The recent events in Paris; Philadelphia; and San Bernardino, California, have reinvigorated the emergency services’ discussions of strategy and tactics in response to terrorism. Foreign terrorist organizations desire to obtain chemical weapons to use in attacks against innocent people and have called for continued acts such as the San Bernardino active shooting. Once again, the fire service must make hard decisions about its response posture for high-risk, low-frequency mass-casualty incidents (MCIs) resulting from intentional acts of violence.
Most agency leaders have little experience in this arena since the United States has fortunately had few organized terrorist attacks since the September 11, 2001, World Trade Center (WTC) attacks. How do we challenge this ever-changing threat, and what procedures should we adopt?
There is no single answer. Some tactics that work in one municipality will fail in another. Other agencies react to intelligence and threat analysis meant for a specific location or municipality that does not apply to their area, expending time and monies that could have been geared toward another need.
This article discusses terrorism response in 2016 and what departments must know to develop a successful and comprehensive response plan to this ever-emerging threat.
The Threats
The Islamic State of Iraq and Syria (ISIS) or the Islamic State of Iraq Levant (ISIL) (depending on the translation) has grown in power and strength and has emerged as the largest independent foreign terror threat facing the United States and its allies. The strategy and tactics of this semigovernmental state are of higher consequence to fire and emergency medical services (EMS) personnel than its history and ideology.
ISIS is distinct from Al Qaeda and other terror organizations in its approach to attacking its perceived enemy, the West. Al Qaeda used secure communications and kept much of its strategic planning secret. It organized terror cells of five to 10 personnel who would carry out a grandiose plan to kill Westerners in a very loud and public manner. ISIS, however, uses social media to inspire sympathizers to take action on its behalf. ISIS doesn’t focus its planning on large-scale attacks but rather on influencing those who sympathize with its ideology and encouraging them to carry out single or “lone-wolf” violence against Westerners wherever and whenever they can.
The strategy is efficient and, unfortunately, quite effective. Such lone-wolf attacks are the hardest threats to anticipate and defend against. ISIS’s organized and larger-scale planned attacks have occurred mostly abroad and in the Middle East. These large-scale attacks are geared toward obtaining territory, increasing the size of its perceived state, or inflicting terror and garnering headlines.
Al Qaeda attempted to destroy the WTC with a vehicle-borne improvised explosive device (VBIED) in 1993 but failed. On September 11, 2001, terror cells flew planes into both towers, causing them to collapse. It took eight years of planning and secrecy to initiate the operation.
In contrast, ISIS itself may not attempt such a feat, but it will announce the desire to see the Twin Towers destroyed and allow sympathizers to construct and carry out such a plan. Even if the plan fails, the act will still have looming effects on the lives of everyday citizens. If only one out of 10 attempts is successful, ISIS considers it a victory. Its tactic is to recruit any and all willing participants to do its work.
![(1) Terrorists will anticipate first responders’ arrival and resist. If they are operating with multiple shooters, they will be looking out from more than one vantage point and communicating with each another. Emergency responders must exercise extreme caution about when, where, and with whom to approach the site of an active shooting. [<i>Photos courtesy of Fort Jackson (SC) Public Affairs Office.]</i>](https://emberly.fireengineering.com/wp-content/uploads/2016/03/1603FE_hamilton1.jpg) |
| (1) Terrorists will anticipate first responders’ arrival and resist. If they are operating with multiple shooters, they will be looking out from more than one vantage point and communicating with each another. Emergency responders must exercise extreme caution about when, where, and with whom to approach the site of an active shooting. [Photos courtesy of Fort Jackson (SC) Public Affairs Office.] |
This tactic is effective because ISIS has declared itself the ruler of all Muslims around the world, a position denounced by many Muslim nations and organizations. ISIS targets the youth and the disadvantaged of the world-individuals looking for a structure or a purpose in their life are prime recruitment targets. This tactic is very similar to street-gang recruitment. Although those who can be easily influenced into shooting or stabbing military or government officials may not be considered ISIS members, they are ISIS sympathizers.
In 2014, ISIS released a document containing the names, addresses, and other biographical information about members of the United States military. The instructions included in the document urged sympathizers to attack the military members and their families at home or while they are out in their communities. The intent was to keep people from feeling safe anywhere. This tactic requires no training or financial or material support. It simply asks people who believe in the religious, cultural, and social agendas of ISIS to go kill military members and their families.
If Al Qaeda had had a similar goal 10 or 15 years ago, it would have most likely selected several military members to target, formed a terror cell of trained attackers, obtained floor plans and blueprints of homes, and observed the targets to plan and carry out an attack. ISIS just releases the information and asks lone-wolf attackers to carry out an attack in whatever manner may be successful.
Fire and EMS agencies must be more diligent than ever before with emergency response to acts of violence. Any violent act may later be determined to be an act of terror, especially at public venues or assembly areas in which a shooting or stabbing has occurred. Of particular concern are events that can provoke large-scale responses in very short order, such as active shootings, releases of chemical or biological materials, and using industrial products to cause injury and harm.
Terrorism experts say there is an ISIS presence in every state in the United States. In a recent shooting in Philadelphia, an ISIS-influenced attacker shot a police officer. Attacks can come in any form, size, and method and at any location. ISIS would rather have 100 attacks resulting in a single fatality than one attack with 100 fatalities.
Active Shooter Attacks
In America and abroad, emergency services have responded more frequently to active shooter incidents in the past few years. Terrorists favor such MCIs because of the fear they inspire in society. Additionally, the resources to carry out such attacks are fairly accessible and relatively inexpensive. Even so, fire departments are still exploring what response they can muster if such an incident occurs in their jurisdiction.
Once, the active shooters’ tactics depended on their ideology. Those with political, social, or cultural grievances tended to use heavier weapons, resist first responders, and deploy improvised explosive devices (IEDs) during their assaults. In contrast, shooters with psychological disorders such as depression, post-traumatic stress disorder (PTSD), and schizophrenia would surrender or take their own lives at the first sign of resistance.
Although this may seem to be true to some extent, such an assumption gives responders a false sense of security. Over the past few years, as the number of active shooter incidents has increased in the United States, attackers have used all of the above tactics regardless of the nature of the shooter’s grievance inspiring the attack.
Formerly, emergency responders would not stage first but respond immediately because it was believed that active shooters would kill themselves on the arrival of first responders. The previous assessment of these scenarios, “Although the shooter has killed himself and you are staged, people are dying. So get in there and provide help. The shooter is probably dead anyway,” is less reliable now.
The terrorists’ tactics have changed. It is almost certain that terrorists, such as the two San Bernardino shooters, will not kill themselves but instead fight and try to kill as many people as possible. The shooter does not care whom he kills-civilians, police officers, firefighters, or paramedics. A dead body is a dead body. Terrorists will anticipate the arrival of responders. They may fortify their position and defend it vigorously. Multiple shooters will be difficult to neutralize, and responders will be targeted on arrival.
Although “risk a lot to save a lot” reminds us of what our job entails, we mustn’t be reckless and make hasty decisions. Just because one department creates a rescue task force (RTF) does not mean your department should. Deciding to make entry with tactical gear under the security of law enforcement personnel should not be an easy decision or one that is taken lightly. Terrorist building takeovers internationally have been well-planned and well-drawn-out incidents that have taken days to mitigate. These incidents have occurred in foreign countries such as the Mumbai hotel attack in India, where the country’s military was needed to quell the attack.
The United States has very strict laws regarding the use of military personnel in civilian-populated jurisdictions. With the recent push by civil rights organizations and our government to demilitarize our police force, responders may be at an extreme disadvantage in the future should such tactics be used in America.
Departments need to consider many aspects of the RTF when determining its applicability. First and foremost, what are the capabilities of your law enforcement agencies? If your police, sheriff’s department, or state law enforcement personnel cannot respond to the scene in less than 20 minutes with enough personnel to neutralize the threat, provide perimeter security for secondary aggressors, assign trained and equipped personnel to provide security for fire/EMS teams, and have the command staff to manage the incident, you should not staff a RTF.
Patients with significant gunshot trauma involving severe hemorrhaging can bleed out in five minutes. Statistically, the active shooter event is over within 15 minutes, but a well-planned terrorist attack can increase that time substantially. Responders cannot effectively make a difference or increase victim survivability if they cannot safely access and treat the patients.
If agencies cannot enter to mitigate those injuries within a reasonable time, they should not attempt it. It would be better to find an alternative that will allow that victim to receive the medical intervention he needs. For example, agencies could train dispatchers to provide tourniquet application instructions over the phone and direct callers in how to seal sucking chest wounds with material available in the environment. Alternatively, facility staff could be trained in such disciplines so that they can assist the wounded in their immediate vicinity during or immediately after a shooting. This type of bystander education is being strongly endorsed by the Hartford Consensus (2). If victims can die from uncontrolled hemorrhaging in five minutes, these bystanders are the very best chance of survival for many victims.
Mass notification systems are becoming more popular in assembly facilities such as malls, theaters, and office buildings. These systems will repeat a preprogramed warning message about a tornado warning, a fire, an active shooter, and other emergency messages. These messages, when activated, will repeat cyclically until the warning is manually deactivated. An active shooter message may include information such as seek shelter, barricade any doors, and lie on the ground. That message can easily be programed to provide basic medical instructions as well, such as “control bleeding with direct pressure, apply tourniquets to uncontrolled bleeding above the wound, and release pressure every 15 minutes” or “call 911 to report your location, injured personnel in your area, or information about the shooter.” Facilities that are not equipped with mass-notification systems, loudspeakers, or megaphones can use other dynamic methods to encourage the lay person into action to save a victim.
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| (2) Terrorists will aggressively defend the access points of facilities from which they are operating. Approaching the building will be among first responders’ most dangerous tasks. |
Moreover, as was seen in Paris, organized terrorist cells are attacking multiple targets simultaneously to overwhelm the emergency system and cause more casualties by delaying or overwhelming responders. Agencies must be prepared to use tactics such as bystander education or dispatcher medical instruction that support entry as well as tactics for when they cannot enter. Entry may be delayed by a lack of personnel or heavy active resistance from aggressors.
Terrorists will put up heavy resistance and fight until they are killed or incapacitated. The terrorists’ skill and training may very well exceed those of first response law enforcement officers. Their tactics, training, and weapons may require a specialized weapons and tactics team (SWAT) or special response team (SRT) to neutralize the threat. If the active shooter resists first responders, be prepared to adjust your tactics.
Responders should proceed with extreme caution at an active scene. If there are multiple mobile shooters within the target area, definitely stage first for responder safety. Law enforcement will take some time to locate, contain, and neutralize them. Until the threat has been identified and located, other emergency responders should stage for first responder safety. Afterward, responders can divide the area into hot, warm, and cold zones.
It is important that responders stage initially regardless of their assignment or capabilities. Even RTFs need to mobilize, gear up, receive a briefing, and plan an approach. This should be done out of the line of sight from the target building if possible. Remember, you may be dealing with multiple shooters, and law enforcement may be heavily engaged in neutralizing the threat.
Police, fire, and EMS agencies should cross-train in multiple topics. Fire and EMS personnel can instruct police officers on victim survivability profiling-i.e., quickly identifying and prioritizing savable victims based on their observable wounds. For example, a victim with center-mass gunshot wounds takes priority over a conscious patient with an extremity wound with the hemorrhaging controlled. Providing this instruction does not teach police officers to be medics or how to perform extensive patient care. If presented this way, fire/EMS responder agencies will find law enforcement to be a much more attentive audience. Armed with this knowledge, as police officers clear rooms of any aggressors, they can relay critical information as to the locations of the greatest rescue needs.
Another option is that law enforcement direct the nonwounded to help remove the wounded. They can use simple carries or improvise using wheeled or straight-legged chairs, rugs, sheets, and the like to help remove victims. Educating law enforcement officers in this concept may allow the removal of most of the victims, under the best circumstances, without the entry of fire and EMS personnel.
Now, active shooters of all kinds are using IEDs, which are common in terrorist attacks. Previously, the use of an IED would have almost guaranteed that it was a terrorist attack, but now any type of aggressors may use them. The presence of IEDs at an active shooter incident indicates that, under most circumstances, the aggressor is very organized and the attack has been well planned as far as fire and EMS responders are concerned. Law enforcement should cross-train fire and EMS personnel in IED recognition and response procedures.
With basic IED knowledge, the presence of an IED should not necessarily prompt responders to evacuate everyone and everything from the building. Where is the IED? How big is the device? What lethal capabilities does it have, and for whom? For example, a six-inch pipe bomb in a third-floor classroom on the C side of the building should not prevent responders from rescuing people from the A side on the first floor.
Explosives response is extremely dangerous, and agencies should liaise with local or state explosive ordnance disposal (EOD) teams for training and education. Policies and procedures for explosives response can vary, but those covering the use of telephones, radios, and standoff distances are fairly concrete. EOD teams can identify the material, the trigger systems, and the damage potential of almost any explosive device. The unified command system should include an EOD team and take its recommendations on response postures very seriously.
ISIS and other terror organizations have developed instructions for using pressure cooker pots, propane cylinders, and other nonsuspicious-looking containers to deliver explosive payloads. It is extremely important not to manipulate anything at a scene of violence that does not absolutely need to be moved. Report anything suspicious looking as soon as possible. The use of the suicide vest IED will eventually become an issue here in the United States. Proper scene security at the incident site, in the staging area, and at the command post is extremely important. Law enforcement must act early and quickly to control and push back bystanders. Remain alert, and be diligent about identifying who is approaching the scene and why.
Active shooter incidents most likely will not decline in frequency any time soon. An active shooter can affect any jurisdiction, district, village, city, town, county, or hamlet. Remember that ISIS wants to have attacks carried out anywhere and everywhere. In many places, “It can’t happen here” was said just before an attack occurred.
Chemical and Biological
ISIS has stressed a desire to obtain and use weapons-grade chemical and biological weapons against Westerners. Aside from the use of mustard gas against Iraqi Kurds, the group has been unable to develop a comprehensive chemical or biological weapons program. To completely understand the threat of a group using such weapons, you must understand what weapons-grade chemical and biological weapons are. Chemical and, more specifically, biological weapons require laboratory engineering to make them weapons grade.
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| (3) Terrorists understand cover and concealment. This individual is poised to engage targets while the walls protect him from return fire. Entry teams and rapid task force personnel will have a difficult time approaching a terrorist who knows and uses good cover and concealment techniques. |
For anthrax spores to become weapons grade, they must be genetically altered at a cellular level. As an example, technicians will add silica to anthrax to reduce the likelihood that the spores will adhere to surfaces, making them more likely to become airborne and extremely dangerous when the environment is disturbed. For the “white powder” calls that occurred after 9/11, responders were instructed to avoid disturbing the environment, and decontamination procedures focused heavily on a person’s hands, feet, and face. Weapons-grade anthrax will disperse back into the area if a door is opened or if someone walks past it. Postal workers were infected during the post-9/11 anthrax incident even though they never opened the anthrax-tainted letters or handled them personally. As a letter went through the sorting machine, the speed and pressure placed on the envelope caused the anthrax spores to leak out and be inhaled by the persons nearby.
Chemicals also require laboratory intervention to be made weapons grade. The sarin gas attacks in Japan in the 1990s were not extremely lethal, but they had deadly potential. For sarin, the lethal concentration dose (LD50) or the amount needed to kill 50 percent of the tested population is 35 milligrams per cubic meter per minute of inhalation. In simple terms, sarin is more than 540 times more lethal than chlorine. The Japan subway sarin attack killed 12 people and caused thousands of others to complain of injuries. Had the terror group obtained and used weapons-grade sarin, the death toll would have been enormous. Producing such material is not farfetched and can be done with the proper knowledge and equipment. Our law enforcement and federal intelligence agencies have done a tremendous job in identifying these threats and neutralizing them before they succeeded. Although it is possible that an individual or group could use chemical weapons, because of the skill and knowledge required to make the material weapons-grade, their lethality probably would be significantly less than military- or government-controlled chemical weapons.
Industrial Materials
Equally effective alternatives to chemical and biological weapons exist. Industrial chemicals, for example, are everywhere; we come in contact with hundreds of thousands of chemicals daily. In the proper concentration or when used unsafely, these chemicals can be lethal. Weapons-grade chemicals are rooted in the industrial realm. German troops used chlorine to attack Allied forces in World War I; Iraqi insurgents used chlorine in the Anbar province, killing two; and ISIS has allegedly used chlorine in at least one VBIED in Iraq. Industrial chemicals can be substituted for weapons-grade chemicals. The average citizen will not distinguish between the two. The fear of an attack compromising something as critical as the air we breathe is quite terrifying.
Agencies should approach these incidents as a hazardous materials incident with victim exposure. Identify the product, decontaminate the victims quickly and efficiently, treat and transport the injured, and contain the incident.
Identifying the product may prove easier than you might think. Terror groups want you to know what they attacked you with. Stolen industrial chemicals used in a large-scale attack likely would still be in their original containers in which they were stolen. Smaller containers may be used at facility heating, ventilation, and air-conditioning air intakes; released in areas of a building with poor ventilation and large numbers of people; or used in IED systems. If a small container of some chemicals is used in IEDs, the explosion will dissipate the chemical faster or potentially consume it so that few people will be exposed or overcome by the chemical.
Intelligence and Preplanning
How do you prepare for such events? Fire and EMS personnel can prepare the same way that law enforcement prepares-through intelligence. Local, state, and federal law enforcement agencies have created task forces, groups, and networks for information sharing, some of which focus on the nation as a whole and others that focus on a particular geographic area. These task forces have a great deal of knowledge that fire and EMS personnel can use.
For example, if thieves steal a 5,000-gallon container of chlorine from an industrial park in a neighboring state, the task forces are notified, and some members may even be involved in the investigation. The specific information regarding the theft is usually “For Official Use Only” (FOUO); such information is not classified and is available to agencies that have a need to know. Command staff can easily articulate a need to know, and many have. Those in the network receive an e-mail or other correspondence notifying them of the chlorine theft and from where it was stolen.
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| (4) Tactical law enforcement teams with heavy weapons and specialized training may be required to neutralize a threat. Patrol officers are trained to immediately enter the area and engage the threat. However, they may not succeed. These teams require time to mobilize and deploy. Use caution and patience while waiting for tactical team deployment. |
Agencies can use information in the most basic way without causing panic or compromising the FOUO limits. With the chlorine theft as an example, fire departments can provide chlorine response training within days of the notification. EMS agencies can train on treating chlorine exposure. Senior leadership can mandate these classes without compromising the intelligence. However, informing the entire department of the theft and that it will train on responding to a possible intentional release of chlorine could very well cause panic or even compromise the investigation’s integrity.
Agency heads are ensuring that personnel are prepared and that information is refreshed based on real-world intelligence and not a general knee-jerk reaction. In contrast, agencies see that a terrorist attack has occurred elsewhere in the world or in the United States and instantly begin preparations for a similar attack in their area. These task forces can provide real insight as to whether that is necessary. Posing the question to the task force or through a city or county representative of a task force will enable an agency to react and determine exactly how it will react while maintaining calm.
Other sources of information exist nationally, including intranet information networks around the country through the Internet. Access to the network is restricted, but agencies can submit a request form that explains the need for access. Fire and EMS agencies nationwide use these networks now-it is almost like Facebook for first responders. Departments interested in obtaining more information on these task forces and networks should contact their local Department of Homeland Security office; local law enforcement agency, county emergency management section; or local Federal Bureau of Investigation office. Acquire this information at the lowest level possible first-from local and state agencies before federal agencies.
Preparation strategies include a regular and comprehensive preplanning of the occupancies in your response area. Start with assembly occupancies, as they have the highest likelihood of being targeted for attack. This should be a multiagency preplan. Fire, EMS, and law enforcement should be part of the process. Information that may prove trivial to one agency can be absolutely vital to another. Ingress and egress routes, floor plans, construction features such as window and door construction, as well as utility locations can be just as important to fire and EMS personnel as to law enforcement. Knowledge of this information can be extremely valuable when an incident occurs.
Terrorism is an unfortunate fact of life for many countries, especially the United States. The current climate and failed proxy wars have made the United States and its allies prime targets for terrorist attacks. The future is unknown as far as the “when” of terrorist attacks, but the “who,” the “where,” and the “why” are fairly certain.
Every community regardless of size, population, or economic status can be a victim of terrorism. Attacks will increase in frequency, and the locations will be varied. Agencies need to ensure that their personnel, allied agencies, and community members, where needed, are ready to respond.
We need to continually change our tactics for responding to intentional acts of violence. The aggressors will target responders. Departments that lack the proper resources to protect themselves should seek tactics other than entering the area and beginning treatment. We must adapt to this newly found threat, or first responders may die.
STEVEN C. HAMILTON is a 20-year veteran of the fire service, a lieutenant with the Fort Jackson (SC) Fire Department, and a reserve deputy with the Richland County Sheriff’s Department. He served as a firefighter in the United States Air Force and in volunteer departments in Texas and New York. Hamilton is a certified fire officer III, an instructor II, an arson investigator, and an NREMT-B. He is an EMT-B instructor for his jurisdiction and a former South Carolina Fire Academy adjunct instructor. Hamilton is the author of the training DVD Responding to Scenes of Violence (Fire Engineering, 2015)..
Steven C. Hamilton will present “Responding to and Preparing for Acts of Violence” on Monday, April 18, 8 a.m.-12:00 p.m., at FDIC International 2016 in Indianapolis.
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