Conceptual Proposal by Oak Ridge Associated Universities for a Radiation Emergency Assistance Center/Training Site

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OAK RIDGE ASSOCIATED UNIVERSITIES RADIATION EMERGENCY ASSISTANCE CENTER/TRAINING SITE A facility for therapy and study of human radiation injury and for medical preparedness tra in ing.

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Installations where serious radiation accidents might occur must be prepared to provide adequate treatment for any radiation accident installations employ 14,000 radiation workers at this time. of this high density of nuclear workers,a need exists for a facility adequately equipped to provide definitive treatment radiation injuries.At the present time, none of the independent facilities in this area have this complete capability.Se cause of the complexity, as well as the in frequency of radiation accidents,a ' central medical facility would b e more practical and less expensive than an independent facility at each nuclear energy Install ; ] tioii. described in this proposal would provide : exposed to radiation ; 2)Training Tor medical and other personnel in the handling of radiation accident victims ; 3) Study and ron tin u ing evaluation of humaii ~ d diaL jo i iii,iinagP. Tlie proposed facility would be located in the new N : : I ~ of the Oak Ridge Hospital of the Methodist Church (ONPIC). The hospital is install ac ions and hiis general supports c rvi - ces and laboratories that are required for the care of radiation accident victims. The Oak Iiidge Hospital ' s location is well-known to non radiation emcrgcncy

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personnel (ambulance drivers, policemen, etc. ) who would be involved in transporting radiation accident victims tothe REACTS facility. The loc it ionis also ideal for the development of a heliport wh-ich, i n conjunction with the Greater ICnosville Airport,could provide rapid transportation for accident victims from anywhere within the Southeastern Although each of the three major Oak Ridge plants has a well - equipped clinical dispensary,neither these minimal care centers nor their staffs are prepared to provide specialized care for workers contamina ted or seriously injured in radiation accidents. However, they All AEC mid AEC-contractor in st nll at ions would bc served by the awjde vni ~ e t yof other kinds oT: nuclear - related work. 'The staf € of 4LOO is served by a well-equipped clinical dispensary for handling industrial health problems and minor accidents. Person ncl involved in radiation accidents would b e LLansported from ORNL tothe ORAU REACTS facility after first - aid and Inl tlal tlcconl.nmlnotion arc complctcd.

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Persons involved in radiation accidents would be transferred tothe REACTS facility.(In 1958 this plant experienced a critical it y accident in which 8persons were exposed t o radiation.Five of these persons were transferred to the OKi U Medical Division for treatment.) 3 . Oak Ridge Gaseous Diffusion Plant (ORGDP) The Oak Ridge Gaseous Diffusion Plant has at present a staff of about 2800 engaged primarily in 235Ll enrichment. A major xp grading of this facility is planned during the late1970 ' s when employment will increase to ah:oi;t 4000. The ORGDP plant has a small medical dispc.nsary for handling minor injuries.Persons injured in radiation accidents will be transported to the REACTS facility. The Comparative Animal Research Laboratory (UT-AIX CARL) 1x1s a number of large radiation sources and routinely uses radioactive materials.This laboratory does not have a medical dispensary or medical staff and would send any persons exposed .to radiation to the REACTS facility.(In 1971 one of their staff was accidentally exposed t o 260-R gamma radiation and was successfully treated at the OKAU Medical Division.) ORAU rou Line ly uses radioactive mat c rials and has several large neutron and other radiations our ccs. Any persons injured. in a radiation accident atOMU would be treated at the REACTS

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Radiation accident victims from other AEC prime contractors anywhere in the U.S. might also be sent to RUC TS if designated The requirements of LFFUR, t o be located 16 mi.lcs from the proposed RWCTS facility,will probably be much the same as those of the other installations described. REACTS could also provide specialized medical care for radiation accident victims from other TVA installations. 6.Privately owned companies, Class I Several small companies i n East Tennessee (N ni clear Fuel Service,U.S. Nuclear Corporation, ORTEC, Tennelcc., etc.) are presently licensed to user adic active materials.Inthe event of an accident at one of these plants, REACTS could be available for care of persons injured by radiation.Contracts providing rct a ii un ent of services on a cost recover nbl c basis will be developed. 7.Privat ci nuclear power facilities, Class I1 REACTS could provide care for victims of radiation accidents from privately owned nuclear power facilities. Thc REACTS staff could also be available as consultants to such companies on a Lull cost I L’C’ x wry basis. REACTS i s ticsigned t o respond to all ty pcs of radiation accidents. l’liysicinns at the 0,ik Iiitlge plants have es tinia tcd th.it the number o f seriously injured or can tamina ted victims in any one major accident would

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probably not exceed 10. The proposed facility will be able to accomodate simultaneously 10 highly contaminated persons and about 50 less seriously contaminated ones. REACTS will provide complctc nicd ic nl care for persons ntion. REACTS would need t o be able to re1.y on ORID4C staff or emergency physicians for some support. The injured persons would be brought to a radiation emergency entrance,Fig. 1, where a physician trained in radiation accident management would evaluate needs for medical care, and a health physicist would assess the degree and kind of contamination. nf contamination and the need for emergency medical attention,this physician w n it ltl route the victim to the appropriate treatment area Depending onthe level ' according to the flowchart,Fig.2. If the victim were highly contaminated,IIC ' would be niovcd into Llie decontamination room, Fig. 1, and shielded to minimiz(. r nJi ation exposures to personriel during this process, 1)econtaminnt ion and ttierapy would proceed in this specially designed decontamination unit under the control of the designated physician manager of the accident. After decontamination and completion of emergency care,the patient would be moved into the Oak Ridge Hospital for definitive surgery or other more prolonged medical procedures. However, if attempts at clicmical dccontam I n ; i t ion were unsuccessful. nricl sitr~:~.c;tl.il(\l>r1.clcwcnt operations would bc performcd inthe HEACTS treatment room, Fig. 1, by Ol ill PIC surgical personnc I .

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too radioactive for treatment in the iliain hospital(OKlUC),he would be cared for tempor nr ilyin a special holding room, Pig. 1. This room, refrigerated room, Fig. 1, is available for use as a temporary morgue or for solid waste storage.All liquid waste generated in the REACT facil - it y during accident operations will be collected inn large underground storage tank. Tlie ventilation system in the decontamination arc'i-is will produce High efficiency filters will ensure that no airborne par [ i ( * ulat econtami nation will be released. 111 order to treat highly radioactive accident vict i in s,n facility within the Oak Ridge Hospital will afford suE f icier it medical manpower to allow the team approach for surgery and decontamination. llecause individual specialists will not be attending thc.,i(Lim for long periods of time, shielding can be minimized. The total lbxposrire of personnel will thus be divided among several persons by strict on-tlic-spot physics sur veil lanc c. large waiting room (also lecture room) adjacent to the e ii try are abc fore bclng released or transferred tothe Oak Ritlp,f. : Il ospital Tor observation

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and any further care that might be required.Tliis room could accommodate up t o 50 people in accidents where a triage systcin i s fundainentral to thc ir A simple whole-body counter,Fig. 1, for measuring major ic tern al .contamination and blood sodium activation in the event of neutron exposures body counting unit will be available for determining uranium and trans - uranium body burdens in emergencies.There shoiild also be a continuous o n - site capability for assaying body burdens by whole bndy counting.This ,will be achieved with the existing ORAU Medical Division sensitive whole body count & - which will be modified to extend its versatility to include plutonium. Ide vi suo liz r using this on patiimnLs, eiiiployces, former un ploy ec s, and ot I I ~ I - swlio might have sign ili cant body burdens.The same instrument. can be ust > d for postino rten studies.Tli is st rid y (if body bur de q llc al th Physics Division of ORNL. In the adjacent health physics and bio as say laboratory, contamiw it ion and bio as say samples would be processed to ident iFv ,ind dssess the levels of both external and internal contaminnt ion. StnCf o Ef ices and the conununications cc nter would be locnl.cd near Lhc main cn trance of the facility. The communications center would provide phone and radio

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resource is needed to protect marrow-depresscd patients from exogeiious infection. Such patients require elaborate care and supporting services pati cn Ls who have severe marrow depression from disease or from cancer chemotherapy. Since it would not lie immediately required for accident patients,planning for movement of a patient to the laminar flow would b e coordinated with the hospital. Ali eli copter landing pad is contempl n tcd to nccommcdnte patients ambulance ser vic c would not be suf fic ic nLl y rapid. The REACTS facility will be under the supervision oE a physician - director.A coreS LLI ~ En ece s s ary to main taj n the facility and operate .will be supplemented by additional physicians, Iienlth physicists, nurses, and par;irneili ral personnel from the surrounding area.The permanent staff, when not rc!qiL i red for operation of the facility in an em(-rgcncy, will study ancl eval uatc prc vio us radiation accidents m do pc rai ‘ I:I’:ACTS for training ph y ski an s, hc:ilth physicists, and paramedical personnel in the handling of radiation. iii.cident victim.This staIE could also be available 011 a consul Lant basis for private industry. 11. Trainiug of ZadiG tion Emergency Persoww I and decisive action by emergency personnel.U ii To t litt lcd fears and the lack of training liave silrnc.times resulted in overreaction And ncgl igence.

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their training and experience in handling real or simulated radiation emergencies,training plaps an important part in all safety programs. This training is needcd not only in the Oak Ridge Operations area but Because the REACTS facility must be kept in readiness and will have specialized equipment, it will be used for training emergency personnel on a routine basis.In the past ORAU has played a major role in this ' type of training and proposes to use this facility for conducting courses i n hand 1i ng radiation ac cid en ts. A. Types of Training Courses Several different types of training courses will be conduct cd. 1. Courses for Physicians A one-week course for training physicians responsible for medical emergencies at nuclear power plants will be cm duct ed three to four times each year. The course will be pat ler ned after the succ css ful program developed by the USAIIC Division of Operational Safety and conductcd frequently atOMU.This course will teach physicians the hazards of radiation, how t o respond in a radiation emergency, and where to obtain additional assistance.OI U U will also be available to help them establish an emergency response program between their local li ospital s and their An advanced course for physicians who have completed thc 2. Courses for llc alt 11 I'irysicls~:; with nuclear powcr pl n nts,stat c regulatory groups,or other groups in need of SUC ! ~ tra iii ing will bc conductcd tlircc o r inore