EMERGENCY MEDICAL SERVICES 
 

FICTITIOUS COUNTY EMERGENCY OPERATIONS PLAN

(Click here for procedures specific to McGuire Nuclear Station or a radiation incident)

Updated: March 18, 2006

 
I. PURPOSE

This procedure provides assistance to the general public by administering medical services during a natural, man-made, or technological emergency.
 
II.

SITUATION AND ASSUMPTIONS
 
  A. Situation:

     

* Most emergency situations can lead to physical harm or bring about other internal medical problems.
 
* A well-planned medical support network is essential during emergency situations.
 
* Depending on the nature of the incident, complications may include traumatic injury or even death.

        

  B. Assumptions:
 
* A large-scale emergency may result in increased demands on hospitals, medical, and emergency medical transport services personnel.
 
* Many injuries both minor and relatively severe, will be self-treated by the public.
 
* People other than medical personnel will transport many injured to medical facilities.
 
* EMS is most critical within the first 30 minutes of the emergency.  Mutual aid assistance usually arrives after this critical period.
 
* Resources available through area and regional medical services mutual aid agreements will be provided.
 
* When local resources can no longer meet the demand of the situation, State agencies will be contacted to provide additional resources and/or assume control of the response.
 
* Catastrophic disasters may affect large areas of the County and medical resources may be damaged, destroyed, or unavailable.
 
* Standard operating guidelines will be developed to guide emergency medical responders in the treatment of patients and personnel involved with radiological and hazardous materials incidents.

 

III.

CONCEPT OF OPERATIONS

   

* Emergency operations for EMS services will be an extension of normal agency operations.
 
* Coordination between EMS/Rescue providers is necessary to ensure emergency operational readiness.
 
* EMS will provide field medical care as needed during emergency situations and coordinate necessary medical transportation.
 
* Volunteer first aid and rescue squads serving the respective response areas will expand EMS capabilities.
 
* During mass casualty incidents, EMS will establish patient triage, holding, and treatment and transportation areas.
 
* When necessary, an EMS official will be located at an established command post to coordinate responding medical units and establish communication links with hospitals and the Communications Center.
 
* Transfer of authority on-scene will be in accordance with established procedures.

         

IV.

DIRECTION AND CONTROL

      

* The EMS director and/ or manager will direct and control EMS operations.  For on-scene incidents, the senior officer will assume direction and control.
 
* The EMS director and /or manager will maintain communications with their field forces and will keep the EOC informed of activities performed along with personnel and equipment needed to maintain adequate response and recovery efforts.
 
* The EMS director and/ or manager will coordinate efforts between the County EMS and the Rescue Squads in the event of an emergency situation.

      

V.

CONTINUITY OF GOVERNMENT

 

                         Line of Succession:
 

1. Emergency Medical Services Director
2. Emergency Medical Services On-Duty Operations Supervisor
3. Emergency Medical Services On-Duty Shift Coordinator
4. Emergency Medical Services On-Duty Assistant Shift Coordinator

 

 
 

Appendix 1
 

Procedures specific to a nuclear incident

                          (complete radiological and decontamination team procedures can be found here)                                  

 

I.

PURPOSE
  To establish procedures, for radiological monitoring, contamination control, exposure control, records, injuries and communications relative to radiological matters.
 
II. SCOPE
  This SOP establishes procedures and responsibilities of EMS (Emergency Medical Service) personnel for response to a contaminated injured person within the 10-mile EPZ (Emergency Planning Zone) of the McGuire Nuclear Station.

*In this SOP the term "injured person" refers to individuals with external injuries, acute internal conditions, or some combination thereof.
 
III. CONCEPT OF OPERATIONS

       

* Radiological monitoring and contamination control will be conducted by trained EMS personnel and/or certified radiological monitors.
 
* The EMS crew will be dispatched to a Staging Area located outside the 10-mile EPZ by the County EOC.  From the Staging Area, EMS will be dispatched to locations within the 10-mile EPZ by the County EOC, as required.
 
* EMS personnel will be provided protective clothing, dosimeters, TLDs and KI (Potassium Iodide) at the Staging Area.
 
* EMS personnel should cover the floor of the Ambulance with sheets for contamination control.
 
* An operational check should be conducted on all Radiological Instruments.  Background radiation levels should be determined and recorded.  Dosimeters should be charged and reading recorded on a dose card.
 
* When dispatched to incident location, EMS personnel should record dispatch information, dress in protective clothing, check floor covering, and dosimeters.
 
* Upon arrival, look for other hazards and perform and record a radiological survey to determine radiation level at scene.
 

REMEMBER THE PRIMARY RESPONSIBILITY OF THE FIRST MEDICAL TEAM ON THE SCENE IS TO RESCUE AND PROVIDE EMERGENCY  MEDICAL TREATMENT.  IF PERSONNEL ARE AVAILABLE RADIOLOGICAL SURVEY MAY BE COMPLETED.    

    

* Life-saving emergency medical care takes priority over dealing with radiation.  Symptoms related to radiation exposure will be delayed. Treat other medical or trauma conditions by normal protocol.
 
* Place a protective cover (sheet) on the ground beside the injured person to provide contamination control area for  treatment and equipment.
 
* External contamination may become internal contamination. Treat injured person as potentially contaminated until proven otherwise.
 
* If possible, conduct a radiological survey on injured person and record results on Contamination Record Form.  It may not be possible to survey injured person until being moved to Ambulance due to ground contamination.
 
* Cover open wounds with clean dressing and elastic bandage; DO NOT USE ADHESIVE.
 
* Wipe around the patient's mouth before applying oxygen mask or respirator.  Be cautious if intubating this  patient.
 
* For intravenous therapy, use uncontaminated area on patient, if possible.
 
* Gently brush away any dry particles and blot with absorbent material any excess liquids that are present.
 
* Cut-away outside clothing, place in plastic bag and label contaminated.
 
* Confine contamination, wrap patient using two-blanket/sheet method; spread two large clean blankets on ground, place backboard on top of blankets, place patient on backboard, fold top of blanket over patient and backboard, leave bottom (contaminated) inside contaminated area.
 
* After placing injured person in Ambulance, remove outer gloves, place in plastic bag and replace with clean pair of gloves.
 
* At scene communicate to hospital concerning contaminated injured person as early as possible. While enroute to Emergency Department communicate information on medical and radiological data to hospital.
 
* At hospital, follow Emergency Department protocols concerning transfer of contaminated patients.
 
* Do not eat, drink, or smoke while in a Radiation Control  Area, or until released by Radiation Safety Officer.
 
* Before returning to regular service, EMS personnel, equipment and ambulance, must be monitored and if necessary be decontaminated.
 
* Final survey of EMS crew and dosimeter reading must be recorded. EMS personnel should be cleared by the  Radiation Safety Officer before returning to service, or leaving the Control Zone.