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{{Adams
#REDIRECT [[NL-15-0820, Farley, Units 1 and 2 - Emergency Plan, Revision 64, Part 2 of 3]]
| number = ML15138A223
| issue date = 04/16/2015
| title = Farley, Units 1 and 2 - Emergency Plan, Revision 64, Part 2 of 3
| author name = Gayheart C A
| author affiliation = Southern Co, Southern Nuclear Operating Co, Inc
| addressee name =
| addressee affiliation = NRC/Document Control Desk, NRC/NRR
| docket = 05000348, 05000364
| license number =
| contact person =
| case reference number = NL-15-0820
| package number = ML15138A238
| document type = Emergency Preparedness-Emergency Plan
| page count = 24
}}
 
=Text=
{{#Wiki_filter:EMERGENCY PLAN Part II  MEDICAL PLAN
 
Rev. 64 Page 1 of 2 Rev. 64 INDEX OF EFFECTIVE PAGES PART II - MEDICAL PLAN PAGE REV. NO. PAGE REV. NO. PAGE REV. NO.      i 24 B-20b DEL C-35 52 ii 24 B-20c DEL C-36 52 iii 7 B-21 DEL C-37 52 1 7 B-22 DEL C-38 52 2 30 B-23 DEL C-39 52 3 52 B-24 DEL C-40 52 4 24 B-25 DEL C-41 52 5 24 B-26 DEL C-42 52 6 30 B-27 DEL C-43 52 7 52 B-28 DEL C-44 52 8 24 B-29A DEL C-45 52 9 27 B-29B DEL C-46 52 10 39 B-30 DEL C-47 52 11 27 B-31 DEL C-48 52 12 24 B-32 DEL C-49 52 13 64 B-33 DEL C-50 52 14 27 APPENDIX C C-51 52 15 19 C-1 52 C-52 52 16 27 C-2 52 C-53 52 17 52 C-3 52 C-54 52 18 7 C-4 52 C-55 52 APPENDIX A C-5 52 C-56 52 A-1 47 C-6 52 C-57 52  C-7 52 C-58 52 APPENDIX B C-8 52 C-59 52  C-9 52 C-60 52 B-i DEL C-10 52 C-61 52 B-1 64 C-11 52 C-62 52 B-2 DEL C-12 52 C-63 52 B-3 DEL C-13 52  B-4 DEL C-14 52  B-5 DEL C-15 52 APPENDIX D B-6 DEL C-16 52 D-1 DEL B-7 DEL C-17 52 D-2 DEL B-8 DEL C-18 52 D-3 DEL B-9 DEL C-19 52 D-4 DEL B-10 DEL C-20 52 D-5 DEL B-10a DEL C-21 52 D-6 DEL B-10b DEL C-22 52 D-7 DEL B-10c DEL C-23 52 D-8 DEL B-11 DEL C-24 52 D-9 DEL B-12 DEL C-25 52 D-10 DEL B-13 DEL C-26 52 D-11 DEL B-14 DEL C-27 52 D-12 DEL B-15 DEL C-28 52 D-13 DEL B-16 DEL C-29 52 D-14 DEL B-17 DEL C-30 52 D-15 DEL B-18 DEL C-31 52 D-16 DEL B-19 DEL C-32 52 D-17 DEL B-20 DEL C-33 52 D-18 DEL B-20a DEL C-34 52 D-19 DEL
 
Page 2 of 2 Rev. 48 INDEX OF EFFECTIVE PAGES PART II - MEDICAL PLAN PAGE REV. NO. PAGE REV. NO. PAGE  REV. NO.      APPENDIX D (CONT'D) D-68 16  D-20 DEL D-69 16  D-21 DEL D-70 16  D-22 DEL D-71 16  D-23 DEL D-72 16  D-24 DEL D-73 16  D-25 DEL D-74 16  D-26 DEL D-75 16  D-27 DEL D-76 16  D-28 DEL D-77 16  D-29 DEL D-78 16  D-30 DEL D-79 16  D-31 DEL D-80 16  D-32 DEL D-81 16  D-33 DEL D-82 16  D-34 DEL D-83 16  D-35 DEL D-84 16  D-36 DEL D-85 16  D-37 DEL D-86 16  D-38 DEL D-87 16  D-39 16 D-88 16  D-40 16 D-89 16  D-41 16 D-90 16  D-42 16 D-91 16  D-43 16 APPENDIX E  D-44 16 E-1 7  D-45 16 E-2 7  D-46 16 APPENDIX F  D-47 16 F-1 49  D-48 16    D-49 16    D-50 16    D-51 16    D-52 16    D-53 16    D-54 16    D-55 16    D-56 16    D-57 16    D-58 16    D-59 16    D-60 16    D-61 16    D-62 16    D-63 16    D-64 16    D-65 16    D-66 16    D-67 16   
 
RADIATION EMERGENCY MEDICAL PLAN
 
I. INTRODUCTION
 
A. PURPOSE
 
It is the objective of the Radiation Emergency Medical Plan to provide for the selection and delivery of appropriate medical care
 
for personnel who may have been exposed to serious radioactive
 
contamination or radiation injury, possibly concomitant with other
 
injuries, at the Joseph M. Farley Nuclear Plant. In the event of an
 
accident, to ensure a smooth flow of action from initial evaluation
 
and treatment through final disposition, knowledgeable decision
 
making regarding medical priorities is required. Adequate
 
arrangements for transportation of injured personnel and assurance
 
that proper facilities as well as expert professional and paramedical
 
services are immediately available are necessary. Through careful
 
planning, training and practice, this objective will be accomplished.
 
B. SCOPE
 
The plan provides for onsite medical support and offsite medical support at three levels:  primary care, definitive care, and back-up
 
definitive care. A description of casualty flow to these facilities
 
including action levels, transportation available and notification
 
procedures, is given.
 
Provisions are made for training at the local level of support to minimize the chance of an accident and to ensure that, in the event
 
of an accident, affected personnel onsite and offsite respond
 
appropriately without compounding the medical or radiological
 
problems present.
 
II. MEDICAL SUPPORT AND FACILITIES
 
A. PLANT SITE
: 1. General Onsite emergency medical activities are performed by trained and qualified persons immediately available under the direction
 
of the Emergency Director and will consist of:
: a. Removal of personnel from hazardous area (high radiation level or contamination levels)
: b. First aid for severe physical injuries
: c. Personnel decontamination
: d. Evaluation of radiation exposure
 
Rev. 7 
: e. Triage of personnel An aerial view of the plant site is shown in FIGURE 1.
: 2. Facilities The health physics and decontamination facility is located at
 
elevation 155 of the Auxiliary Building as shown in FIGURE 2 and
 
FIGURE 3.
This facility is located near potentially contaminated and high
 
radiation areas so that health physics support, first aid, and
 
personnel decontamination can be effectively administered. A
 
Health Physics technician will normally be available at this
 
facility.
In the event of a Site Area or General Emergency when the health
 
physics and decontamination facility might become untenable, the
 
Nursing Station (FIGURE 4) at the Training/Visitor's Center will
 
normally become the center for personnel first aid and
 
decontamination activity. The necessary first aid and
 
decontamination supplies for these facilities are listed in
 
APPENDIX A.
B. SOUTHEAST ALABAMA MEDICAL CENTER (SAMC)
The Southeast Alabama Medical Center (SAMC) of Dothan, Alabama, has
 
agreed to accept injured, contaminated and/or irradiated casualties
 
(APPENDIX B). This hospital is a 400 bed general hospital fully
 
accredited by the State Hospital Association and Joint Commission for
 
Accreditation of Hospitals and Organizations. It has a modern fully
 
equipped emergency room of sixteen suites with provisions to perform
 
all necessary procedures; complete laboratory and diagnostic x-ray
 
capabilities; and 13 major and 1 minor surgical suites. There are
 
approximately 100+ members on the active staff, the majority board
 
certified or qualified representing all major medical specialties.
Space (FIGURE 5) at the hospital provides a receiving area for
 
potentially contaminated and/or irradiated patients and has a separate
 
entrance from the normally used emergency entrance. This facility is
 
adequate for:
: 1. Personnel decontamination
: 2. Emergency treatment
: 3. Storage of emergency equipment and supplies A permanent helipad exists for air evacuation of injured or irradiated
 
personnel via helicopter. Communications can be established by FNP
 
with SAMC through the hospital's switchboard or directly with the
 
hospital emergency room.
 
Rev. 30 
 
FIGURE 1  Aerial view of plant site Rev. 52 Alabama 95  County 42 ContractorParking Lot Fabrication Shop  Training Center ParkingLotUnit 1Cooling Towers Unit 2Cooling Towers Water TreatmentPlant Utility Building AuxiliaryBuilding DieselBuilding N OutageSupport Building  Turbine Building ServiceBuilding Protected AreaDetail A Switch House See Detail A CSC Parking Lot HighVoltage Switchyard Warehouse Control Room OSC and TSC 
 
FIGURE 2 Gen. Rev. 24
 
FIGURE 3 Gen. Rev. 24
 
FITNESS FOR DUTY/NURSE'S STATION Figure 4
 
Gen. Rev. 30 
 
C. THE UNIVERSITY OF ALABAMA HOSPITAL (RCTF)
 
The University of Alabama Hospital in Birmingham, Alabama, has agreed to admit and provide on a priority basis definitive care for
 
contaminated and/or irradiated casualties (APPENDIX B). This
 
hospital is a 639 bed teaching institution affiliated with the
 
University of Alabama in Birmingham School of Medicine. It is
 
accredited by the Joint Commission on Accreditation of Hospitals and
 
Organizations and is licensed by the Alabama State Board of Health. 
 
It is a member of the American Hospital Association, the Council of
 
Teaching Hospitals and the Alabama Hospital Association. Its
 
specialists in oncology, hematology, infectious disease,
 
endocrinology, gastroenterology, nuclear medicine, radiology, and  the surgical specialties render it fully capable of providing effective medical care. Already in existence are portable and        fixed isolation units capable of maintaining a sterile environment.                                                       
 
Facilities for the care of radiation emergency casualties have been developed to provide a Radiation Casualty Treatment Facility (RCTF).
 
The RCTF consists of a nine bed unit, a nursing station, utility
 
room, storage room, and a treatment and examination room.
 
D. OAK RIDGE Institute of Science and Education (ORISE)               
 
Oak Ridge Associated Universities operates a Radiation Emergency Assistance Center Training Site in Oak Ridge, Tennessee. Its
 
specialized facilities and staff are available for the care and
 
treatment of possible radiation casualties from the Joseph M. Farley Nuclear Plant of Alabama Power Company in Dothan, Alabama (APPENDIX B). The ORISE-REAC/TS can accommodate approximately 20      patients who are contaminated or have received external radiation.
A laminar flow facility with two sterile rooms is available for patients requiring isolation. Sophisticated whole-body counting equipment, probes for locating radioactive particles in wounds, and
 
computer-based monitoring services are also available. The staff      of the ORISE-REAC/TS has considerable experience in total-body irradiation and several have participated in the handling of previous radiation accident casualties. The nursing staff, aides and orderlies, likewise, are experienced in handling patients who have been treated with or accidentally exposed to both external and
 
internal radiation. Full diagnostic laboratory and radiographic
 
back-up facilities are available. A description of their facilities
 
is given in APPENDIX E.
 
III. RADIATION CASUALTY HANDLING PROCEDURE
 
A. NOTIFICATION
 
A general order of notification in the event of an incident at the Farley Nuclear Plant is given in PART I, FIGURE 24. Detailed lines
 
of notification and communication concerning medical support are
 
given in FIGURE 6 of this plan.
Rev. 24
 
B. ONSITE RESPONSIVE ACTION
 
Actual or suspected radiation casualties, with or without concomitant trauma, will be moved to the primary onsite decontamination area as
 
shown in FIGURE 2 and FIGURE 3. If this primary onsite
 
decontamination area is unavailable as a result of the emergency, the
 
casualties will be moved to the secondary onsite decontamination area
 
as shown in FIGURE 4. The priority order of onsite medical emergency
 
action will then be:
: 1) First aid of life-threatening or severe physical injury;
: 2) Personnel decontamination, to the extent that trauma is aggravated;
: 3) Evaluation of radiation exposure, external and internal, with concomitant first aid of other injuries.
 
The actual or suspected casualties may be grouped into three classes for triage considerations.                                 
 
Class I
 
Criteria
: 1) Estimated radiation dose greater than applicable 10CFR20 limits but less than 5 rem to whole body (including eyes, gonads, and
 
blood-forming organs); or
: 2) Estimated radiation dose to the skin of the whole body greater than the 10CFR20 limit but less than 30 rem; or
: 3) Estimated radiation dose to the feet, ankles, hands, or forearms greater than the 10CFR20 limit but less than 75 rem.
 
ACTION
: 1) Without trauma - Send to Southeast Alabama Medical Center (SAMC) for evaluation after clearance by Health Physics for
 
contamination.
: 2) With trauma - Apply appropriate first aid then send to SAMC for evaluation. Monitoring for contamination is desirable prior to
 
sending the casualty to SAMC.
 
Class II
 
Criteria
: 1) Estimated radiation dose to the whole body (including eyes, gonads, and blood-forming organs) greater than 5 rem but less
 
than 25 rem, or 
 
Rev. 27
 
MEDICAL NOTIFICATION ORDER
 
FIGURE 6 - MEDICAL NOTIFICATION ORDER
 
Gen. Rev. 39
* If injury involves contamination, excessive exposure or if it is anticipated that injured will be admitted to the hospital for observation or treatm ent in excess of 48 hours duration.
SHIFTSUPERVISO AMBULANCESAMSURGEONRCTFEMERGENCDIRECTOEO MANAGEMEDICALADVISORSNCPROJECMEDICALDIRECTOSTATE OFALABAMAORISE-NRC*
: 2) Estimated radiation dose to the skin of the whole body greater than 30 rem but less than 150 rem; or
: 3) Estimated radiation dose to the feet, ankles, hands, or forearms greater than 75 rem but less than 375 rem.
 
Action
: 1) Without trauma send to SAMC for evaluation after clearance by Health Physics for contamination.
: 2) With trauma apply appropriate first aid, then send to SAMC for evaluation. Monitoring for contamination is desirable prior to
 
sending the casualty to SAMC.
 
Class III
 
Criteria
: 1) Estimated radiation dose to the whole body (including eyes, gonads, and blood-forming organs) of 25 rem or more; or 
: 2) Estimated radiation dose to the skin of the whole body of 150 rem or more; or
: 3) Estimated radiation dose to the feet, ankles, hands, or forearms of 375 rem or more.
: 4) Internal radiation exposure estimated to be significant.
 
Action
: 1) Without trauma - after proper decontamination by Health Physics, send to SAMC for evaluation and potential                transfer to the Radiation Casualty Treatment Facility (RCTF) in Birmingham or to ORISE-REAC/TS in Oak Ridge,Tennessee.
: 2) With trauma - appropriate first aid, decontamination, and send to SAMC for treatment and potential transfer to RCTF or REAC/TS.
 
The above estimates of external and internal radiation exposures will be performed by the Health Physics staff on the basis of all
 
available information, including dosimeters, area monitors, air
 
monitors, and survey instruments.
 
Contaminated casualties sent to SAMC, RCTF, or REAC/TS will be accompanied by a person who is qualified in radiological monitoring
 
and will stay in attendance and maintain radiological control until
 
decontamination is complete. Contaminated casualties will be covered
 
with suitable protective clothing or plastic sheets so as to prevent
 
or minimize the spread of radioactive material. Radiation exposure
 
to the vehicle operator and any attendant personnel will be
 
Rev. 27 minimized to the extent possible, and shadow shields may be used.
Inhalation of airborne radioactive material may be minimized through
 
the use of respiratory protective devices.
 
Each casualty will be identified before leaving the plant with a nonremovable hospital type wristband showing his name and an
 
identification number for use for reference purposes in all
 
communications, to avoid possible confusion in reporting estimates of
 
radiation dose and similar matters.
 
C. SAMC RESPONSIVE ACTION
 
All casualties sent to SAMC will enter the Radiation Casualty/Decon-tamination area and be surveyed by qualified personnel assigned for
 
that purpose. Emergency medical care will be provided if required
 
together with further decontamination.
: 1) Criteria
 
Those casualties with estimated radiation doses less than 25 rem to the whole body (including eyes, gonads, and blood-
 
forming organs) and estimated from bioassay measurements and
 
other reasons not to be bearing significant quantities of
 
internal emitters.
 
Action
 
Hospitalize if necessary for continued treatment of trauma or illness; otherwise continue minor treatment, observation and
 
evaluation on out-patient basis, after release by Health
 
Physics personnel. Observation and evaluation will include
 
hematological surveys, bioassays of urine and feces, and
 
general physical condition, including opthalmological and
 
dermatological examinations. If evaluation so indicates (e.g.,
 
leukopenia), transfer to RCTF or REAC/TS.
: 2) Criteria
 
Those casualties with estimated radiation doses of greater than 25 rem to whole body, or thought from bioassay measurements and
 
other reasons to be bearing significant quantities of internal
 
emitters.
 
Action
 
Transfer to RCTF or REAC/TS (after emergency treatment of trauma or illness).
 
In the event of mass casualties, a decision will be made as to which casualties will be sent from SAMC to RCTF, or directly to ORISE REAC/TS. This decision will be made by the Medical Director of the Southern Nuclear Operating Company or his designated alternate, with the advise of staff and consultants.
 
Rev. 24 Contaminated and/or irradiated casualties sent from SAMC to RCTF, ORISE-REAC/TS or elsewhere, will be accompanied by    a person qualified in radiological monitoring. This person will stay in attendance and maintain radiological control until the patient is transferred to a similarly
 
qualified person at the receiving institution.
 
All rooms, equipment, and supplies used to treat contaminated personnel will be made controlled areas and considered to be
 
contaminated until released by the Health Physics staff.
 
D. RCTF RESPONSIVE ACTION
 
Casualties sent to RCTF will be met outside the building by an individual qualified in radiological monitoring, will enter through
 
the appropriate emergency room entrance of the University of Alabama
 
Hospital, be surveyed and then transported directly to the RCTF. 
 
The staff of the RCTF will have been previously notified and will be
 
ready to accept the patients.
 
IV. TRANSPORTATION
 
A. SERVICES AVAILABLE
: 1. Local Rescue Squads Ashford Rescue Squad Columbia Rescue Squad
: 2. Dothan Ambulance Service (Pilchers Ambulance Service), Inc.
 
Dothan Ambulance Service, Inc. has agreed to transport potentially contaminated and/or irradiated casualties from    the plant site to SAMC and on to the University of Alabama Hospital in Birmingham, Alabama or Radiation Emergency
 
Assistance Center Training Site (REAC/TS) of Oak Ridge
 
Institute for Science and Education (ORISE) in    Oak Ridge, Tennessee ORISE-REAC/TS. Their ambulances are equipped with radios so they can be in communication through SAMC with the Control Room.
 
Rev. 64  
 
B. ROUTES
: 1. Plant Site to SAMC (Figure 7, 8)
 
Normally, emergency vehicles will proceed west on County Road 42 to County Road 33; southwest on County Road 33 to County Road 55; south on County Road 55 to U.S. 84, west on U.S. 84,
 
until its junction with State Highway 210 (Ross Clark Circle)
 
at which point the Medical Center is located.
 
If the normal route is unavailable then an alternate route will be directed by the control room. Two such alternate routes are shown on Figure 7.                                 
: 2. Plant Site or SAMC to the University of Alabama Hospital (FIGURE 9)
 
As in 1 above, to State Highway 210 (Ross Clark Circle); then north on 210 to its junction with U.S. Highway 231; Highway 231
 
north to Montgomery and junction with Interstate 65 then north
 
on Interstate 65 to Birmingham. Exit Interstate 65 at 8th
 
Avenue South; east to 19th Street; north to 6th Avenue South;
 
east to University Hospital Emergency Room.
: 3. SAMC to Oak Ridge, Tennessee (FIGURE 9)
 
As in 2 above on Interstate 65 to Interstate 59 north to Chattanooga, Tennessee; north on Interstate 75 to    Interstate 40; west on Interstate 40 to State Highway 95; north on State Highway 95 to Oak Ridge, Tennessee, then north on New York Avenue to West Tennessee Avenue; east to ORISE-REAC/TS.                                             
 
V. DRILLS
 
Radiation emergency practice drills will be conducted annually to maintain the proficiency of the organization and personnel at the plant, SAMC and at
 
the RCTF and to verify the arrangements made with other groups. Drills
 
will be arranged so as to provide quantitative data on response times for
 
each communication, decision and action element of the overall Radiation
 
Emergency Medical Plan. These response times will be used to predict the
 
effectiveness of the Plan and to disclose areas where improvement in
 
training, equipment or organization is needed. Management review of
 
critique comments obtained from drill monitors will be conducted. 
 
Identified, necessary, or required alterations in training or for the
 
Emergency Plan/EIPs will be implemented in a timely manner.
 
VI. TRAINING
 
A. OPERATIONS AND MAINTENANCE PERSONNEL
 
Permanently assigned personnel will undergo radiation protection
 
training, the extent of which will depend on the nature of the 
 
Rev. 27
 
specific job. Each employee will be required as part of his training to be familiar with radiation protection practices, facilities and
 
equipment at the plant as described in the Health Physics Manual. At
 
least one person on each shift will be qualified to perform first
 
aid.
B. HEALTH PHYSICS PERSONNEL
 
All Health Physics Technicians will be thoroughly trained in the principles of radiation protection including personnel dosimetry,
 
decontamination and monitoring.
 
C. PHYSICIANS
 
Several physicians in the Houston County area have been retrained to provide care for injured, contaminated, and/or irradiated victims. These physicians are encouraged to attend a training seminar on the care of radiation injuries. The Medical Director      for the Southern Nuclear Operating Company has also attended this seminar.                                                           
 
D. PARAMEDICAL PERSONNEL
 
Ambulance attendants, nurses and hospital technicians will be encouraged to attend annual training sessions. These sessions will
 
be conducted under the direction of the Training Director. Training
 
will include a description of the facility, its health physics
 
program, the spectrum of possible accidents with emphasis on
 
potential resulting casualties and procedures for implementing the
 
Radiation Emergency Medical Plan.
 
VII. RADIATION EXPOSURE GUIDELINES
 
The following guidelines are given for the exposure of hospital and ambulance service personnel:
 
A. 3 REM
 
If there is an adequate number of attendants such that rotation  may
 
be accomplished without further endangering the patient(s).
 
B. 5 REM
 
If the number of attendants is limited such that personnel cannot be rotated.
 
C. 25 REM
 
To save a life.
 
The above guideline numbers refer to whole body penetrating radiation.
When careful monitoring is provided, the extremities dose may be up to 5
 
times the value given and the skin dose may be up to 2 times the value
 
given.                    Rev. 19 
 
Major Route to SAMC FIGURE 7 
 
Rev. 27 
 
Figure 9. Major Routes to Birmingham and Oak Ridge, Tennessee Rev. 7 APPENDIX A EMERGENCY EQUIPMENT AND SUPPLIES
 
I. HP OFFICE 
 
Blankets First Aid Supplies Protective Clothing and Supplies Decontamination Supplies Wristbands Survey Meter
 
II. NURSING STATION
 
Audiometric Testing Equipment Pulmonary Testing Equipment Vision Testing Equipment Physical Examination Equipment First Aid Supplies
 
III. PEV DELETED
 
IV. AMBULANCE KIT
 
Protective Clothing Lead Covering Material Blankets Signs and Labels Wristbands Dosimetry Devices
 
V. SOUTHEAST ALABAMA MEDICAL CENTER
 
Survey Meters and Supplies Dosimetry Devices Signs and Labels Protective Clothing Surgical Clothing Decontamination Supplies Specimen Containers Disposable Cartons Logbook and Pencil
 
A-1                                Rev. 47 APPENDIX B Letters of Agreement on File
 
Listing of letters can be found in Appendix 2 (B) Index of Part I of the Farley Emergency Plan.
 
B-1                                Rev. 64
 
APPENDIX F
 
ROSTER OF MEDICAL CONSULTANTS
 
I. SOUTHERN NUCLEAR MEDICAL DIRECTOR C. Calvert Dodson, III, M.D.
 
II. SNC CONTRACT PHYSICIANS (FAIRVIEW CLINIC, DOTHAN)
Earl F. Mazyck, M.D. James A. Robeson, Jr. M.D.
J. Ryan Conner, M.D.
Christopher L. Miller, M.D.
 
III. SAMC STAFF James C. Jones, D.O., Director, Emergency Room
 
IV. UNIVERSITY OF ALABAMA MEDICAL CENTER STAFF Chris Roskoe, M.D., Medical Director, Emergency Room
 
F-1                                Rev. 49}}

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