IMPLEMENTATION OF PROTECTIVE ACTIONS - USE OF KI FOR EMERGENCY WORKERS, INSTITUTIONALIZED INDIVIDUALS, AND THE GENERAL PUBLIC

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1 OBJECTIVE 14: IMPLEMENTATION OF PROTECTIVE ACTIONS - USE OF KI FOR EMERGENCY WORKERS, INSTITUTIONALIZED INDIVIDUALS, AND THE GENERAL PUBLIC OBJECTIVE Demnstrate the capability and resurces t implement ptassium idide (KI) prtective actins fr emergency wrkers, institutinalized individuals, and, if the State plan specifies, the general public. INTENT This bjective is derived frm NUREG-0654 which prvides that OROs shuld have the capability t prvide radiprtective drugs fr emergency wrkers, institutinalized individuals, and the general public within the plume pathway emergency planning zne (EPZ) fr whm immediate evacuatin may nt be feasible, very difficult, r significantly delayed. While it is necessary fr State and lcal gvernments t have the capability t prvide KI t emergency wrkers and institutinalized individuals, the prvisin f KI t the general public is a State ptin, reflected in ORO plans. Prvisins shuld include the availability f adequate quantities, strage, and means f the distributin f radiprtective drugs. (See evaluatin criteria frm Planning Standards E., J., and N.) Federal plicy n the distributin f KI is prvided in the Federal Register ntice dated July 24, 1985, entitled Federal Plicy n Distributin f Ptassium Idide Arund Nuclear Pwer Sites fr Use as a Thyridal Blcking Agent. When KI is ingested befre expsure t radiidine, it effectively reduces accumulatin f radiidine in the thyrid gland by 90% r mre. This reductin can be achieved if KI is administered (130 milligrams fr adults, 65 milligrams fr infants) befre r immediately after expsure t radiidine and treatment cntinues fr at least 48 hurs beynd the time f last expsure. If KI is nt administered until fur hurs after expsure, the thyrid dse reductin is apprximately 50%. Primary radiatin expsures f cncern t emergency wrkers are: whle bdy external expsure t gamma radiatin frm airbrne particulates, gases, and particulate radiactivity depsited n the grund and internal thyrid expsure frm inhalatin f radiidines. D.14-1 September 1991

2 DEMONSTRATION CRITERIA NUREG J.10.e.,f. 1. KI is made available nce a decisin t recmmend use f KI is made. Apprpriate recrd keeping f the administratin f KI fr emergency wrkers and institutinalized individuals (nt fr the general public) is effected. Explanatin OROs shuld demnstrate the capability t make KI available t emergency wrkers, institutinalized individuals, and, where prvided fr in the State plan, t members f the general public. OROs shuld demnstrate the capability t accmplish distributin s that KI is available t thse wh shuld take it when it needs t be taken. KI may be distributed either befre r after the State's decisin t administer KI, depending upn prcedures set frth in the ORO plans. Organizatins shuld have the capability t develp and maintain lists f emergency wrkers and institutinalized individuals wh have received and ingested KI, including dcumentatin f the date and time they were instructed t ingest KI and the dsage administered. When recmmended by a State health fficial t administer KI, its use by emergency wrkers, institutinalized individuals, and the general public is vluntary. Persnnel trained t recrd the administratin f KI t institutinalized individuals shuld be designated (unless thse individuals are already at the institutins). Supplies f KI shuld be allcated but need nt be dispatched in the exercise. Extent f Play Under this criterin, the transprtatin and distributin f KI may be simulated by physical distributin f a substitute item (e.g., empty pill bttles, candy, r slips f paper) t emergency wrkers. Trained persnnel and KI supplies shuld be allcated fr KI distributin t institutinalized individuals (unless KI stcks and trained persnnel are already at the institutin) but need nt be actually dispatched in the exercise. Fr States planning t distribute KI t the general public, the lgistics f this peratin shuld be discussed but n actual distributin is necessary. Available supplies f KI shuld be within the expiratin date indicated n KI bttles r blister packs. As an alternative, a letter frm the Department f Health and Human Services/Fd and Drug Administratin shuld be available that dcuments a frmal extensin f the KI expiratin date. NUREG J.10.e.,f. 2. Sufficient quantities f KI are available fr emergency wrkers, institutinalized individuals, and, if the State plan specifies, members f the general public. D.14-2 September 1991

3 Explanatin Respnsible OROs shuld demnstrate that they have the capability t maintain inventries f KI sufficient fr use by emergency wrkers, institutinalized individuals, and, where stipulated by the State plan, members f the general public within the plume pathway EPZ. Respnsible OROs shuld demnstrate that the supply f KI available is adequate t meet prjected needs f emergency wrkers as indicated n rsters, and institutinalized individuals as indicated in capacity lists fr facilities. In States that plan t prvide KI t the general public under certain cnditins, OROs shuld demnstrate that the KI supply is sufficient fr the EPZ ppulatin that may be advised t take KI. Extent f Play Quantities f KI available and strage lcatin(s) shuld be cnfirmed during exercises thrugh ne f the fllwing methds: physical inspectin at central strage lcatin(s) such as emergency peratins center(s) (EOC) r institutins r dcumentatin by up-t-date inventry sheets identifying the quantity and strage lcatin(s). D.14-3 September 1991

4 NUREG E Apprpriate instructins are available fr thse J.10.e.,f. advised t take KI. Explanatin Respnsible OROs shuld demnstrate the capability t frmulate apprpriate instructins n the use f KI fr incrpratin int messages fr the Emergency Bradcast System and ther means f primary ntificatin in ORO plans fr the general public, emergency wrkers, and institutinalized individuals and news releases. These instructins/messages shuld include infrmatin n which grups f peple are advised t take KI, the purpse f taking KI, the dsage and time perid during which it shuld be taken, infrmatin n lcatin(s) where KI can be btained r hw it will be distributed, and pssible side effects which can result frm the use f KI. OROs shuld demnstrate the capability t disseminate this infrmatin in time t ensure that thse fr whm the messages are intended will receive instructins prir t the time KI shuld be taken. Extent f Play All activities assciated with this criterin shuld be perfrmed as they wuld be in an actual emergency. NUREG N.1.a. 4. All activities described in the demnstratin criteria fr this bjective are carried ut in accrdance with the plan, unless deviatins are prvided fr in the extent-f-play agreement. Explanatin Respnsible OROs shuld demnstrate the capability t fllw plicies, implement prcedures, and utilize equipment and facilities cntained in their plans and prcedures. OROs shuld demnstrate that they can fllw sequences utlined in the varius prcedures and perfrm specified activities, as necessary. D.14-4 September 1991

5 Extent f Play Under this criterin, all activities shuld be carried ut as specified in the plan, unless deviatin frm the plan is prvided fr in the extent-f-play agreement. CLARIFICATION OF TERMS Administer, as used in this bjective, refers t the ral ingestin f KI. Emergency wrker refers t an individual wh has an essential missin within r utside the plume expsure pathway emergency planning zne t prtect the health and safety f the public wh culd be expsed t inizing radiatin frm the plume r frm its depsitin. Emergency wrkers may include the fllwing: radiatin mnitring persnnel; traffic cntrl persnnel; evacuatin vehicle drivers; fire and rescue persnnel, including ambulance crews; medical facilities persnnel; emergency peratins center persnnel; persnnel carrying ut backup alerting prcedures; and essential services r utility persnnel. Institutinalized individuals are individuals wh reside in institutins, such as nursing hmes r prisns, and may need t depend n thers fr assistance with prtective actins. Institutinalized individuals may r may nt have special needs. KI (ptassium idide) is a prphylactic drug that can be used effectively t blck the uptake f radiidines by the thyrid gland. Timely, as used in this bjective, refers t distributing KI early enugh t achieve ptimum benefits, given simulated scenari events and exercise play. D.14-5 September 1991