There is an increasing violent threat to emergency responders on the horizon — Hybrid Targeted Violence (HTV) attacks.
HTV is defined as the use of violence, targeting a specific population, using multiple and multifaceted conventional and unconventional weapons and tactics. The HTV attackers often target several locations simultaneously.
HTV attacks overseas have increased and recent events in France, Lebanon, Tunisia, Kenya and Belgium should give us concern here in the U.S.
The attack in Paris, still raw and palpable in our hearts and minds, shows the vicious and senseless disregard for innocent lives that HTV attackers embrace. The terrorist attackers have only one end game: To kill as many people as possible before they die, either by self-detonation, or by law enforcement use of force. Many experts believe that it is only a matter of time before an HTV attack is launched in the U.S.
In November of 2008, one of the most deadly HTV attacks occurred in Mumbai, India. Ten Pakistani Islamic militants attacked several venues with automatic weapons, grenades and intentionally burned several buildings. In a span of four days, 164 people were killed and over 300 people were injured in this well-coordinated and vicious attack.
Components of hybrid targeted violence
HTV attacks differ from the more common active shooter incidents (ASI) in that they tend to involve more perpetrators, and use of military type tactics and weapons to hit multiple targets. HTV attacks may include the following components:
- Well-trained, tactically competent, and willing-to-die perpetrators.
- Multiple operators (attackers) working in small tactical units.
- Effective internal and external communications/coordination.
- Purposeful luring of first responders to inflict even more carnage.
- Use of fire to complicate first-responder operations and cause further damage.
- Use of high-powered military type weapons and explosives, including suicide bomb vests.
- Release of toxic hazardous materials requiring hazmat and decontamination.
While HTV attacks are not exactly new, or unheard of in the U.S., intelligence estimates show that international extremist groups are very interested in initiating, supporting and inciting this kind of attack on American soil. Events such as the April 2013 Boston marathon bombing, killing of a police officer and following shootout qualify as an HTV attack.
HTV prevention and response preparation
The FBI and other federal, state and local law enforcement agencies have significantly increased awareness, diligence and have been successful in the disruption of many terrorists’ cells in the U.S. In addition, recent advancements in coordinated and multidiscipline response to active shooter incident, such as the development of Rescue Task Forces will better prepare us for the inevitable HTV attack.
Active shooter incidents and other mass casualty attacks are not uncommon in the U.S. The recent FBI report titled, “A study of Active Shooter Incidents in the United States Between 2000 and 2013” clearly shows an increasing trend of these kinds of incidents averaging about one a month in the last few years.
There are some lessons learned from recent active shooter incidents that are directly applicable to HTV attacks, but there are some significant differences where response strategies must differ. For example, the vast majority of ASIs in the U.S. were instigated by a single perpetrator (all but 2 of 160 incidents analyzed by the FBI were a single shooter). Another interesting finding is that most active shooter incidents are over in 5 minutes or so. Short duration will not be the case with most HTV attacks.
Most law enforcement, EMS and fire departments have drastically changed their approach to an active shooter incident. Local police realize they can no longer wait for the SWAT team to mobilize. The current widely accepted standard is for responding law enforcement officers to immediately go toward the crisis site/shooter with whatever resources are on hand.
Police are looking to engage, distract and hopefully neutralize the threat. This active shooter law enforcement strategy is similar, but not exactly the same response to an HTV; aggressive, rapid response to distract, engage and neutralize the threat with whatever resources are available. Hopefully, the law enforcement response will include multiple officers to increase the chances of rapidly neutralizing the threat.
In the meantime, other forces begin to muster and stage outside the crisis site. This includes a variety of law enforcement, fire departments and EMS assets.
Top priorities in active shooter incident
The public safety community has largely embraced the concept of unified command and a multidiscipline and coordinated approach to save lives. The top two priorities in active shooter incident and HTV attacks are threat elimination and lethality reduction. In other words:
1. Stop the killing!
2. Stop the dying!
The adoption of Rescue Task Force type models, bringing law enforcement and fire/EMS assets together, greatly enhances the ability to deliver medical assets to the crisis site quickly, yet with a protective force to insure greater safety for all involved. This multidiscipline approach to active shooter response is becoming more accepted with increased availability of training, equipment and exercises. There are several publications, national organizations and white papers supporting the notion of a multidiscipline and coordinated response to an active shooter incident; all emphasizing responder safety, threat elimination and rapid medical aid to casualties.
The HTV presents a significant increased threat, not only to the initial victims, but to the responders themselves. Overseas HTV attackers have purposely lured rescuers into targeted areas and have even attacked police stations directly. The other HTV attack game changer requires all responders to be able to react to and deploy to multiple locations with appropriate assets. For example, there needs to be some coordination between target locations to insure one hospital is not overwhelmed with casualties from multiple sites. The ICS concept of Area Command should be considered, where coordination from an Emergency Operations Center might be better suited to manage a multiple site HTV attack.
Preparing for an HTV attack
There is still much work to be done to increase our readiness for HTV attacks. Current emergency responder training strategies tend to be role-defined public safety disciplines working in silos, training in isolation from one another with an occasional exercise that brings the various disciplines together.
There are challenges to implementing a new multidiscipline, coordinated, seamless response strategy because of linear, stove piped perceived responsibilities, as well as historical and political hurdles. Fire suppression, threat elimination and rendering of casualty care should not be looked at as separate and sequential events; nor are they to be managed by separate disciplines in traditional lanes of responsibilities. The new paradigm and reality necessitates a more comprehensive overhaul of our current strategies.
With the threat of an HTV, all public safety responders must develop well-crafted strategies and practices to cooperatively respond to active enhanced threats that may use military type weapons, strategies, and maneuvering tactics. These threats will likely use high-powered firearms, improvised explosive devices, and the use of fire as a weapon.
The integration of law enforcement, EMS and fire during active shooter and HTV incidents has been well established in some enlightened and forward-thinking jurisdictions around the country. Others are working their way through the administrative, labor, training and policy process to develop Rescue Task Force models. Unfortunately, some areas have yet to address this challenging paradigm shift for one reason or another. All public safety personnel must plan to respond to the real threat of an HTV attack together, or will inevitably deal with the attack in a traditional role-defined manner thus resulting in greater loss of life, possible including responders themselves.
The August 2015 Interagency Board produced a well-crafted Executive Strategy that outlines HTV and active shooter issues and makes recommendations for policy makers to begin a more comprehensive integrated response plan. The Interagency Board recommends this process needs to include federal, state and local government officials, law enforcement, fire, medical (hospitals), EMS; as well as dispatch center, labor, legal, and fiscal representatives.
Best practices to effectively prepare for HTV attacks will require all public safety disciplines to be part of the same team, with the same priorities, strategies and training to most effectively eliminate the threat and provide needed medical care to the casualties. This, of course must be done while offering the utmost priority to public safety protection from the threat itself.
Resources to learn more
Learn more about active shooter incident and HTV attack response with these resources, position statements, guidelines and training courses.
- Committee for Tactical Emergency Care. 2014 Tactical Emergency Casualty Care (TECC) Guidelines.
- International Association of Fire Chiefs. (2013). IAFC Position Statement: Active Shooter and Mass Casualty Terrorist Events.
- Active Shooter Incidents: The Challenge for EMS. Washington, DC: Government Printing Office. U.S. Department of Homeland Security (2008).
- Morrissey, Jim. Active shooter: Rescue Task Force medics get to victims faster.
- Morrissey, Jim. Standard EMTs need to be ready for active shooters.
- Fire/Emergency Medical Services Department Operational Considerations for Active Shooter and Mass Casualty Incidents. Washington, DC: Government Printing Office. Urban Fire Forum (2014).
- Integrating Law Enforcement, Fire, and Emergency Medical Services during Active Shooter/ Hybrid Targeted Violence Incidents (August 2015) - The InterAgency Board.
- Federal Bureau of Investigation (2013). A Study of Active Shooter Incidents in the United States Between 2000 and 2013. Washington, DC: Government Printing Office.
- Active Shooter, How to Respond.
- A Paradigm Shift for First Responders: Preparing the Emergency Response Community for Hybrid Targeted Violence, Police Chief Magazine. May 2013.
- Hybrid Targeted Violence: Challenging Conventional “Active Shooter” Response Strategies. Homeland Security Affairs, Vol 10, article 3 (February 2014).
