[ RadSafe ] " Homeland Security Chief Sees Nuclear ForensicOffice as Attack Deterrent "

[MikeNukeEP at aol.com]

Steven: 
FEMA's posture is indeed puzzling.   A little background: There's a planning 
standard under the REP program (NUREG-0654 and FEMA Guidance Memorandum MS-1) 
requiring each nuclear plant emergency plan designate a primary and secondary 
hospital within 10 miles of the plant that is trained and equipped to handle a 
radiologically contaminated and injured individual. Typically, the utilities 
contract with hospitals to serve in that role and FEMA evaluates annual 
"medical drills" to determine that the MS-1 standard is met.  The notion of a 
"contracted" MS-1 hospital near the plant makes sense since the most likely origin 
of a seriously contaminated/injured victim is the plant site itself, i.e., a 
plant worker. The injured plant worker may, in fact, be seriously contaminated 
or exposed and need extraordinary handling.   What Illinois, Washington State 
and other jurisdictions recognized long ago was that in the event of a reactor 
accident, a waste shipment mishap, or a terrorist event, having just one or 
two hospitals capable of handling contaminated and/or exposed victims doesn't 
begin to address   the concept of "preparedness" nor having the response 
capability where it might be required to address the needs of the general public.    
For members of the general public, few if any will need more than simple decon 
and routine medical evaluation.   In today's environment, EMS providers are 
directed to take patients to the nearest hospital capable of meeting their 
medical needs, and ambulatory individuals will migrate to whatever hospital their 
insurance coverage provides for.   Obviously the more hospitals and EMS 
providers that have basic skills to deal with radiological contamination, the 
greater the preparedness and capability in terms of radiological emergency response. 
  FEMA doesn't dispute that argument, but it does say that the only medical 
services standard it recognizes is its own, the MS-1 requirements, that were 
originally devised based on projected power plant accident exposures.   Making 
every hospital meet those standards is expensive, unnecessary and irrational, 
but since FEMA doesn't require States and localities to do so except for the 
power plant locations, few bother to do the training and drills that would 
ensure a genuine medical response capability exists.   Don't misunderstand. There 
are many hospitals nationwide with excellent plans and procedures and staff 
trained and equipped to address a radiological emergency in their communities.   
Unfortunately, they are few and too far between.   DHS continues to assert 
that a dirty bomb attack is still a real possibility and has focused its efforts 
on prevention and interdiction.   It wouldn't hurt to put a little more 
emphasis on preparedness and consequence management if, and when, the prevention 
strategy fails. Isn' that what FEMA is supposed to be advocating?
Mike Sinclair


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