Harmony I Program

Harmony I: Regional Medical Response Exercise

Location: Yerevan Regional EMS Training Center,

Yerevan, Republic of Armenia

Date: August 15-18, 1999

Exercise Director’s Report

The Harmony I exercise was a simulation of a radiation exposure involving 20 patients who were followed over a period of 70 hours. During the simulation, first-responder personnel in the five countries participating in this regional project managed emergency medical response using computer, telephone, and fax connections to an online regional accident management network. The exercise was intended to test whether first-responder personnel would be able to use the principles of radiation accident response to respond to a radiation exposure involving victims from their countries. The principles upon which the exercise was based were formulated in the Radiation Emergency Assistance Center/Training Site (REAC/TS) curriculum and in the “Emergency Medical Response Plan for Radiation Accidents.”


The objectives of the exercise were:

Emergency medical personnel recognize accidental exposure to a radioactive source and initiate the appropriate cascade of events;

They conduct medical assessment of potentially exposed individuals;

Rule out external and internal contamination;

Assess for evidence of acute radiation illness;

Perform appropriate laboratory tests;

Consider therapy;

Arrange for a radiation exposure assessment at the site of the accident;

Report accident to proper authorities in Armenia and in participating countries (i.e., those to which victims return) and to international agencies;

Demonstrate international coordination/cooperation in victim identification, assessment and medical management;

Employ telecommunications technology to connect medical responders in participating countries during the exercise; and

Carry out a debriefing teleconference immediately following the exercise.

During the exercise the director and co-directors were able to maintain a good exchange of data and ideas by following a preplanned script.ÿ All of the participating centers were successfully connected to each of the seven conferences that comprised the electronic interface.ÿ Although some technical difficulties were encountered, each center participated actively in each conference. In summary, all of the exercise objectives were satisfactorily met. Inter-regional medical response was facilitated during the exercise and it represented a logical extension of the progress made in the completion of activities supported by this project.

Initially, participants at one site indicated that they thought the exercise lacked sufficient sophistication.ÿ This opinion changed when they were asked to calculate the estimated radiation exposure for the simulated victims and correlate the calculations with the victims’ symptoms and findings on exam and laboratory results.ÿ The videotape of the simulated radiation exposure along with the graphics provided to each site helped give participants a sense of “live” and “real time” activity. The exercise participants seemed satisfied with the overall planning of the event as well as the venue.ÿ Each site completed and transmitted to the incident command center in Yerevan the patient-related forms requested of them.

Following the exercise, an observer from the Armenian Nuclear Regulatory Agency (ANRA) stated that the agency would be interested in participating with this project in a nuclear power plant accident simulation sometime in the year 2001.

REAC/TS curriculum prepared for project in August 1997 and “Emergency Medical Response Plan for Radiation Accidents” prepared for project in February 1999.

Two training cycles totaling 8 courses and development and distribution to participating centers of the “Emergency Medical Response Plan for Radiation Accidents.”ÿ

Primary teaching affiliate
of BU School of Medicine