RESPONSE TO CRITICAL INCIDENTS

BY AUGUST VERNON

Today’s “bad guys,” criminals and terrorists, are more determined and heavily armed than ever before, and crisis situations such as terrorist attacks, illicit labs, civil unrest, active shooters, barricaded subjects, and hostage takings are occurring with alarming frequency. Increasingly, fire and emergency medical service (EMS) responders are finding themselves drawn into these types of events.

Remember to follow local guidelines and procedures; this article is for informational and educational purposes only. Many of these types of events cannot be peacefully resolved or negotiated, as was the case at the Bank of America in North Hollywood (CA) shootout and the Columbine High School attack in Littleton, Colorado. One important note to remember is that there are active hate groups and extremists in all 50 states.

ACTIVE SHOOTINGS

Mass shootings are very dynamic situations and may involve numerous casualties. An active shooting may be ongoing even as you arrive. Law enforcement, fire, and EMS share some of the same priorities during a mass-shooting event. Planning and interagency cooperation for any critical incident should be paramount. Several issues must be addressed during the planning phase.

Law enforcement will need fire and EMS coverage and equipment (vehicles, ladders, breaching tools, fire extinguishers, trauma packs, skeds, for example) during the event. EMS may need to provide tactical medics and set up several triage areas away from the scene. Law enforcement will need to provide security and “over watch” for the fire and EMS units entering the “hot zone.” There is a tremendous need for an immediate coordinated effort among all agencies to ensure a safe and effective response. Responders’ safety is paramount during this type of event.

Experience with past mass shooting/active shooter events have shown the following:

Preplanning is critical.
First-arriving units have a drastic effect on the progress of the incident. You must quickly and safely conduct a “windshield survey.”
Immediate interagency cooperation/unified command are essential.
You must use the incident command system.
Clear communications are necessary for effective operations.
Access to helicopters for overhead assessments is a plus.
Notify all key agencies and supporting entities as soon as possible (emergency management, hospitals, for example).
Plan on large and immediate media response.
Plan on a large and immediate response of parents, family, and friends to the incident scene.
Fire personnel should wear helmets clearly marked “Fire”; EMS personnel should wear EMS jackets. If there is any doubt of whether a responder is a firefighter or an EMS responder, responders should wear a road vest or T-shirt with highly visible lettering.
Body armor should be obtained for those responding into the “impact” area.
During these types of events, related and unrelated 911-call volume may go up.
EMS may need to implement disaster procedures such as triage tags, casualty collection points, and field treatment areas for minor injuries.
Use of tactical medics in support of law enforcement operations is encouraged.
Numerous mass-shooting and active-shooter events have seen the use of improvised explosives devices (IEDs), so be aware of this hazard and the growing use of secondary devices.
Fire/EMS can be targets of violence!

One excellent tool to assist public safety agencies in planning for mass shootings is the “Wanton Violence at Columbine High School Technical Report,” available without cost from the Federal Emergency Management Agency (FEMA) at http://www.usfa.fema.gov/applications/publications/ tr128.cfm/. This report is an in-depth analysis of the fire service and EMS operations and the overall response to the assault on the school on April 20, 1999. Incident command, special operations, and mass-casualty emergency medical services are featured. A CD-ROM that contains audio and video clips compiled by the Jefferson County Sheriff’s Office is also included.

It is also important to remember that several Al-Qaeda training materials such as the “Encyclopedia Jihad” series and numerous training videos provide specific guidance on the use of firearms for many different missions, including kidnapping, drive-by shootings, and assassinations. These documents and others can be found by searching on-line.

BODY ARMOR

Does your agency provide body armor for responders? Can you gain access to body armor in a crisis situation, such as a terrorist, mass shooting, or civil unrest event, in your community? This is a topic that is being increasingly debated in the fire and EMS communities. Old “hand-me-downs” from the military and law enforcement agencies may not always be the best choice, as the armor may be severely damaged or worn out. Some jurisdictions provide no armor; some provide armor for all staff; others provide armor only for fire/EMS units that routinely respond to a large number of shootings and stabbings.

On the other hand, the cost of body armor is very restrictive, typically starting around $800 and up per unit. If your agency is looking into purchasing armor, speak to your local law enforcement agencies, and do careful research; numerous types and levels of body armor are available. For additional information on body armor, see the “U.S. Department of Justice (DOJ) Body Armor Safety Initiative” at http://www.ojp.usdoj.gov/bvpbasi/.

CIVIL UNREST

If there were a report of a violent protest or civil unrest event in your community, how would you respond? Can you deal with the numerous medical and fire calls that will occur during this type of event? Acts of civil unrest take place each year across the United States. Annually, firefighters and paramedics have been injured during these situations (civil disorders, riots, or protests). As our society becomes more complex, populations continue to increase and give rise to many intricate problems. First responders must gain knowledge and understanding to solve these issues and respond safely when they occur.

Civil unrest incidents can escalate for a variety of reasons and are not limited to urban areas. They can occur in various situations: peaceful demonstrations that turn confrontational, violence related to major sporting events, concerts and “block parties” that turn violent, political conventions that are disrupted because of activists, confrontations at “hot spots” such as abortion clinics and research laboratories, and riots related to racial tensions.

Civil unrest events also have occurred at or near college campuses when teams have won or lost critical games. Does your jurisdiction host large or controversial political conventions, conferences, or demonstrations? Past experience at events such as the Free Trade Areas of the Americas, the Republican National Convention, the Democratic National Convention, the G8 Summit, and the World Trade Organization and International Monetary Fund (IMF) meetings have shown the need for preplanning and interagency communication.

Fire-EMS agencies must meet with local law enforcement to develop agreements concerning police support during critical events prior to any incidents. Any civil unrest event has the potential for a large increase in fire and medical calls. Law enforcement, fire, and EMS agencies share the same priorities during a critical incident. Planning and interagency cooperation for any event should be paramount. Several issues need to be addressed. Law enforcement will need fire and EMS coverage and must provide security for fire and EMS units entering the “exclusion area” or “hot zone.” Tactical medics and triage areas may be necessary. The fire department may have to assist in extracting demonstrators who have locked themselves into “protester devices.” There will be a tremendous need for a coordinated effort among all agencies to ensure a safe and effective response. Now is the time to review your guidelines and procedures.

An excellent tool to assist in planning/training efforts in reference to civil unrest is the FEMA/National Fire Academy “Report of the Joint Fire/Police Task Force on Civil Unrest” at http://www.usfa.fema.gov/downloads/pdf/publications/fa-142.pdf/.

ILLICIT LABS

Law enforcement raids on illicit drug or clandestine laboratories (laboratories that manufacture illegal controlled drugs or substances) have the potential to escalate into a haz mat, fire, or EMS response. Increasingly, law enforcement agencies request that fire and EMS assets be available during the thousands of raids of these labs that take place across the United States annually. Every year, first responders are exposed and injured at these labs. These labs have been found in single- and multiple-family dwellings; motel rooms; campgrounds; storage buildings; and motor vehicles, especially rental trucks.

Clan labs are not a new problem for first responders. (See “The Fire Service Should Know about Clandestine Drug Labs,” Fire Command, National Fire Protection Association, Nov. 1970.) According to the Drug Enforcement Agency (DEA), more than 99 percent of labs seized were meth labs. Other illicit drugs like PCP, MDMA, and LSD are also manufactured in clan labs.

One of the problems is that meth is very simple and inexpensive to make. Most “cooks” learned formulas at prison or from other cooks or on the Internet. These labs can be full of toxic materials and gases, flammable and reactive chemicals, and possible “booby traps.”

Another issue that arises is the fact that one pound of produced meth will generate up to five or more pounds of hazardous waste. As the number of labs in the United States increase and continue to spread into the eastern United States, it is important that first responders receive some type of awareness-level training so they will be able to recognize the components of a lab and call for the proper assistance. Emergency responders in rural areas are likely to encounter a meth lab operation. In 2004, there were 17,170 clandestine drug lab incidents involving labs, dumpsites, and chemical/lab equipment sites across the United States. Remember, if you think you have found a lab, get out! For additional information from the DEA, such as maps of reported labs and clan lab indicators, see http://www.dea.gov/concern/amphetamines.html/.

FIRE/EMS Warning Signs

Unless you are requested to stand by at drug lab “take-downs,” most drug lab incidents are usually reported as other emergencies or are discovered during routine activities such as medical aid calls with burn or smoke inhalation victims, “man down” calls, structure fires, rubbish fires that may be accompanied by explosions or “loud booms,” and investigation calls (smoke investigations, odor complaints, illegal dumping, sick buildings, for example).

Some items/materials you may discover inside of a structure or vehicle include the following:

A large amount of cold tablet containers that list ephedrine or pseudoephedrine as ingredients (the key ingredient for all methods of meth production).
Jars containing clear liquid with a white or red colored solid on the bottom.
Jars labeled as containing Iodine or containing dark shiny metallic purple crystals.
Jars labeled as containing Red Phosphorus or containing a fine, dark red or purple powder.
Coffee filters containing a white pasty substance, a dark red sludge, or small amounts of shiny white crystals.
Bottles labeled as containing sulfuric, muriatic, or hydrochloric acid.
Bottles or jars with rubber tubing attached.
Glass cookware or frying pans containing a powdery residue.
An unusually large number of cans of camp fuel, paint thinner, acetone, starting fluid, lye, and drain cleaners containing sulfuric acid or bottles containing muriatic acid.
Large amounts of lithium batteries, especially if they have been stripped.
Soft silver or gray metallic ribbon (in chunk form) stored in oil or kerosene.
Propane tanks with fittings that have turned blue.
Occupants of the residence going outside to smoke.
A strong smell of urine, or unusual chemical smells like ether, ammonia, or acetone.

These indicators are not proof that you have found a clandestine drug lab; they should raise a “red flag” for responders to be more aware of their surroundings.

IED INCIDENTS

Several of the public safety agencies involved in the response to the July 7, 2005, attacks in central London, including the London Fire Brigade, had been training for large-scale terrorist attacks since 9/11 and stated that the “training paid off during the July 7 response.”

How does your agency respond to reports of suspicious packages or events that might involve improvised explosives devices (IEDs)? Each year across North America, there are dozens of incidents involving actual and suspected IEDs. When responding to an actual or possible IED event, you need to become more “tactical” in your thinking. Get all the dispatch information you can. Look at the routes into the event area. Survey the scene for a moment. Keep an escape route to get out of the scene quickly. Look at the area where you are parking and staging. Be aware of secondary devices.

Several methods of attack and IED constructions are described in the Al Qaeda Manual, in terrorist-training videos, and on several extremist Web sites and are easily available to anyone with an interest. Any of the numerous means described could be used in the United States during a terrorist attack. The design and implementation of these devices are limited only by the bomber’s imagination. An IED can look like ANYTHING! Several important decisions will need to be made very quickly at the scene. The National Incident Management System (NIMS) is one of the best tools for agencies to use to deal with these types of events. On being notified of an actual or suspected IED, the incident commander should implement the U.S. Military’s “5 Cs Rule”: confirm there is a device, clear the area, cordon off the location, control all entry and exit points, and check the immediate area for secondary devices.

The response to an IED can be similar to a haz mat response. Use your “zones of control”: Hot zone-where the device is located; Warm zone-where the perimeter will be established; and Cold zone-location of a unified incident command post and staging. All appropriate agencies (fire, EMS, law enforcement, bomb squad, emergency management office, and others as needed) should be notified as soon as possible. Preparation is the key to safely mitigating an IED incident. That includes having a clear idea of what your actions will be before the incident occurs.

The first step toward preparedness for these events is to properly train all response personnel. This should include an awareness of the hazards associated with IEDs. Awareness-level training can easily be provided to first responders in a few hours. If there is a local bomb squad or hazardous devices unit in your area, ask for its assistance with your training and planning. Most bomb technicians will be glad to train your agency on their procedures and equipment, since they will require your support during an actual incident.

Another excellent training resource for first responders is the Incident Response to Terrorist Bombings (IRTB) course in Soccoro, New Mexico, funded through the U.S. Department of Homeland Security (DHS). This course gives first responders information regarding planning for and responding to IED or terrorist events. The student will be able to witness live explosive events ranging from a small pipe bomb to a large car bomb. The course prepares students for teaching awareness-level training. For additional information, see www.emrtc.nmt.edu/.

NIOSH

The National Institute for Occupational Safety and Health (NIOSH) Fire Fighter Fatality Investigation and Prevention Program analyzes firefighter line-of-duty deaths to formulate recommendations for preventing future deaths and injuries. For additional information on the program, see www.cdc.gov/niosh/firehome.html/. NIOSH recently released report FACE-F2004-11, which listed the following recommendations for fire departments involved in responding to scenes of violence:

Develop standard operating procedures (SOPs) for responding to potentially violent situations.
Develop integrated emergency communication systems that include the ability to directly relay real-time information among the caller, dispatch, and all responding emergency personnel.
Provide body armor or bullet-resistant personal protective equipment; train on its use, and consistently enforce its use when responding to potentially violent situations.
Ensure that all emergency response personnel have the capability for continuous radio contact, and consider providing portable communication equipment that has integrated hands-free capabilities.
Consider requiring that emergency dispatch centers incorporate the ability to archive location or individual historical data and provide pertinent information to responding fire and EMS personnel.
Develop coordinated response guidelines for violent situations, and hold joint training sessions with law-enforcement, mutual-aid, and emergency response departments.

OPSEC

Prior to planning for mass shootings, terrorism, and other “critical incidents,” think about the information that will be released to the public and the media. For public safety agencies and special operations teams involved in planning and training for terrorism, clan labs, and other “critical events,” it is important that Operations Security (OPSEC) practices be integrated in the planning and training efforts. OPSEC is a five-step risk-management process used by military and security professionals to protect unclassified and sensitive information adversaries could use against responders or their operations. Critical information such as planning and training efforts must be protected.

Extremists and organized criminals can take weeks and months to select their targets and plan their operations. To be successful, they need specific information about personnel, response plans, capabilities, and infrastructures. It is important that the responders involved in planning and training for critical events identify and treat their critical information as sensitive so that it does not end up in the hands of the “bad guys.”

SPECIAL RESPONSE TEAMS

If there is a local law enforcement Special Response Team (SRT), Special Weapons and Tactics (SWAT), or Bomb Squad unit in your jurisdiction, contact them to ask for assistance with your mass shooting, terrorism, and critical incident training and planning issues. Because of the increase in these types of incidents in the past decade, most if not all special response teams have trained for these events. These teams should be willing to provide your agency with some guidelines for critical incidents, since they may require your support during an actual incident. One must also take into account that much of SRT/SWAT and Bomb Squad training and equipment information is very sensitive in nature and must be handled as such. Some of this type of information is not for the public or the media because of safety concerns.

SUICIDE BOMBERS

Every day on television, we see the scenes of chaos and destruction caused by suicide bombers in cafes, buses, and streets across the globe. It is a very simple and inexpensive process to make a suicide belt or bomb. The suicide bomber has become one of the few remaining ways for terrorists to effectively target their enemies. First responders at all levels must learn to work together to deter suicide bombers from attacking locations in their jurisdictions and to safely respond if an attack should occur.

Incidents throughout the world have highlighted the growing threat of suicide bombers, especially in Iraq and Afghanistan. On July 7, 2005, four coordinated suicide bomber explosions rocked central London during the morning rush hour. More than 50 people were killed and more than 700 were injured. The blasts occurred in a span of just 30 minutes and were well coordinated. These devices were built from readily available commercial and household chemicals and materials.

One way to plan and prepare for future critical incidents is to look at incidents that have already occurred in the United States. Below is a case study of such an event.

In the early morning of July 31, 1997, an informant in New York City reported to the New York Police Department (NYPD) that two individuals from the Middle East had built suicide devices and were planning to detonate them on the New York City subway. A day earlier, a massive suicide attack occurred in Jerusalem using the “double tap” method (the first bomber detonates and the second one moves in during the response to target first responders), which inspired the two men to move forward with their plans.

On investigation, the NYPD determined the report was a credible report. The two young men had successfully built four large pipe bombs “salted” by dozens of four-inch nails. The plan was to strike the Atlantic Avenue B subway line, which is heavily used by the Orthodox Jewish population, during the morning rush hour. With just under four hours of investigation and planning, the NYPD Emergency Services Unit (ESU) successfully raided the location where the two individuals were armed with the devices. At 4:50 a.m., the ESU made entry into the apartment, shooting and injuring the two suspects, one of whom was able to flip one of the device’s toggle switches, arming the device, prior to being shot. Fortunately, the device did not explode.

In 1999, both terrorists were sentenced to prison. One has since been released from prison and been deported to the Palestinian Authority. He has since disappeared. The other is serving out his life sentence at the “Supermax” prison in Florence, Colorado.

Since 2000, more than 900 Israelis have been killed in bombings and shootings, and suicide/homicide bombers cause the majority of these fatalities. Suicide bombings have occurred in Afghanistan, Argentina, Algeria, Egypt, Sri Lanka, India, Iraq, Lebanon, London, Kuwait, Israel, Turkey, East Africa, Croatia, Chechnya, Yemen, Panama, Morocco, Saudi Arabia, and Pakistan.

Response agencies must plan how they will respond to a suspected suicide bomber, which could be an individual walking around in a crowded location such as a mall or a movie theatre. This is referred to as a “pre-detonation event.” This type of event will have the potential for large numbers of traumatic casualties. Fire/EMS responders must be aware of the potential for secondary devices and must never approach a suicide bomber or their remains in this type of response.

SIZE-UP

On arrival at any critical incident, conduct a quick “windshield survey” even when a scene is said to be “secure.” It is always important to gain as much prearrival information as possible and to listen for key verbal indicators that may come across, such as the fact that this is a high-violence area; that you have been to a location before (bar or club); and reports of shooting, alcohol involved, and crowds. Typical procedures require that law enforcement be dispatched to any type of incident that has the potential for violence, but you may find yourself on the scene because of a wrong address, victims came to you, or you suddenly discovered the incident. Any type of violent incident (stabbing, civil unrest, shooting) should raise a red flag for responders to be more aware of what is occurring prior to and during the response. When responding, get all the dispatch information you can. Look at the routes into the event and survey the scene for a moment. Keep an escape route to get out of the scene quickly. Look at the area where you are parking and staging. Never hesitate to call for law enforcement assistance if you think you may need it.

TACTICAL MEDICINE

One excellent source for protecting your responders and the public during a “critical incident” response is to use tactical medics. According to the International Tactical EMS Association (ITEMS), “These medical providers can then maintain the wellness of the team’s members and provide immediate medical care to anyone in need, whether they’re law enforcement officers, innocent bystanders, or suspects.”

Fire/EMS agencies should look at officer down and tactical medic courses for dealing with these types of situations. These medics have received additional training in multiple subjects such as firearms use, remote site medical care, IEDs, terrorism, preventive medicine, tactics, and ballistic injuries. Tactical medics are great assets to any agency during “critical incident” responses (active shooters, law enforcement support, barricaded subjects, civil unrest, VIP escorts, meth lab responses). Tactical medics have also proven to be valuable “lifesavers” for military and contractor security/convoy teams currently operating in Afghanistan and Iraq. For additional information on tactical medicine and “real world” tactical medic training opportunities, visit www.tacticalelement.com/.

VBIEDs

In July 2005, the DHS distributed an Information Bulletin that addressed the threat of vehicle-borne improvised explosive devices (VBIEDs). The bulletin states that there is no specific or credible intelligence indicating that terrorist organizations intend to use VBIEDs against U.S homeland targets. However, the growing use and frequency of lethal VBIED incidents overseas is cause for continuing concern. VBIEDs have been proven a favorite and effective mode for terrorists’ successfully penetrating a target and creating injuries and chaos.

Two notable events involving VBIEDs that occurred in the United States were the first World Trade Center bombing in 1993 and the 1995 Oklahoma City bombing. In each case, a rental truck was used to deliver the device to the scene and the bomb was assembled from commercially available materials.

According to the U.S Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF), the minimum safe evacuation distance for a small compact sedan loaded with up to 500 pounds of explosives is approximately 1,500 feet. Larger vehicles can require up to about 6,000 or 7,000 feet for the minimum safe evacuation distance. Dozens or even hundreds of people may be within that range, and they will need to be quickly and safely evacuated away from the “hot zone” if a suspected VBIED is discovered.

First responders (fire, EMS, or law enforcement) who come across a suspicious vehicle or device during routine activities should immediately inform all personnel and leave the area. Do not use your radio for this activity until you are some distance away from the vehicle. If you find yourself next to a possible VBIED, take these steps:

Call out to other personnel that you have found something (wires, devices, containers, for example).
Do not touch or move anything.
Do not open or close the doors, hood, or trunk.
If inside the vehicle, exit the same way you entered.
Move yourself, other responders, and the public out of the area as quickly as possible.

At this point in the incident, time could be of the essence, as the device could be set on a timer or detonated remotely by the handler watching the incident. If you discover an exploded or unexploded VBIED, you have discovered a serious crime scene, and it must be treated as such.

• • •

Safety is paramount for all responders during these types of events. Again, remember to follow local guidelines and procedures. Each community should have some type of plan in place to address these events. The more public safety agencies prepare, the better equipped they will be to effectively manage any type of situation that might arise. The community has entrusted us with their safety. Let’s prepare now.

AUGUST VERNON is an assistant coordinator for the Forsyth County (NC) Office of Emergency Management. He returned in 2005 to his position at Emergency Management after a year in Iraq as a security contractor conducting long-range convoy security operations. Vernon has been a member of emergency management since 2000 and a member of the fire service since 1990. He has served in the U.S. Army as an NBC (nuclear, biological and chemical) operations specialist. He teaches courses in incident management, OPSEC for public safety, haz mat operations, and terrorism/WMD response. He has been published in several national publications.