare patient transfer forms-providing personal data, diagnosis, medications, etc. Assemble necessary medications and supplies to accompany ,
patients.
- 8. Place identificati'en bracelet:/taas on-all patients.
9.- Time permitting, contact families to pick up patients identified as being 1 appropriate'for release, and release t patients to family care whenever possible.
- 10. Consolidate nursing units to reduce staffing requirements, and dismiss staff as appropriate.
t
-p. .o l NH EH 1 Page 22 -1 Rev 0
-c NOTE TIME
- 11. Assemble required special care '
patient transportation needs (e.g., portable oxygen apparatus, patient restraints, etc.) at the appropriate ( nursing stations. ;
- 12. -Ensure that potassium iodide (KI) and dosimetry are distributed to on-duty ;
staff and nursing stations, and that staff are briefed on procedures (refer to Section 4.4 and Form NH EH E) and medical protocols for the r L administration of KI. L
- 13. Ensure bedridden patients are provided extra blankets for7 padding, bed pans and toilet tissue. j
- 14. Confirm transportation resources ,
through the Exeter Emergency Response Organization and ensure that transportation providers have been readied for dispatch.
- 15. Notify designated host facilities (refer to Figure 1)=confirmingLbed availability (refer to Form NH EH B),
and reserve available beds for Exeter Hospital evacuees. l NOTE Request additional beds-through i the Exeter Emergency Response i Organization. l
- 16. Prepare a roster of patients for each vehicle,-their destinations,and mode '
of transportation.
- 17. Time permitting, notify patients' families of the possibility of an l evacuation and provide the name and location of the appropriate host facility.
J l l
o e - hH EH 1 Page 23 Rev. O _2 NOTE. TIME
- 18. If advised by pFMG through the Exeter Emergency Response Organization, __
instruct staff to administer KI to themselves and patients (if sa consistent with physician orders and um medication protocols) in accordance ~ with instructions provided in Section < 4.4 and Form NH EH E. y
- 19. If thelterina is recommended:
A. Remain indoors with all doors and 22 windows closed; and B. Have maintenance or engineering adjust heating, ventilation, or air conditioning systems, where possible, to minimize the intake of outside air. NOTE HVAC systems should nat be shut down unless specifically directed to do so by NHDPHS or by the Exeter Emergency Response Organization.
- 20. If RYACR?ll2n is recommended:
A. Notify the host health care facility (refer to Figure 1) of - the evacuation, commissioning d confirmed beds (refer to Form 5 NH EH B) for patient evacuees and j determining arrangements to a accommodate transfer of staff, j reporting any unmet resource 9" needs to the Exeter Emergency Response Organization. - g B. Confirm the dispatch of required : transport vehicles from the - Exeter Emergency Response Organization.
..,_.6 .. i...
e . NH EH 1 Page 24 Rev. O NOTE TIME C. If not done earlier, complete a roster of patients for each vehicle, their destinations and mode of transportation. D. Staffing levels permitting, assign staff to patient evacuees as follows: Cateoorv I - Advanced life support. Cateoorv II - Requires medical supervision / litter-dependent. Cateoorv III - Requires medical supervision but may be ambulatory. E. Pending estimated time of arrival of vehicles, prepare patients to the extent possible for loading on evacuation vehicles. F. At the order to evacuate, assemble patients as medically appropriate, together with patient charts, medication 4 charts, transfer forms and other necessary medical support equipment at departure areas as practicable as follows: o Evacuation Bed Bus cases will be picked up at the East Wing loading dock.
- q. o Reclining Seat Bus cases will be picked up at the admitting entrance.
o Ambulance cases will be picked up in the Emergency DepErr, ment. 4 I
1 NH EH 1 Page 25 Rev. O J NOTE TIME G. Assign nursing staff to multiple- ; patient transport vehicles, as i appropriate and available. ' H. Assist patients into appropriate transportation vehicles. J I. Secure the facility via the shutdown of non-essential ! mechanical, electrical and ' physical plant systems with the exception of safety systems such as sprinkler and alarm systems, , or heat in cold weather. J. Secure records by locking all file cabinets and/or fire files, i locking important records in fire files. K. Secure patients' personal [ l valuables and lock the safe, depositing an inventory list in a i separate locked file, and take a i copy to the temporary l administrative headquarters. 1 , I L. Secura drugs / medications not c being transported by locking all medication cabinets. . M. Notify the Exeter Emergency ' Response Organization of the location selected as the temporary administrative headquarters when an evacuation is complete. N. Depart when.the facility is locked and secured.
l D: % NH EH 1 Page 26 Rev. O NOTE TIME 3.4 Termination /De-escalation Upon notification from the Exeter Emergency Response Organization that the emergency has been terminated or de-escalated, the Chief Executive Officer or Administrator on call oversees the orderly return of Exeter Hospital as determined by the new emergency classification. 3.5 Reentry Before reoccupation of the building, a safety inspection of the physical plant and surrounding areas is performed by the Chief Executive Officer or Administrator on call an_d the Facilities Director. Upon the determination by the State of New Hampshire that reoccupation of Exeter Hospital is considered safe, the Chief Executive Officer or Administrator on call and Far*11 ties Director er.sures that the facility is fully prepared to resume normal operations prior to reoccupation. When the facility is fully prepared the Executive Director coordinates transportation and reoccupation through the Exeter Emergency Response Organization.
b O NH EH 1 Page 27 Rev. 0 4.0 INSTRUCTIONS FOR ISSUING DOSIMETRY AND POTASSIUM IODIDE (KI) 4.1 Purpose This document provides guidance and instruction for issuing dosimetry and potassium iodide (KI) and for the authorization and administration of KI to the staff and patients of Exeter Hospital. 4.2 Responsibilities
- 1. The Director of the New Hampshire Division of Public Health Services (DPHS) is responsible for authorizing the ingestion of KI. NHDPHS may authorize KI for hospital staff and institutional .
l patients if assessment of accident conditions ! indicates that projected thyroid dose will exceed ' the US Environmental Protection Agency protective action guide' established for emergency workers (25 rem). This authorization if an when made will be provided to Exeter Hospital through the l Exeter Emergency Response Organization.
- 2. The Chief Executive Officer or Administrator on call in each institution is responsible _for
! overseeing the distribution of KI to the staff and residents / patients. NOTE KI is to be distributed only to those patients and residents of hospitals and nursing homes whose physicians have granted prior authoriza-l tion for its use.
- 3. The Chief Executive Officer or Administrator on call in each institution is responsible for ensuring that a record for each ingestion of KI by patients is maintained. .
- 4. Each hospital staff person is responsible for maintaining a personal Dosimetry /KI Report Form (refer to Form NH EH C).
j
. c.
NH EM 1 Page 28 Rev. 0
- 5. Each hospital staff person is responsible for reading his/her self-reading dosimeters every 30 minutes (overy 15 minutes if a release of radioactive material has occurred at the station), maintaining personal dosimetry /KI record forms and reporting readings as directed by their supervisor.
- 6. The senior official in each institution is responsible for collecting dosimetry readings from staff and reporting them to DPHS and the local Radiological Officer.
4.3 Distribution of Dosimetry /KI to Staff Actions (by senior official or designee assigned responsibility for distribution of dosimetry /KI):
- 1. Divide dosimetry for staff into units consisting of o 1 0-20R direct-reading dosimeter o 1 0-200mR direct-reading dosimeter o 1 Thermoluminescent Desimeter (TLD) o 1 Bottle of Potassium Iodide (KI) o 1 Dosimetry-XI Report. Form (refer to Form NH EH C) o 1 Potassium Iodide Acknowledgement Form (refer to Form NH EH E)
Each on-duty staff person receives one unit as described above.
- 2. Have each person complete the top section of the Dosimetry /KI Report Form (refer to Form NH EH C).
Ensure form is signed.
- 3. While each person is completing the top section of the Dosimetry /KI Form, read the direct-reading dosimeters. If not done previously, recharge or zero the dosimeter in accordance with Sections 4.5 and 4.6.
- 4. Have each person record the serial numbers for the direct-reading dosimeters and TLD in the appropriate block on the Dosimetry /KI Report Form (refer to Form NH EH C).
! 1 i
o . 1 I NH EH 1 Page 29 i Rev. O !
- 5. Have each person read both direct-reading i dosimeters and record the reading in the "before" !
bicek for each dosimeter (refer to Form NH EH C). )
- 6. Record the Date/ Time and Person / Organization in l the TLD issued blocks on the Dosimetry /KI Report i
Form (refer to form NH EH C). ;
- 7. Have each person complete the Potassium Iodide Acknowledgement Form as specified (refer to Form NH EH E).
- 8. Retain signed and dated Potassium Iodide l Acknowledgement Forms. :
- 9. Verify the appropriate information on the Dosimetry Log Sheet (refer to Form NH EH D).
- 10. Provide each person with Section 4.4, Emergency Workers Information fer use during the incident.
l 11. Individually, or as a group, brief the staff on Sections 4.4, 4.5 and 4.6. 5 i I t
1 NH EH 1 Page 30 Rev. O ; 4.4 Emergency Worker Information Readina the Dosimeter: The direct-readir.g dosimeter shows the total or ' accumulated amount of gamma radiation to which it has been exposed starting from the time of recharging (or zeroing) the instrument. This gamma exposure is read by holding the instrument so that it is pointed toward ,- a light source and looking through one end, the end with the clip on it. The gamma exposure is shown by the position of a hairline along a scale of nu;icers marked MILLIROENTGENS or ROENTGENS. The scale usually , ends with 200 or 20 at the right side.
- 1. Point the dosimeter towards a light and look through the eyepiece, staying about 1/2 inch from the lens. '
1
- 2. Rotate the dosimeter so the words ROENTGENS or MILLIROENTGENS appears right side up.
- 3. Read ths location of the hairline on the center li scale, estimating to the nearest whole number.
Refer to Figures 4.4.1 and 4.4.2 for examples of readings for the 0-200 mR and 0-20 R dosimeter. Figure 4.4.1 MILLIROENTGENS 0 20 40 60 80 100 120 140 160 180 200 ' l l l l l l l l l l 25 Milliroentgens i
. i NH EH 1
- Page 31 ]
Rev. O ; i Figure 4.2.2 ROENTGENS l 0 2 4 6 8 10 12 14 16 18 20 {
! ! ! ! .! ! ! l l l ,
10 Roentgens , Precaration and,,U,gg:
- 1. Dosimetry '
Dosimetry should be worn in the breast pocket or ' clipped to the collar, neckline, or belt from the time of issue until you are dismissed from duty, ; or until you are notified by your supervisor that l dosimetry is no longer necessary. *
- 2. Form NH EH C, Dosimetry /KI Report Form Keep this form in your possession at all times.
Make sure you understand how to use the form.
- 3. Form NH EH D, Potassium Iodide-KI Acknowledgement '
Form , Ensure you understand all the instructions on this form. Make sure that these forms are turned in before emergency workers are dispatched.
- 4. Radiation Exposure Control Begin reading your direct-reading dosimeters about every 15 minutes if notified by your supervisor that a. release of radioactive material has occurred at the station. (About every 30 minutes if a release has not occurred. )- Refer to Figure 4.4.3, Emergency Worker Radiological Limits and Action Levels, for an action guide at ,
exposure limits.
. i NH EM 1 Page 32 l Rev. 0 .;
i If your 0-200 mR direct-reading dosimeter indicates an exoosure of 175 mR, notify your d supervisor and begin reading the 0-20 R dosimeter. Notify your supervisor if your 0-20 R direct-reading dosimeter indicates an exoosure of 1 R. l The supervisor will instruct you either to leave g the affected area or assign you a new exposure 4 level. I The maximum amount of whole-body exposure a local worker is allowed to receive prior to being t removed is 5 R. However, emergency workers'and supervisors are cautioned that 5 R accumulated : exposure is a guide. Workers should attempt to { keep exposure as low as reasonably achievable by l rotating of assignments or termination of assignments. The exposure to radiation should be kept to a minimum for all persons. .Any one individual should not receive a total dose ; significantly in excess of other emergency ; workers if circumstances permit substitution of personnel, termination of assignment, or other l protective action. If your dosimeter indicates an exoosure of 5 R or areater, notify vour , suoervisor who will instruct you to oroceed to a , ( location outside of the affected area, i
- 5. Potassium Iodide Potassium Iodide (KI) is an.over-the-counter drug -
that will block the absorption of radioiodines in the thyroid and thereby reduce the exposure of the thyroid to radiation. KI DOES NOT reduce the uptake of other radioactive materials by the body, nor does it provide protection against exposure from external radioactive contamination. F Inform your supervisor if you are allergic to iodine (i.e., allergic to shellfish, iodized salt, etc). DO NOT take KI. Make arrangements with your supervisor to leave the area. l
i . h l NH EH 1 Page 33 ! Rev. O j Usually, side effects of Potassium Iodide happen when people take higher doses for a long time. , You should be careful not to take more than the recommended dose.nor should you take it for , longer than you are told. Side effects are ' unlikely because of the low dose and the short - time you will be taking the drug. Possible side effects include skin rashes, swelling of the salivary glands and " iodism" (metallic taste, burning mouth and throat, sore teeth and gums, symptoms of a head cold, and f sometimes stomach upset and diarrhea). A few people have an allergic reaction with more serious symptoms. These could be fever and joint + pains or swelling of parts of the face and body and, at times, severe shortness of breath requiring immediate medical attention. Keep the bottle of'KI with you at all times. Do , not misplace or discard it. , l l When instructed to do so, take one KI tablet and - L record the time and date on Form NH EH C, j Desimetry/KI Report Form. ' If you experience any side effects, reoort them immediate1v to your supervisor. Unless instrucP.ed otherwise, continue to take ONE table each day for the next 9 consecutive days, totalling 10 days, recording each on Form NH EH - C, Dominetry/KI Report Form. I 6. Terminat ion of Assignment NOTE . , Based on conditions of the plant and protec-tive action recommendations received from the State, you may be directed by your supervisor to report to another location other than your duty station upon termination of assignment. If this occurs, report to the location as instructed and complete actions as stated.
4 4 NH EH 1 Page 34 Rev. O At the end of your assignment, report back to your duty station unless directed otherwise by your supervisor. Record the final reading of your dosimeter in the AFTER block on Form NH EH C, Dosimetry /KI Report Form. Subtract the BEFORE reading from the AFTER reading and record results in the MISSION TOTAL block. Report mission completion and the total mission exposure to your supervisor. Stand by for further instructions from your supervisor. If you are being relieved of your assignment b*r another individual, then: (1) turn over all logs, procedures, and equipment except Dosimetry /KI to your relief, (2) notify your supervisor of the turnover, (3) report to the area where you were issued dosimetry to turn it in unless directed otherwise by your supervisor, and (4) keep a copy of the Form NH-EH C, Dosimetry-KI Report Form.
let 1 Page '35 Revo 0 Figure 4.4.3 EMERGENCY W.RI R RADIOEOGICAL LIMITS MO ACTICMS IEVEIS Type of Limit Limit / Action level Action Icvel Actions Required Whole Body Expos. 175 mR Ehergency worker reports reading to his supervisor. 1R Dnergency worker reports reading to his supervisor. A deteratination is made to assign the worker a new action level or instruct worker to leave the affected area. 2 R, 3 R, 4 R Same as 1 R. 5R Incal energency workers will be instructal to leave the affected area. State euer-gecy wkus can be assigned a higher action level if their duties are critical to the rt=,puse effort and no replacement is available, and the new action level is approved by IFO Coordinator. Any worker who enM this level will be included in the Radiological Screming F1uytan. - 10 R, 15 R Same as 5 R for state c,=:tysm y workers. 20 R State energmcy ukus will be instructed to leave the affected area. Additional
- exposure numst be approved in Auad=m with Section 8.0, Energency Exposure l Authorization Procedure, Voltmu 8.
! 25 R U[per limit of EPA PAG for emergscy wAus. 75 R Maximana exposure for life saving activities. 1hyroid Exposure (Projected) 25 run DFHS Director approves use of Ibtassitan Iodide (KI) for energency wkets. Persormel, Vehicle 100 cpa aby and Equipnet bkgd with a Contamination CIN-700 or equivalent at 1 inch Refer to Decontasnination Section of the appropriate Reception Center. l Lung Dose 15 R Bnergecy wiets directed to leave the affected areas. Entries by energency w kets will be approved with appropriate protective measures. v v+% gr = que " *P-* v " . --Be - __ 9 m '1lP _ _M - p
i . , ; I NH EH 1 Page 36 [ Rev. 0 . i 4.5 Operational Checks for the Dosimeter Charger
- 1. To check the dosimeter charger, loosen the !
thumbscrew in the top or bottom center of the ; charger with a coin or screwdriver, and remove the bottom case. Observing the indicated > polarity, install the battery and reassemble' .
- 2. Position the charger on a flat surface such as a l table. Unscrew the cap on the charging contact i and place the end of the dosimeter opposite the pocket clip and the eyepiece on charging contact .
of the charger (Figure 4.5.1). Figure 4.5.1
! I
.f.:$]y'p
- f. :.': ::: : :7. : . .
. , tilliii...
f;.. .;..;; -
/:f:::..
..: i.l;
;.i.:-:;: ' ;: ::::l.
r N ?.f.@ i t
... :.. ; ::. r. .f:::
. . . ..:. . . .;j
.. .: .::f ::.- , .
i pi 4k 4
!'[.': :.: '. . 'g . l i
. 1 l f
i .. :. ,:;. . . : : i. .: .' "*:.:. r!! .!.
....: Q- -
l y.
.j. c 2 ^
.,. :9.i: ' '.::::l:;, . : . .
- ..- . t
- ,:.: ;i.:..
O i .- p , a:s :: - Ei , p , s a
' D'h; ' '
-Q% r -
a . I i Placing a dosimeter on Resetting a dosimeter to the charger. zero with a dosimeter cha rge r,. [
- 3. Apply firm downward pressure. hou should see a meter scale and a vertical line while looking through the dosimeter. If no line is visible, rotate the voltage control knob located in the lower left hand corner (Figure 4.5.1), until a line appears, b
i- . NH EH 1 Page 37 Rev. 0
- 4. Set line at or near zero (Figure 4.5.2) by rotating the voltage control knob.
Figure 4.5.2 ROENTGENS 0 2 4 6 8 10 12 14 16 18 20
; ; ; ; ; ; ; ; l ;
- 5. Remove the dosimeter and replace the cap over the charging contact.
- 6. The charger is considered operational if the light source for reading dosimeters i's working and the charger con move the hairline on a direct-reading dosimeter to, or close to, zero.
- 7. Replace the battery if the light source fails to work and repeat the check sequence. If the light still fails to operate, replace the light bulb with the spare provided inside the charger case and repeat the check sequence.
- 8. If the light source works bat you are unable to move the line on the dosimeter, clean the charging contact on the charger with a soft cloth which is free of grit, dirt, lint, and moisture.
Do not use strong solvents or cleaning fluids to clean parts as they can dissolve the plastic. Repeat the check sequence.
- 9. If the check is still unsatisfactory, get another charger and perform the check sequence.
i NH EH 1 Page 38 Rev. 0 4.6 Operation Check /7eroing Direct-Reading Dosimeters
- 1. Place the end of the dosimeter opposite the pocket clip and eyepiece on the charging contact !
of the dosimeter charger (Figure 4.6.1). Figure 4.6.1 i
.v: :9. .
,- @. . . { ;
W [?,
)
s
'C j i a y :" '
. .s .,. 5 - g
-4' = . g
':. l D, '-
pf)',
- 2. Apply firm downward pressure on the dosimeter. !
You should see a meter scale and a vertical line r while looking through the dosimeter (Figure 4.6.2). If no line is visible, rotate the voltage control knob of the dosimeter charger , until a line appears. ~ Figure 4.6.2 MILLIROENTGENS t 1 0 20 40 60 80 100 120 140 160 180 200 t ! ! t i f ! f i' l I f 4 I i I i 4 6 I I 25 Milliroentgens t
+F l NH EH 1 Page 39 [
Rev. O NOTE - If you have trouble finding the line on a dosimeter: o Apply more pressure on the dosimeter, o Clean the charging contacts on the ' dosimeter and the dosimeter charger with a soft cloth; or l o Replace the batt .y in the_ dosimeter ! charger, ,
- 3. Set the line on the dosimeter to zero by turning
<. the voltage control knob on the dosimeter charger.
- 4. Remove the dosimeter from the charging contact.
Point the dosimeter towards a light source and , look through the dosimeter. Determine the position of the hairline on the scale. NOTE When reading the dosimeter, keep it as level
- as possible and ensure that the scale is parallel with the horizon.
- 5. Continue to Step 7 if the dosimeter reading is zero.
t
- 6. Repeat the procedure if the reading is not zero.
While charging the dosimeter, set the line an equivalent amount away from zero in the opposite direction to compensate for movement when, the dosimeter is removed from the charging contact. NOTE If time is critical, a reading of one-quarter scale or less is an acceptable charge on a direct-reading dosimeter. L 1
d i NH EH 1 Page 40 Rev. 0 $ l
- 7. If a dosimeter is not to be issued immediately, {
allow it to sit for about 15 minutes, then road. If the reading has increased, dosimeter has , excessive drift and should not be used. !
?
L v i
?
D k i s
s s 1 l NH EH 1 Page 41 Rev. 0 5.0 PLAN MAINTENANCE AND TRAINING 5.1 The Chief Executive Officer or Administrator on call and Disaster Planning Committee should review this plan annually. Corrections and updated information shall be provided to Exeter Emergency Response Organization or to the New Hampshire Office of Emergency Management. 5.2 The Chief Executive Officer or Administrator on call and designated staff should receive training on this plan on a regular basis. Plan content and the duties assigned herein should be reviewed as needed with new staff.
4 t l NH EH 1 Page 42 Rev. O FIGURE 1 CONTACT SHEET I. Exeter Hospital ! Emergency Task Force Emergency Department Heads I (Reference Department Head List) II. HosL Health Care Facility ' Facility: Concord Hospital 250 Pleasant Street Concord, NH Telephone: (603) 225-2711 Facility: Catholic Medical Center 100 MacGregor Street Manchester, NH Telephone (603) 668-3545 Facility: Hampstead Hospital ' East Road Hampstead, NH Telephone: (603) 329-5311 III. Local Agencies Exeter Emergency Responsa Organization (Exeter EOC)
Contact:
Emergency Management Coordinator Albert " Bud" Field Telephones 772-7061 or 772-1212 IV. New Hampshire Office of Emergency Management
Contact:
Special Facilities Representative Telephone (800) 852-3792/(603) 271-2231
e o ! l NH EH 1 Page 43 l Rev. 0 ) I 1 FIGURE 2 ! AVERAGE CENSUS / ESTIMATED RESOURCE REQUIRDEENTS
- 1. Average Census Staff Census Maximum Patient Census: _
II. Estimated Transportation Resource Requirements Available Required to at the ' Resource Evacuate Facility Needed SchoolBusesfo{ Evacuation Beds (E) 2* O 2 ' RecligingSeat Buses (Coach) (R) 2 0 2 Ambulances 3 (A) 11 0 7-Other 0 0 0 III. Estimated Radiological Resource Requirements 11gm Total Reauired 0-20R Dosimeters 180 0-200mR Dosimeters 180 Thermoluminescent Dosimeters 180 Dosimeter Charger 2 Bottles of KI Tablets 260
- Ten evacuation beds required.
1 2 Bus conversion beds will accommodate 10 patients per bus. Assuming 36 persons per bus. Reclining seat buses (coaches) have individual reclining seat backs. School buses have bench type seats. 3 Assuming 2 patients per ambulance.
s C NH EH 1 Page 44 Rev. O FIGURE 2 EMERGENCY RESPONSE PIAN TRANSPORTATION ASSESSMENT (Continued) This assessment is provided to estimate the transportation requirements needed if a patient evacuation at Exeter Hospital were necessary. Patients are categorized into various types based upon their physical health, the medical attention they require, and their means of movement. These types are as follows. TYPE I Patients who require continued monitoring and hands-on medical attention while in transit to host health care facilities. These l patients may require advanced life support and are totally dependent upon litter transport. , Patients require ambulances which are staffed and equipped to l provide the same level of care which the patient was receiving at l the risk facility. TYPE II Patients who are litter-dependent but do not require the continued hands-on medical attention found with Type I patients. These patients will be monitored and have their needs attended I to but should not require advanced life support. ! Patients will be transported by school bus which has been converted to an ambulance which should be staffed by institution or emergency medical personnel who will provide the same level of care that the patients were receiving at the risk facility. l Patients will be dependent upon litter transport to and from the bus. TYPE III 1 Patients who are non-ambulatory and can only sit for long l periods in a reclined position. These patients will be monitored and have their needs attended to. Patients will be transported by commercial-type, climate-controlled bus equipped with reclining seats. These buses will be staffed by institution or emergency medical personnel who will provide the same level of care that the patients were receiving at the risk facility. Patients will be transferred to and from the bus by wheelchairs and/or ambulance-type stairchairs.
f
...i MUNICIPAL REPORTING FORM
, (Typical) .
i DATE/ TIME HOSPITAL i CENSUS AND TRANSPORTATION REQUIREMENTS [ t TRANSPORTATION REQUIREMENTS BUS CONVER- RECLINING AMBULANCE SION BED SEAT BUS PATIENT CLASS PATIENTS PATIENTS PATIENTS TOTAL CAT. I CAT. II CAT. III CENSUS HATERNITY1 PEDIATRICS ' NEONATES MEDICAL / , SURGICAL STS UNIT OPERATING ROOM / RECOVERY ROOM INTENSIVE / CARDIAC CARE ' PATIENT l TOTALS l STAFF CENSUS 1 Mothers with newborns count as Sat. Form NH EH A Rev. O L i
HDST FACILIT ED INFUIt3ULTION - (Typical) a. MED/SUR. MATERNI PED NEO STS RECOV- ICU/CCU TOTAL HOST ERY
- FACILITY STATUS 2 g y i
A / R / C / l l A / R / C / A / R / C / TOTAL A / R / C / I Mothers with newborns count as one. 2 Status: A = Available R = Reserved C = Confirmed Form NH EH B Rev. 0
._ _ .. . _ - __ . - ~ . _ .
. 1 I ett u !
N N. E 4 -
, 2i l
$i!
; I l i l .l.!. !..! ! G I.
,: li .
; j[, .
1 l ,u. .u
. .ll. I . .
a,g r . 13 3 l f 5 1 i I ti
>1 u , ,
, c t ,
; 1 l !5 j 5,f j
. i s i l '
g
- . .i s . . . . u. . . . . i
. l l l 'I i 1 1 11 1 1 1 1 1 1 }a .6 l'I
. ; , , , i i s i g I .o. , _yi
- t. ..
i
.i, ! l a r g t 1 1 1 1 1 1 1 1 1 :
tw3 . I l l s : i 3 g b {1. s, '( n
! 1 R, 1 i :" ' . ,o ". l.I.'
a gi! ! g.
, 1 16
,x
.! j! ,
a, , .5g a. r . m3.
.i l a j
.e:
- , 3}43;,,
I .. .. .. .. .., 3 : 1
.la l 8 -
1:. : r 1;. {. 3 !
$ f L}; : '
1). 1 l3
' l
- I ti [,. I e
i i. u .
. t
; at a g j; i J :
8[ 9 t g v
< ,y I, l La y jj -
h- *
, 1 qI) '
, ir l .
1 i 's e , Ia n' ll
!!.i l . - - . . I! i ii iil l
'fi y l{l
. . . . c. :
i? g a 4 t Eo \ h i ! 1j 3- , vs e ai ! l! a ln .- 2
- g. kas.
l g.13 l eEE h , I
.l
.. .. . o 135A POTASSIUM IODIDE ACKNOWLEDGEMENT FORM (Typical) I will not take my first XI tablet until I receive instructions to do so. If instructed to do so, I , , understand that in order to obtain maximum protection for the thyroid, I will tako 130 milligrams per day (1 tablet) of the ' thyroid blocking agent Potassium Iodide for 10 consecutive days. I have been informed that this drug will block the absorption of radioiodine by my thyroid and thereby reduce the exposure to ' radiation of the thyroid; that Potassium Iodide does not reduce the uptake of other radioactive materials by the body; nor, does ' it provide protection against exposure from external radiation. I have been told that if I am allergic to iodine that I should - not take Potassium Iodide. i SIGNATURE DATE Form NH EH E Rev. O
,i ill ll R
r 0 0 3 a i T! mO E G B I .x v.e aR E E E u A o I I A w V A D E RI U Q B R Y R K f 3 E V R N I N I r O N! ) E l 4 a i c p . E y T Y L ( sCF A nNWE C I oGD sAS G 0J GI D , A U R G O I *K s TC s o s s s o AE e Y e Y N e Y e Y oe NY N R E P O . O 6 4 r d e t n d t n a n e 0e a sr m 5m e i 's i - s n 5 s r t e s o r 0n t t e o 4 e t e e m D e g ts nn l b aC
& i t
c s n i t r a eI u m s o i l ay T r o i so h e t i I D C ve It s t c D 1 1 D Rm h s r e i v ur qu Ka f D n I su S e R i n t e eS oe f ec t o o 0 u u m rr si aF t 0 0 l i s oh eL i 2 2 c / l g sr 0 0
- a n
e D o 0R 0n 7 tf tl oe vIo f e h Bh e S R 1 N-G h
= . . . A CERTIFICATE OF SERVICE I, Thomas G. Dignan, Jr., one of the attorneys for the Licensees herein, hereby certify that on June 26, 1990, I made service of the within document by depositing copies thereof with Federal Express, prepaid, for delivery to (or, where indicated, by depositing in the United States mail, first class postage paid, addressed to): Administrative Judge Ivan W. Smith Adjudicatory File Chairman, Atomic Safety and Atomic Saiety and Licensing Licensing Board Board Panel Docket (2 copies) U.S. Nuclear Regulatory U.S. Nuclear Regulatory Commission Commission East West Towers Building East West Towers Building 4350 East West Highway 4350 East West Highway Bethesda, MD 20814 Bethesda, MD 20814 Administrative Judge Richard P. Cole Robert R. Pierce, Esquire Atomic Safety and Licensing Board Atomic Safety and Licensing U.S. Nuclear Regulatory Commission Board East West Towers Building U.S. Nuclear Regulatory 4350 East West Highway Commission Bethesda, MD 20814 East Wesu Towers Building 4350 East West Highway Bethesda, MD 20814 Administrative Judge Kenneth A. Mitzi A. Young, Esquire McCollom Edwin J. Reis, Esquire 1107 West Knapp Street Office of the General Counsel Stillwater, OK 74075 U.S. Nuclear Regulatory Commission One White Flint North, 15th Fl. 11555 Rockville Pike Rockville, MD 20852 George Dana Bisbee, Esquire Diane Curran, Esquire Associate Attorney General Andrea C. Ferster, Esquire Office of the Attorney General Harmon, Curran & Tousley 25 Capitol Street Suite 430 Concord, NH 03301-6397 2001 S Street, N.W. Washington, DC 20009
- Atomic Safety and Licensing Robert A. Backus, Esquire Appeal Panel 116 Lowell Street U.S. Nuclear Regulatory P. O. Box 516 Commission Manchester, NH 03105 Mail Stop EWW-529 Washington, DC 20555
* . ., A Philip Ahrens, Esquire Suzanne P. Egan, City Solicitor Assistant Attorney General Lagoulis, Hill-Whilton &
Department of the Attorney Rotondi
. General 79 State Street Augusta, ME 04333 Newburyport, MA 01950 Paul McEachern, Esquire John Traficonte, Esquire Shaines &,McEachern Assistant Attorney General 25 Maplewood Avenue Department of the Attorney P.O. Box.360 General Portsmouth, NH 03801 One Ashburton Place, 19th Fl.
Boston, MA 02108
- Senator Gordon J. Humphrey R. Scott Hill-Whilton, Esquire U.S. Senate Lagoulis, Hill-Whilton &
Washington, DC 20510 Rotondi (Attn: Tom Burack) 79 State Street Newburyport, MA 01950
- Senator Gordon J. Humphrey. Barbara J. Saint Andre, Esquire One Eagle Square, Suite 507 Kopelman and Paige, P.C.
Concord, NH 03301 101 Arch Street (Attn: Herb Boynton) Boston, MA 02110 H. Joseph Flynn, Esquire Judith H. Mizner, Esquire Office of General Counsel 79 State Street, 2nd Floor Federal Emergency Management Newburyport, MA 01950 Agency 500 C Street, S.W. Washington, DC 20472 Gary W. Holmes, Esquire Ashod N. Amirian, Esquire Holmes & Ells 145 South Main Street 47 Winnacunnet Road P.O. Box 38 Hampton, NH 03842 Bradford, MA 01835 Mr. Richard R. Donovan Mrs Jack Dolan Federal Emergency Management Federal Emergency Management Agency. Agency - Region I Federal Regional Center J.W. McCormack Post Office & 130 228th-Street, S.W. Courthouse Building, Room 442 Bothell, Washington 98021-9796 Boston, MA 02109
- n. ' .o- s ., 6 '
f
' George Iverson, Director 1 N.H. Office of Emergency Management State House Office Park South
)
107 Pleasant Street Concord, NH 03301 l
+
.t
/
i ma's G. Di4JfigJr.
.(*= Ordinary U.S..First Class Mail) 4.. ,
k
-{
ti) 1.f (k '
-}}