MS PIP 2019 Mississippi Partners in Preparedness Summit Sustaining Radiation Response Volunteers Corps (RRVC) members for enhanced response capabilities during radiological emergencies

Mississippi State Department of Health - Division of Radiological Health (DRH) Lead agency for radiological exposure control Decision-making organization for protection of the public’s health and safety during a radiological emergency Provides radiation dose projections and assesses the risk of exposure by time and location Provides population monitoring after an event where radioactive materials have been released and have potentially contaminated or exposed members of the general public.

Mississippi State Department of Health - DRH Main state-level advisory body during an event at the Grand Gulf Nuclear Station (GGNS) Guide and supplement population monitoring activities occurring in the counties surrounding the GGNS https://www.nrc.gov/reactors/operating/map-power-reactors.html The Mississippi State Department of Health (MSDH) is the Emergency Support Function 8 (ESF-8, Public Health and Medical Services) coordinating agency for radiological response efforts within the State of Mississippi. Furthermore, the MSDH Division of Radiological Health (DRH) is responsible for protecting the public from unnecessary radiation exposure from radiological sources and materials. As part of the Mississippi Radiological Emergency Plan (MREP), the MSDH DRH is the main state-level advisory body during an event at the Grand Gulf Nuclear Station (GGNS) and will guide and supplement population monitoring activities occurring in the counties surrounding the GGNS. Subsequently, according to the MSDH’s Population Monitoring Plan, the MSDH, through its Office of Emergency Planning and Response (OEPR) and DRH both located with the Office of Health Protection, is responsible for activating and mobilizing population monitoring activities during all other radiation emergencies across the state that might require such.

Population Monitoring Plan for Non-Fixed Nuclear Facility Emergencies Establish guidelines and procedures to: Identify individuals whose health is in immediate danger; Identify people who may need medical treatment for contamination or exposure, further evaluation, or short-term health monitoring; Recommend practical steps to minimize risk of future health consequences; and Register potentially affected populations who may be identified for long-term health monitoring. Developed in 2013 Identify individuals whose health is in immediate danger and who need immediate care, medical attention (whether radiation-related or not), or decontamination; Identify people who may need medical treatment for contamination or exposure, further evaluation, or short-term health monitoring; Recommend (and to the extent possible, facilitate) practical steps (such as administering KI, Prussian Blue, or DTPA) to minimize risk of future health consequences; and Register potentially affected populations who may be identified for long-term health monitoring.

Community Reception Center (CRC) MSDH’s plan calls for the operation of CRCs to provide the following basic services: screening people for radioactive contamination; assisting people with washing or decontamination; registering people for long-term follow-up; and prioritizing people for further care.

Mississippi’s Radiation Response Volunteers Corps (MRRVC) Can’t staff a CRC or preform population monitoring on their own, therefore the MSDH OEPR and DRH recognize the need for professional, volunteer assistance in responding to radiological incidents. Mississippi Radiation Response Volunteer Corps (MRRVC) was chartered in January 2011 as a Medical Reserve Corps (MRC) unit to help supplement existing capabilities in the State of Mississippi. The MRRVC was developed to assist state and local authorities with population monitoring following a radiological incident. The mission of the MRRVC is to recruit and train individual volunteers to screen the public for radiation contamination and to fulfill multiple roles during population monitoring operations during activation of a Community Reception Center (CRC) or during the activation of sheltering operations where radiation screening may be required.

MRRVC Volunteers Radiation professionals (health physicist, medical physicist, radiological or nuclear medicine technologist), physicians, nurses and others Recruitment from hospitals, healthcare organizations, academia, and the retiree pool Receive initial classroom-based training upon registering Reoccurring training The MRRVC works to recruit radiation professionals, including health physicists, medical physicists, radiological or nuclear medicine technologist, and others, to provide a much needed resource to their community. As of April 2014, the MRRVC currently includes 91 registered volunteers.

MRRVC Video Production Partnership between: UAB School of Public Health University of Mississippi Medical Center MSDH DRH Funding from CRCPD To help meet the needs of the MRRVC, a series of videos were created to help with the recruit of volunteers into the MRRVC and train volunteers once they are registered with the MRRVC. All this in hopes that if a radiological emergency happens, Mississippi has a cadre of volunteer radiation professionals to assist with CRC operations and populations monitoring activities. Funding for the videos was made possible by a grant from the Conference of Radiation Control Program Directors (CRCPD) for Radiation Response Volunteer Corps Development. Partnership between: UAB School of Public Health – scripting and video production University of Mississippi Medical Center – support and staff CRC Mississippi State Department of Health – Division of Radiological Health – lead agency for population monitoring activities

Aims and Goals To improve the ability of the MSDH to recruit and manage a cadre of volunteer radiation professionals. To increase awareness of the capabilities of MSDH DRH and MRRVC during a response to a radiation emergency and activation of CRCs. To enhance the ability of the MSDH to provide just-in-time training to the members of the MRRVC. Videos were created with the following aims and goals. Not only to recruit and train volunteers with the MRRVC, but to also increase awareness of the capabilities of the DRH and MRRVC during a radiation emergency response, and specifically to educate local response jurisdictions of population monitoring plans and the need for population monitoring response capabilities in the state.

MRRVC Videos Recruitment Video 60 seconds Fast-paced/action montage Engage audience Recruit volunteers CRC Informational Video 5 minutes Introduction to a CDC Narrated by MSDH staff Provides a visual of the activities of a CRC Just-in-Time Training Videos Series of 7 videos (one for each station) 2-5 minutes long Reviews specifics of each station Three videos were created in total. The first video was designed to assist with recruitment into the MRRVC. It’s a short (only about 60 seconds) action montage that serves as an inspirational piece to trigger the interest of Mississippi citizens to join the MRRVC. Can be used as a PSA as a call to volunteer. The second video is more educational and goes into more detail on the operations of a CRC and the need for volunteers. Describes populations monitoring, the purpose of a CRC, the need for volunteers and the roles of volunteers at each of the CRC’s 7 stations. The video is narrated by MSDH Division of Radiological Health staff, which we was important because it makes the video a little more personal (puts a face with names and the organization) and strengthens the local connection. Knowing that is may be hard for volunteers to visualize what activities take place at a CRC, especially those without a radiation background, video clips from a CRC set-up drill are used in the video to give potential volunteers a visual picture of the activation and operations of a CRC. The third video is actually a series of videos. For each station within the CRC, a just-in-time training video was created to review the expectations, responsibilities, and procedures of volunteers at that station. The videos are short – they are anywhere from 2-5 minutes long. They are intended to be refresher trainings for volunteers after they have already gone through the initial training.

Recruitment Video Initially created in PowerPoint Produced by UAB School of Public Health Review and revised using comments from MSDH Rad Health, MSDH, UMMC Two videos created 1) specific to Mississippi 2) general recruitment for any RRVC Show recruitment video. The outline for the video was initially created in PowerPoint. Our videographer at the UAB SOPH then took the images and merged them into a video/audio template to create the final product. The video was reviewed by UAB, MSDH, and UMMC several times and edits were made. Two recruitment videos were created – one specific for Mississippi and another video that is more general which any MRC could use to recruit volunteers into their radiation response teams. In total, it took about 3 months to complete both videos (included drafting the slides, finding images, merging into template, edits and revisions). https://videohive.net/item/epic-intro/12005713?s_rank=1798

This video was placed on the MSDH website to help with recruitment and shown to nurses in each of the 9 public health districts in Mississippi.

CRC Informational Video CRC footage - CRC set-up by MSDH DRH and UMMC MSDH DRH narration - filmed at the UAB SOPH recording studio Clipped together scenes from CRC set-up drill and audio/visual filmed to create the CRC Introduction Video Show the second video. The idea for the second video was based on a similar video created by FEMA from a CRC exercise in New Haven, CT. Our video was adapted to Mississippi’s population monitoring plan and again is narrated by MSDH DRH senior staff members. https://www.fema.gov/media-library/assets/videos/109671 The CRC footage was filmed from a half day CRC set up at the Copiah County Community Center and the narrated portions from the MSDH staff were filmed at the UAB SOPH in a professional recording studio. Using our script as a guide, we clipped footage from the CRC set-up and combined them with the studio footage for the final CRC introduction video.

CRC Informational Video - Filming and Editing Script developed using the Mississippi Population Monitoring Plan Drafted the content of each scene including the images/visual to be used The script was developed using information from the Mississippi Population Monitoring Plan. The script outlined what we wanted each scene to look like (what video/image we wanted to use) and what lines the MDSH staff that narrated the films would say. This helped our videographer pull it all together once MSDH staff filmed their parts. We sent them the scripts 3 weeks ahead of time to give them time to review the scripts and practice reading them aloud so they would be more familiar with the wording when it came time to film. They were encouraged to change words as needed to make the script read more comfortably to them.

Just-in-Time Training Videos One video for each of the 7 CRC stations Each video is 2-5 minutes long Purpose of the station Roles and responsibilities of the volunteers Radiation detection equipment Personal protective equipment required Safety measures required at each of the stations After initial training, it may be months or years before volunteers are called upon to staff a CRC during an exercise or actual event. To maintain readiness after initial training, we developed a series of just-in-time training videos that review the expectations, responsibilities, and procedures of each of the stations within the CRC. These videos provide critical information that volunteers need to know in order to work effectively at each station and protect themselves and others from potential cross contamination. Each JITT video reviews: - Information about the station which included the purpose of the station, what types of activities take place at the station, and placement of the station within the CRC. Roles, responsibilities and expectations of the volunteers at each of the stations and how they work alongside MSDH staff. What equipment is used at each of the stations (radiation detection equipment) Personal protective equipment and safety measures required at each of the stations As well as who to address any concerns with while working at the CRC

Video Content Each video features a combination of live action shots or stills from a CRC set-up drill, figures and diagrams from the CDC’s population monitoring plan (like CDC flow diagram), and images of equipment that is used at each of the stations to help familiarize volunteers with the equipment they may be using.

Just-in-Time Training Examples Initial Sorting Station First Aid Station Contamination Screening Station Wash Station Registration Station Radiation Dose Assessment Station Discharge Station Show Videos. Footage for the videos were filmed during a CRC set-up drill at the Copiah County Community Center, which had several advantages: Allowed volunteers to receive hands-on training. MSDH was able to set-up the CRC at a potential CRC site – gave them a chance to determine if there would be any logistical challenges and resolve them before a CRC is established in a real emergency

Script Development For the JITT videos, the script was developed before the CRC set-up drill, which worked well because we knew exactly what we needed to film the day of the drill. Excel chart outlines the audio (the message we wanted to convey) and the corresponding images/video. The audio was voiced over at a later time by UAB SOPH staff.

Knowing every second counts in a real-world radiological emergency, a Quick Response Code (QR Code) was created for each station video. After placing these QR codes at each of the stations, the QR code can be rapidly scanned and are linked to the station specific training video which are uploaded to an unlisted YouTube channel. The idea came from Minnesota's Department of Safety – they created JITT videos and QR codes for their Radiological Emergency Preparedness program –their videos were specific for public safety workers and cover radiation equipment, emergency worker brief, portal monitor, and stations they would staff. The QR codes provide instant access to these just- in- time training videos for anyone that has a smartphone with a camera and internet access. MSDH also hopes to provide preloaded portable computer devices with just-in-time training content and make them available onsite during a deployment of the CRC. Having station specific videos readily available to each of the volunteers allows the volunteers to watch the videos at their own pace and minimizes the need for group just-in-time training prior to the opening of a CRC. Overall, utilization of QR codes can significantly increase the speed of delivery of training for volunteers at their specific CRC work station location and provide consistent information to volunteers when in a chaotic response environment

Future Uses Full-scale CRC exercise Additional videos Evaluate ability of MSDH DRH and MRRVC to set-up and operate a CRC Update Job Action Sheets Evaluate just-in-time training videos Additional videos Wash procedures Using radiation detection equipment PPE/safety procedures In the future, MSDH plans to conduct a full-scale exercise of the CRC. The exercise will give MRRVC volunteers a chance to receive more hands-on training. At the exercise, both the JITT videos and the job actions sheets created for each of the stations will be evaluated by volunteers. This will give MSDH a chance to see what works, what steps or processes need further clarification, and update any procedures and policies. Additional videos we hope to create is one specific to wash procedures at the decontamination station, videos on how to use various radiation detection equipment, and another on safety procedures/PPE.

Contact Dr. Lisa McCormick, UAB, lmccormick@uab.edu Elena Kidd, UAB, enlinn@uab.edu Karl Barber, MSDH DRH, Karl.Barber@msdh.ms.gov

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