ML12026A352

Transmittal of Lawrence Memorial Hospital Medical Services Drill Conducted on December 13, 2011

ML12026A352
Person / Time
Site:	Millstone, 03001275
Issue date:	01/17/2012
From:	Colman S US Dept of Homeland Security, Federal Emergency Management Agency
To:	Document Control Desk, Office of Nuclear Reactor Regulation
References
Download: ML12026A352 (20)

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U.S. Department of Homeland Security FEMA Region I 99 High St., 5"h Floor Boston, MA 02110-2320 SFEMA Januaiy 17, 2012 NRC Headquarters Document Control Desk US Nuclear Regulatory Commission Washington, DC 20555-0001

Dear Sir/Madam:

Enclosed is a copy of the final report for the Lawrence Memorial Hospital Medical Services (MS-1) Drill that was conducted on December 13, 2011.The State of Connecticut, the Lawrence Memorial Hospital, and New London Fire Department Ambulance successfully demonstrated their capabilities to implement their off-site radiological emergency response plans and procedures.

Based on the evaluation of this exercise by the FEMA Region I evaluators, there were no deficiencies, and no Areas Requiring Corrective Action (ARCA).State and local preparedness remains adequate to protect the health and safety of the public living in the vicinity of the Millstone Power Station and provides reasonable assurance that appropriate measures can be taken off-site in the event of a radiological emergency.

If you have any questions regarding this matter, please feel free to contact me at 617-832-4731, or Helen LaForge, of my staff, at (617) 956-7584.Sincerely, Steven Colman RAC Chair, Region I Enclosure E-copy: NRC Region I www.fema.gov Millstone Power Station Lawrence Memorial Hospital MS- I Drill -December 13, 2011 Radiological Emergency Preparedness Program Final Report: January 13, 2012 FEMA Region I X~ vRTAN FEMA ND S~Final Drill Report Millstone Power Station Licensee:

Dominion Generation Millstone Power Station Exercise Date: December 13,2011 Report Date: January 13,2012 U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MANAGEMENT AGENCY REGION I RADIOLOGICAL EMERGENCY PREPAREDNESS 99 HIGH STREET BOSTON, MASSACHUSETTS 02110 This page is intentionally blank.I I I I TABLE OF CONTENTS Page TABLE OF CONTENTS ....................................................................................................

1 EXECUTIVE

SUMMARY

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2 II. INTRODUCTION

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3 III. DRILL EVALUATION AND RESULTS ......................................................................

5 A. NEW LONDON FIRE DEPARTMENT AMBULANCE

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5 B. LAWRENCE MEMORIAL HOSPITAL ...............................................................

6 List of Appendices APPENDIX I DRILL EVALUATORS

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7 APPENDIX 2 CRITERION AND EXTENT OF PLAY ...............................................

8 APPENDIX 3 SCENARIO ..........................................................................................

12 I I I. Executive Summary I On December 13, 2011, a MS-I Drill was conducted at Lawrence Memorial Hospital, New London, Connecticut.

The purpose of this drill was to assess the capability of the I Lawrence Memorial Hospital and New London Fire Department Ambulance Services to respond to a radiological incident involving the Millstone Power Station. This drill was held in accordance with FEMA's policies and guidance concerning the exercise of State and Local radiological emergency response plans (RERP) and procedures.

FEMA wishes to acknowledge the efforts of the many individuals who participated in this important medical services drill, the Lawrence Memorial Hospital Emergency Department Staff and Support Staffs, the New London Fire Department Ambulance EMTs, and the Millstone attending Health Physicist.

Sincerest thanks to all who participated in making this a successful MS-1 Drill from start to finish.Protecting the. public health and safety is the full-time job of some of the drill participants and an additional assigned responsibility for others. Still others have willingly sought this responsibility by volunteering to provide vital emergency services to their communities.

Cooperation and teamwork of all the participants were evident during this drill.This report contains the final evaluation of the MS-I Drill.The Lawrence Memorial Hospital staff and New London Ambulance team demonstrated knowledge of their emergency response plans and procedures and adequately implemented them. There were no Deficiencies identified and no Areas Requiring Corrective Action (ARCAs) identified as a result of this drill. I 2I II. Introduction On December 7, 1979, the President directed the Federal Emergency Management Agency (FEMA) to assume the lead responsibility for all off-site nuclear planning and response.

FEMA's activities were conducted pursuant to 44 Code of Federal Regulations (CFR) Parts 350, 351 and 352. These regulations are a key element in the Radiological Emergency Preparedness (REP) Program that was established following the Three Mile Island Nuclear Station accident in March 1979.44 CFR 350 establishes the policies and procedures for FEMA's initial and continued approval of Tribal, State, and local governments' radiological emergency planning and preparedness for commercial nuclear power plants. This approval is contingent, in part, on State and local government participation in joint exercises with licensees.

FEMA's responsibilities in radiological emergency planning for fixed nuclear facilities include the following: " Taking the lead in offsite emergency planning and in the review and evaluation of RERPs and procedures developed by State and local governments;

• Determining whether such plans and procedures can be. implemented on the basis of observation and evaluation of exercises of the plans and procedures conducted by State and local governments;

• Responding to requests by the U.S. Nuclear Regulatory Commission (NRC)pursuant to the Memorandum of Understanding between the NRC and FEMA dated June 17, 1993 (Federal Register, Vol. 58, No. 176, September 14, 1993);and" Coordinating the activities of Federal agencies with responsibilities in the radiological emergency planning process: U.S. Department of Commerce, U.S. Nuclear Regulatory Commission, U.S. Environmental Protection Agency, U.S. Department of Energy, U.S. Department of Health and Human Services,-U.S. Department of Transportation,-U.S. Department of Agriculture,-U.S. Department of the Interior, and-U.S. Food and Drug Administration.

Representatives of these agencies serve on the FEMA Region I Radiological Assistance Committee (RAC), which is chaired by FEMA Region I.3 Formal submission of the RERPs for the Millstone Power Plant to FEMA Region I by the State of Connecticut and involved local jurisdictions occurred on September 4, 1981. I Formal approval of the RERP was granted by FEMA on October 9, 1984, under 44 CFR 350.A MS-I Drill was conducted on December 13, 201 1,by FEMA Region I to assess the capabilities of the Lawrence Memorial Hospital and New London Fire Department Ambulance in implementing their RERPs and procedures to protect the public health and I safety during a radiological emergency involving Millstone Power Station. The purpose of this drill report is to present the drill results and findings on the performance of the off-site response organizations (OROs) during a simulated radiological emergency.

The findings presented in this report are based on the evaluations of the Federal evaluator team with final determinations made by the FEMA Region I RAC Chairperson.

The criteria utilized in the FEMA evaluation process are contained in the following:

I" NUREG-0654/FEMA-REP-1, Rev. 1, "Criteria for Preparation and Evaluation of Radiological Emergency Response Plans and Preparedness in Support of Nuclear I Power Plants," November 1980;" "Radiological Emergency Preparedness:

Exercise Evaluation Methodology," I published in the Federal Register on September 12, 2001, and revised April 25, 2002.Section III of this report, entitled. "Drill Evaluation and Results," presents detailed.information on the demonstration of applicable exercise objectives at each jurisdiction or functional entity evaluated in a jurisdiction-based, issues-only format. I 4 III. DRILL EVALUATION AND RESULTS Contained in this section are the results of the evaluation of the New London Fire Department Ambulance and the Lawrence Memorial Hospital, of New London, CT, from the December 13, 2011, MS-1 Drill that tested the medical service capabilities to respond to an incident involving the Millstone Power Station.Each functional entity was evaluated on the basis of its demonstration of criteria delineated in the Evaluation Criterion contained in "Radiological Emergency Preparedness:

Exercise Evaluation Methodology," published in the Federal Register on September 12, 2001, and revised April 25, 2002.The following is a status of functional entities evaluated.

A. New London Fire Department Ambulance The Emergency Medical Technicians from New London Fire Department Ambulance demonstrated their knowledge and expertise in caring for the injured contaminated worker. They accurately followed the guidance of the Millstone Health Physics (HP)Technician minimizing the possibility of radioactive cross contamination.

Having a HP technician ride along in the ambulance was an excellent source of information.

The Ambulance Team did an excellent job of contamination control. All activities associated with this criterion were based on the ORO's plans and procedures and completed, as they would be in an actual emergency, unless noted above or otherwise indicated in the extent of play agreement.

a. MET: Criterion 6.d.1 b. DEFICIENCY:

NONE c. AREAS REQUIRING CORRECTIVE ACTION: NONE d. NOT DEMONSTRATED:

NONE e. PRIOR ARCAs -RESOLVED:

NONE f. PRIOR ARCAs -UNRESOLVED:

NONE 5 B. Lawrence Memorial Hospital The Emergency Radiological Team at the Lawrence Memorial Hospital successfully demonstrated excellent knowledge of the hospital's radiological response plan from startI to finish. Communication among the Lawrence Memorial Hospital, Millstone Power Station, and the New London Fire Department Ambulance via telephone and radio was excellent.

Staff responded immediately following notification of an injured worker with I radiation contamination being transported to the hospital from Millstone.

The Emergency Radiological staff was briefed on the patient's status. Without delay staff suited up, checked radiological equipment and prepared the radiological emergency room I and ambulance bay in preparation to receive the injured radiation contaminated patient in accordance to their plans and procedures.

The hospital staff did an excellent job of preventing cross contamination while treating the patient. All activities associated with I this criterion were based on the ORO's plans and procedures and completed, as they would be in an actual emergency, unless noted above or otherwise indicated in the extent of play agreement.

a. MET: Evaluation Area Criterion 6.d. 1 b. DEFICIENCY:

NONE c. AREAS REQUIRING CORRECTIVE ACTION: NONE I d. NOT DEMONSTRATED:

NONE e. PRIOR ARCAs -RESOLVED:

NONE E. PRIOR ARCAs -UNRESOLVED:

NONE f. PIORARC~ -NRE OLVE: NNE I APPENDIX 1 DRILL EVALUATORS The following are the personnel who evaluated the Medical .Services Drill (MS-I Drill) for the Millstone Power Station, December 13, 2011.EVALUATION SITE OBJECTIVE EVALUATOR ORGANIZATION New London Ambulance 6.d. 1 Robert Swartz DHS/FEMA Lawrence Memorial Hospital 6.d. 1 Helen LaForge DHS/FEMA 7 APPENDIX 2 CRITERION AND EXTENT OF PLAY EVALUATION AREA 6: SUPPORT OPERATION/FACILITIES Sub-element 6.d -Transportation and Treatment of Contaminated Injured Individuals Intent This sub-element is derived from NUREG-0654, which provides that OROs should have the capability to transport contaminated injured individuals to medical facilities with the capability to provide medical services.Criterion 6.d.1: The facility/ORO has the appropriate space, adequate resources, and trained personnel to provide transport, monitoring, decontamination, and medical services to contaminated injured individuals. (NUREG-0654, F.2, H.10., K.5.a.b., L.I., 4.)Extent of Play -General OROs should demonstrate the capability to transport contaminated injured individuals to medical facilities.

However, to avoid taking an ambulance out of service, any vehicle (e.g., car, truck, or ambulance) may be utilized to transport a simulated victim to the medical facility.

If an ambulance is used, normal communications between the ambulance/

dispatcher and the receiving medical facility should be demonstrated.

This would include reporting radiation monitoring results, if available.

Additionally, the ambulance crew should demonstrate, by interview, knowledge of where the ambulance and crew would be monitored and decontaminated, if required, or whom to contact for such information.

Monitoring of the simulated victim may be performed prior to transport, done en route, or deferred to the medical facility.

Prior to using a monitoring instrument(s), the monitor(s) should demonstrate the process of checking the instrument(s) for proper operation.

All monitoring activities should be completed as they would be in an actual emergency.

Appropriate contamination control measures should be demonstrated prior to and during transport and at the receiving medical facility.The medical facility should demonstrate the capability to activate and set up a radiological emergency area for treatment.

Equipment and supplies should be available for the treatment of contaminated injured individuals.

The medical facility should demonstrate the capability to make decisions on the need for decontamination of the individual, to follow appropriate decontamination procedures, and to maintain records of all survey measurements and samples taken. All procedures for the collection and analysis of samples and the decontamination of the individual should be demonstrated or described to the evaluator.

8 Monitoring, decontamination, and contamination control efforts will not delay urgent medical care for the simulated victim.All activities associated with this criterion must be based on the ORO's plans and procedures and completed as they would be in an actual emergency, unless otherwise indicated in the extent of play agreement.

Extent of Play -Specific: All responding station and offsite emergency response personnel, equipment, and procedures will demonstrate response actions within the following limitations:

1. All non-invasive medical protocol and contamination control (radiological and blood borne pathogen) measures will be demonstrated.

Medical procedures will be conducted in accordance with Millstone Power Station, state, local and hospital protocols.

Invasive protocols will not be demonstrated.

Moulage, injured individual role-playing, and scenario data will be used to simulate victim physical injuries as well as contamination levels.2. The simulated accident will be staged on December 13, 2011 at Millstone Power Station.This area may be a simulated or real Radiological Control Area (RCA) at Millstone Station.The area may be posted as a "Contaminated Area" "Training Only" or "Drill Only" but will not actually be contaminated.

1. If a real RCA is used, all personnel entering the RCA must comply with HP RCA requirements including use of electronic dosimetry and sign in on a valid Radiation Work Permit (RWP- 32 Task 1 is available for EP activities),# If a real RCA is used, a timeout may be used to monitor the patient and caregivers as they exit the RCA. If the patient is boarded and collared, he/she will return to the station following "release" from the hospital and will pass through the routine RCA exit monitoring.

3. Security restrictions and controls cannot be suspended for simulated emergencies.

Note that ambulances routinely respond to the site for real medical emergencies.

Since the process for granting non-emergency access to the Protected Area (PA) results in a substantial delay, one of the following simulations may be used: " The accident scene may be simulated to be within the PA. The actual location may be outside of the PA but still in the Owner Controlled Area (OCA).-or -" The ambulance may be pre-staged within the PA. Five minutes after radio dispatch, the ambulance will simulate driving through the PA gate.-or -" The ambulance may respond real time, go through the search process, and the extra time noted as drill artificiality.

9 I 4. One individual will role-play a contaminated injured patient. Simulated injuries will be i assessed medically and radiologically.

Priorities of care will be determined based on medical condition, simulated injuries and the magnitude of radioactive contamination.

5. A controller will make the initial notification to the Millstone Unit 3 Control Room (29.11)reporting the injury. The Control Room will use station procedures and systems to dispatch first responders (radiological and emergency medical), request offsite assistance, and notify the hospital.6. The patient will be transported to L&M Hospital, which is equipped to treat radiological 1 contaminated/injured individuals.

7. Per Millstone procedures, a Millstone Health Physics (HP) Technician will accompany the patient and transport vehicle to the hospital.

Additional pre-designated HP staff/supervision will travel to the hospital to provide support. All scene personnel (Medic I st Aid Responders, EMT Volunteer Responders, Fire Brigade, Security, HPs), facilities and equipment will be simulated "clean" and available upon departure of the patient from the accident scene.8. Communications will be demonstrated between the vehicle (ambulance) crew and hospital via medical radio equipment (med patch).9. The ambulance will respond in non-emergency mode at all times. Emergency lights and sirens will not be used. All normal traffic laws will be followed.10. Regardless of the severity of injuries and Connecticut Trauma Regulations, neither Lifestar, nor any Trauma Center will be utilized for the drill. Advanced Life Support (Paramedic intercept service) if available will be used.11. Controllers will determine if the ambulance, crew, and/or equipment have been contaminated.

Decontamination of ambulance personnel and emergency vehicles will be l demonstrated through a discussion with players.12. The exercise, or portions thereof, will be suspended if emergency responders are called upon i for an actual emergency, L&M hospital declares a diversion, or Millstone EP management determines immediate station needs require suspension.

i 13. The exercise will be terminated based on an agreement between the FEMA lead evaluator and the drill manager.Area Requiring Corrective Action (ARCA)(None) i 10 APPENDIX 3 SCENARIO 11

" The drill date can be assumed to be Tuesday, December 13, 2011." The plant status Is as reported In the morning." The Waterford Ambulances unknown to our site will be unavailable.

• The site fire brigade has just extinguished a small fire in a contaminated area. No offsite fire apparatus was requested by the station.ACCIDENT SCENE _____________________

0745 Lead Exercise Coordinator to call all Controllers to identify if all drill locations are set to start.0800 A call to the U3 Control room from the simulated After receiving the information the U3 Control Room may call the FBL requesting a site medical response for a FBM Waterford Dispatch Center via 911 requesting an ambulance to the who has a large facial laceration and an injured arm. station for a facial laceration and an injury to an arm.The FBL reports that the FBM was in a contaminated area within the TBA building.If an ambulance is requested by the U3 CR at this time the following response would be suspected; Waterford dispatch informs the U3 CR that all WTFD ambulances are busy and will request New London Dispatch to have a New London ambulance respond to the station.0802 U3 CR refers to C OP 200.3 and pages on shift The on shift medical responder and any available volunteer EMT' to medical responder and all volunteer EMT's. start heading toward the TBA Building.12= = = = = = 1 = = m m = = = m -m

= = M -= = 1-111rl = -= = = m = = = n TIME ( EVENT DESCRIPTION ANTICIPATED RESPONSE 0803 U3 CR makes overhead page announcing a medical HP techs to start their response to the medical scene.emergency in TBA building and for all volunteer I EMT to respond to the location.0805 HP Tech on scene Tech to start evaluating the scene 0805- Medical responders to arrive on scene. Start patient care to their level of training.0810 0810 Medical responders identify the injuries require the HP tech should add to the communication to the U3 CR that the need for offsite ambulance to transport and call the injured person is potentially contaminated at this point. U3 May have U3 CR to request ambulance to the scene for an already requested an ambulance.

I injured worker.If an. ambulance has not already been requested the U3 CR will call Waterford Dispatch Center requesting an ambulance to the site: Waterford dispatch informs the U3 CR that all WTFD ambulances-are busy and will request New London Dispatch to have a New London ambulance respond to the station.0811 U3 CR notifies Security and HP that an ambulance is coming to the site. _0812 U3 CR calls Lawrence and Memorial Hospital L& M Hospital ED Staff should initiate their radiological emergency Emergency Department to notify them that a plan and prepare the radiological emergency area (REA) for the potentially radiological contaminated patient is being patient's arrival.I transported to their facility.0814 L&M Hospital makes verification call back to the U3 CR.0815 The patient's injuries are addressed and control the Due to the ground level fall with the weight of the fire fighting gear it is bleeding and stabilize the arm injury, expected that the patient will be collared and back boarded.0815 New London Ambulance in route. If ambulance has been staged on site they will not report to the incident area for ten minutes.0820 Patient packaging for transport.

An effort to remove the fire gear may, challenge the timeline.0825 New London Ambulance onsite going to incident 13 scene.0830 New London Ambulance on scene. Once the ambulance is on scene the crew should get briefed by HP's, and EMT's.0835 Patient turnover from on site responders to NL Patient vitals and assessment by New London Ambulance should Ambulance EMT's. occur in ambulance.

...... AMBULANCE TRANSPORT 0840 NLFD begin transport to L&M A med patch may be made prior to leaving site to the L&M Hosp. to brief Hospital on patients condition and contamination levels.0845 Ambulance at VAP. If desired, and if patient was back boarded the EMT's will remove patient from backboard to walkthrough SAP while the vehicle goes ,_through VAP.0850 Ambulance in route again to L&M. U3 CR should notify L&M Hospital to inform them that ambulance has left site and give estimated arrival time.0850 -Patient care during travel to L&M. One more med patch to L&M would be expected, giving patient 0910 update and any changes as well as ETA.L&M will continue to set up their REA._L&M Hospital REA 0910 NLFD Ambulance arrival at L&M L&M Security will back in ambulance 0915 Transfer of care from NLFD to L&M Hosp. Staff EMS personnel once released from patient care responsibilities as well as the ambulance should be surveyed for contamination at this.time or any time after, depending on the status and readiness of hospital and MP HP staff to perform this function.Neither the EMS personnel nor the ambulance itself will be contaminated, unless contamination was spread during the 14 11111- M--- -1111110 M m m M -M m-n---_ m -m -m m m -n m- n -m m m-m TIME (=) EVENT DESCRIPTION ANTICIPATED RESPONSE response/transport to the hospital.

The controller who travelled in the ambulance and observed contamination control measures shall make this determination.

If based on actual actions taken by ambulance personnel during transit to the hospital.

Ad Hoc contamination levels should be assigned by the controller.

If contamination is identified during ambulance personnel or vehicle monitoring/surveying, the person surveying the vehicle should require it to be returned to the station for decontamination if initial attempts are unsuccessful.

The HP should describe procedure at this point. If ambulance is clean it can return to service.0920 L&M Staff performing patient care. Any remaining clothing that is in area of injuries would be moved.REA ED Staff radiological exposures should be periodically monitored during and after patient receipt and when care is provided.0925 Attempting to decon the wound site. Site HP to assist if necessary.

All activities should be done by hospital plan.0930 Facial contamination has been removed. Patient is clear of all contamination.

After successful patient decontamination is performed, the-patient-may be transferred out of REA if necessary.

0930 X ray of injured wrist. May occur in roomý or after removal from room.0940 The medical staff will be monitored as they leave the REA as well as equipment.

0945- Controllers will consult with FEMA to ensure all Critique willfollow.

1000 required actions have been observed.

Any required on the spot corrections will be conducted.

Drill is terminated.

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