by Mr. Frank Rando, CBRNE – Protective & Biomedical Countermeasures SME, University of Arizona, USA
Asymmetric threats, urban warfare and tactical ultraviolence are no longer limited to the battlefields of Iraq, Afghanistan, Syria, or Africa. While foes and enemies have drowned us in urban warfare and terror attacks in the streets and venues of Belfast, London, Paris, New York, Tel Aviv, Munich, Boston, Moscow and other cities throughout the world, the carnage continues today in the form of armed assaults, edged weapons attacks, vehicles mowing people down and, of course, improvised explosive devices at our schools, houses of worship, shopping centers and other locations. Sometimes, multiple modalities may be used such as semi-automatic weapons, assault type rifles, explosive, or even incendiary devices. These acts of violence are not restricted to jihadists, political revolutionaries, or antigovernment extremists. Oftentimes, these attacks are perpetrated by disgruntled employees, bullied students, delusional individuals, or an individual hate monger among other characterizations.
While any form of violence, whether perpetrated against an individual or a group is frightening and a cause for alarm, the use of military or paramilitary tactics, maneuvers and weapons against a civilian population entails especially ominous, vicious, and terrifying connotations and consequences. For instance, the realities imposed by confronting an armed attacker(s) who commits arson and is executing individuals using an AK-47, strapped with a bandolier of ammunition and fragmentation grenades, and wearing head-to-toe ballistic protection and night vision equipment, are quite different than those of the urban mugger demanding money or the armed street thug committing a robbery at a liquor store. In tactical ultraviolence/hybrid tactical violence, the perpetrator(s) has/have “upped the ante”, possibly via a thorough tactical planning and sophisticated military-style assault tactics and weaponry. At this juncture, the emergency services triad of police, fire and EMS assets responding will be confronted with a complex, challenging, evolving and dynamic tactical situation which may exceed the range of operational hazards that they are accustomed to.
Hybrid tactical violence attacks, especially, go beyond the definition of an active shooter event. The compound effect of this type of violence requires a paradigm shift of thought which involves a synergistic planning and response strategy. Essentially, the collective efforts and focus of the emergency services/public safety sector must stress a comprehensive and integrated counterterrorism/anti-terrorism approach.
In planning for such attack scenarios, planners need to conduct a historical survey of hybrid tactical violence events by revisiting the occurrences at, namely, Mumbai, the Columbine High School, the Aurora, Colorado movie theatre attack, the Dubrovka theater siege, the Las Vegas mass shooting, the Christchurch, New Zealand attack, the Charlie Hebdo event, the Sandy Hook, the Connecticut mass shooting and the multitudes of other examples of tactical ultraviolence, hybrid tactical violence and coordinated attacks. Lessons learned from these, and more such tragedies, are very valuable and close analysis is warranted to effectuate proper, safe, and successful collaborative multiagency responses. Optimal multiagency operational goals must focus on threat elimination and lethality/mortality reduction. This cooperative level of response can only be achieved through pre-event dialogue, collaborative planning, and joint public safety – emergency services exercises and simulation. Traditionally, the police, firefighters and EMS have compartmentalized roles, responsibilities, expectations, and rivalries which need to be adjusted and adapted to form effective and integrated public safety response/rescue task forces to respond to these high acuity, high impact events.

The concept and definition of interoperability is not limited to communications but needs to be applicable to our public safety/emergency services/first response agencies and its personnel. The collaborative and interoperable first responder is an essential commodity when responding to an asymmetric, high-threat event such as a hybrid tactical violence or coordinated attack situation. For example, EMS/Fire elements must be integrated into a tactical entry to provide immediate, lifesaving care and victim extractions while law enforcement provides operational security and tactical overwatch. There may be one or multiple attackers present in the tactical environment, and threat neutralization is of paramount importance. Yet, medical/rescue elements must be immediately available to provide life-saving interventions such as tourniquet application for severe extremity hemorrhage or to relieve a tension pneumothorax caused by penetrating chest trauma. The initial response cannot be delayed for the arrival of a Special Weapons and Tactics team (SWAT), and emergency medical assets cannot be staged a block away waiting for an “all clear” from the Incident Commander. The initial arriving units must be trained and ready to form an immediate Integrated Public Safety Response/Rescue Task Force team to address the immediate operational needs of the situation, such as tactical entry, threat elimination, victim rescue and emergency medical care. As additional units arrive, more assets can be used to serve as back-up entry teams, secure the perimeter, establish, staff, and secure a casualty collection/extraction point, perform render safe operations, provide additional tactical overwatch and other functions, as needed. Moreover, all personnel must be trained to recognize real or potential secondary, antipersonnel devices and always maintain a high level of situational awareness. Team operational safety is always first and foremost! It must be solemnly remembered that the lack of engagement due to awaiting scene security by law enforcement and, the cost associated with delayed response by fire and EMS response, were clearly documented in the Rand Corporation’s Lessons on Mumbai report [1] and in The Report of Governor Bill Owens Columbine Review Commission [2].
As in any emergency preparedness and response efforts, citizen engagement, awareness, training, and empowerment are integral components to enhance community wide preparedness and resiliency for tactical ultraviolence, hybrid tactical ultraviolence/coordinated attack events. This would include grass roots efforts provided by non-governmental organizations (NGOs) such as the American and International Red Cross / Red Crescent, and other entities such as the Arizona – based Integrated Community Solutions to Active Violence Events (ICSAVE) and the Southeastern Arizona Stop the Bleed Coalition [3]. These entities offer citizen awareness, preparedness and empowerment programs which allow citizens to participate in training and exercises that address topics such extremism, terrorism tactical ultraviolence and community wide emergencies. Specifically, courses such as “Stop the Bleed” turn citizens of all ages into immediate responders by being trained to control and stop severe hemorrhage through the use of direct pressure, tourniquets and wound packing. The “Stop the Bleed” program is a national initiative in the U.S which has attracted international attention. Similarly, there are other programs such as ” A.L.I.C.E.” and ” Run, Hide, Fight” which addresses active shooter countermeasures which our communities can take advantage of. The possibility of a Mumbai-style, coordinated, hybrid conventional weapons attack, or a Sandy Hook, Columbine type of school mass violence event, must be confronted, studied, and engrained into our mindset as professionals responsible for saving lives. And when lives are being lost to an attack during those initial few seconds, First Responders must have the readiness and adaptable capabilities of acting as a unified force and, without hesitation, stare down pure evil as a team and proceed to save lives.
References:
[1] A Rabasa, RD Blackwell,P Chalk,et al., Lessons on Mumbai. Santa Monica,CA. Rand Corporation, 2009.
[2] William H.Erickson, The Report of Governor Bill Owens Columbine Review Commission. Denver,CO., State of Colorado, May 2001.
[3] ICSAVE.org
Author: Bio
Frank Rando currently serves as an allied health programs educator / lead instructor and healthcare emergency preparedness/medical readiness /public health preparedness and tactical, operational – disaster medicine and homeland security Subject Matter Expert, educator, instructor and curriculum designer. He has served in instructional, guest speaker and consultative roles for DHS-FEMA, various components of the National Domestic Preparedness Consortium, DoD, industry, academia, health, safety and regulatory entities, emergency services organizations and healthcare. He recently served during the COVID-19 public health emergency as a clinician and clinical researcher and served in medical and health care support as a clinician for US Customs and Border Protection. Frank is also an experienced clinician, first responder and an occupational – environmental health scientist with real world experience in hazardous materials management, hazards and pollution control, biosafety, industrial, environmental and inhalation toxicology, environmental epidemiology, exposure and risk assessment and emergency response. Frank has also received advanced training in Integrated Biological -Chemical Response from the US Army -Dugway West Desert Test Center and the National Ebola and Special Pathogens Training Centers. Frank’s experience includes public safety roles in law enforcement, pre-hospital medicine/EMS and military duty as a Nuclear, Biological and Chemical/CBRN Specialist, NBC medical defense instructor Special Forces Medical Sergeant, Dive Medical Technician, Intelligence Sergeant, and Medical Intelligence Analyst.