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The existence of terrorism is not new but sitting back and thinking it is something that happens overseas is an indulgence that we no longer can afford. The FBI defines terrorism as "the unlawful use of force or violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives." Recently, we witnessed domestic terrorist attacks involving the use of explosives, some of them with hidden secondary devices intended to injure and/or kill responders.
From 1990 to 1995, there were 15,790 criminal bombing incidents in the United States. The result was 355 people killed, 3,176 injured and $659.1 million in damage, according to the FBI's Explosives Unit/Bomb Data Center. Usual targets of these bombings are locations with a specific focus such as mass gatherings, structures with particular distinctions (government buildings, abortion clinics, physical plants with political tenants and centers of commerce). In each of these instances, the common denominator is the potential for a high-impact event, significant casualties and a requirement for a multi-agency response.
An alarming trend that involves the use of secondary or additional perimeter devices has been noted of late. Although this is a technique common in military operations, as emergency response personnel we have not really taken into account this anti-personnel maneuver and how it will directly affect our scene safety and choreography strategies.
When a bombing occurs, the public has a belief that the emergency response community can and will respond in a professional and appropriate manner. Consistent with the sheer existence of an emergency response agency, a community bond and public trust are promulgated whereby the community expects us to prevent or rescue them from these events.
By the use of secondary devices, the net result is the neutralization of the emergency response organization's ability to achieve its mandate of scene stabilization and assistance to the community. The failure to meet this public mandate also plays into the hands of the sponsoring or perpetrating individual(s)/organization(s) by demonstrating the alleged vulnerability and impotence of the government in this case, emergency responders to protect themselves or the public.
A prime example of the risk exposure from secondary devices can be seen examining the Atlanta abortion clinic bombing. A secondary device was detonated on the periphery and resulted in the injury of six people. For an EMS or fire department response, this problem exposes our membership to potentially devastating injuries, complicates scene management due to responders injured or killed, and escalates the victim count, requiring the commitment of additional resources at the scene to manage the events.
Scene Safety & Operations
As with any other emergency response, the first step required for a safe and effective management of the event is to implement the incident management system (IMS). All agencies should have an adequate understanding of IMS and how to implement it, as well as their response roles and responsibilities.
Clearly, EMS providers should be concerned with the location, extrication, triage, treatment and transportation of the injured. An explosion site is not the place for "freelancing." Location of additional devices and crowd control is the responsibility of law enforcement agencies. Implementation of the IMS process with a good member accountability system is key to avoidance of the above cited problems.
While enroute to the scene, units should ask the dispatch center to relay any pertinent information about the event. This should include but is not limited to the staging area, numbers of patients, suspected device vs. actual explosion, command post location and whether radio traffic has been cleared for the area. If the clearance for radio transmissions at the site cannot be determined, then it should be assumed that transmissions are prohibited.