Lessons Learned from a Decade of Conflict - Boekje Pienter

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And schools are the only place in America where large numbersof children can be found, relatively unprotected, throughlong periods of the year and where schedules are easy to obtainthrough even rudimentary intelligence-gathering efforts (mostare on school Web sites).Learning from the PastIn examining even the most recent significant school attacks inAmerica, we can glean valuable lessons. Although the attack onthe elementary school in Beslan may well be the worst situationimaginable, right now our enemy is imagining an attack quite abit worse than even that.Attacks on schools can and will take place on a variety of levelsfor both our tactical operators and medic/rescuers. For instance,lower-level school attacks by U.S. children and adults in recentyears may well approximate the homegrown, individually motivatedterrorist attacks al Qaeda is seeking to inspire in every oneColumbine: Lessons LearnedVisit www.JEMS.com for a look back on lessons learnedfrom the Columbine school shooting as we near the 10thanniversary of the incident. Wayne Zygowicz, EMS chieffor Littleton (Colo.) Fire Rescue, shares his thoughts onhow the incident has changed his agency’s response toactive shooter incidents.of the 2 million Muslims in America. Therefore, it’s importantto look at some of the more significant recent attacks that ourenemy is even now studying, and looking to outdo.I’ve encountered many school administrators who say theydon’t have to worry about Beslan happening at their schools.They point out that there were more than 100 bombs in that attackand that was possible only because Beslan sat on the edge ofa war zone. In reaching such a conclusion, however, they’re ignoringthe intel on one of the more devastating attacks Americahas already experienced.Most people in our country are familiar with some aspects ofthe attack on Columbine High School in Colorado, committed byDylan Kleibold and Eric Harris on April 20, 1999. What many donot know: In that attack, two untrained teenage assaulters manufacturedand transported more than 90 explosive devices to the school.The majority of the bombs did not explode, due to an error theymade in the use of a certain type of clock as a timed detonator.And while most school administrators and teachers don’tknow what that mistake was, they must recognize that studentswho contemplate launching a Columbine-style attack—and terroristsconsidering the same thing—do know what Kleibold andHarris did wrong. Each of them will ensure the same mistake isnot repeated.The body count at Columbine resulted in modificationsin law enforcement response tactics throughout the country.“Active Shooter” responses by police since that time (immediatelyattacking the threat) have resultedin many school attacks being quicklystopped before the shooters could amass aColumbine-level toll in human life. Butnothing about the Active Shooter responseaddresses the holding of children hostage.In two of the more recent attacks inAmerica, we’ve seen adults entering schools,intent on holding hostages, sexually assaultingyoung girls and ultimately killing studentsin buildings that should be sanctuaries fromharm. On Sept. 27, 2006, Duane Morrison enteredRoom 206 in Platte Canyon High Schoolin bucolic Bailey, Colo. He held hostage sevenyoung ladies, brutally sexually assaulting all ofthem over a four-hour period, before his threatsto blow up the building forced a law enforcemententry that resulted in the death of16-year-old Emily Keyes and himself.One week later, on Oct. 2, 2006, CharlesCarl Roberts walked into a one-roomAmish school building in tiny NickelMines, Pa. He drove everyone out of thebuilding but 10 young girls, all of whomwere bound by their feet and made to lieshoulder to shoulder beneath the blackboard.He, too, sexually abused childrenbefore killing them.Shortly after the arrival of the PennsylvaniaState Police (PSP), he began shooting.At the sound of the first shot, PSPtroopers raced to the building and attemptedimmediate entry, where they encounteredlumber barricades Roberts had nailed over thedoors and windows. The police fought desperatelyto gain entry; one state trooper tore outall his fingernails trying to rip wood away.Breaching the building took a little more thantwo minutes—rapid entry in light of the fortificationsencountered. But Roberts neededmerely eight seconds to discharge 13 roundsinto the 10 girls, killing five and leaving one in avegetative state.Seung-Hui Cho had the advantage of seeingall of this in the half-year prior to his attackon the Virginia Tech campus. And in each attack,the tactics and fortifications of the assailantwere better than the ones that had comebefore. At the Bailey, Colo., school attack,Morrison had packed the space between thedoor and himself—30 feet across the room—with all of the desks and chairs. He held EmilyKeyes in front of him as a human shield whilepolice fought their way through the jumbledfurniture, not daring to take a thin-marginshot from such a distance. One week later,Roberts’ fortifications in the small schoolhousewere even better.6War on TraumaJournal of Emergency Medical Services
Cho improved on them both during his attackat Virginia Tech. He selected Norris Hallin part because it was one of the few remainingbuildings whose doors had the old-stylehinged swing bars, rather than the solid pushbars found in buildings today. This enabledhim to simply loop chain through the bars andsecure them with inexpensive locks, therebyeasily trapping his prey in the building, as wellas fortifying it against law enforcement entry.As with the two prior school incidents, lawenforcement fought to gain entry, ultimatelyblowing the deadbolt lock out of another doorwith a shotgun slug. Contrary to news reports,from the moment of the breaching round, ittook the entry teams merely 38 seconds to maneuverthrough a large and complex machineshop, race around a corner, down a short halland into a recessed staircase (while a secondteam raced all the way down a 40-yard corridorto the next set of stairs) and reach thesecond floor, forcing Cho to take his own life.Even then, the carnage was so great the policewould not initially accept there had beenonly one shooter. While attempting to securethe students against further attack, police andtwo tactical medics began providing medicalcare to the dozens of affected students andteachers. In all, 30 innocent people perished,with another 25 suffering wounds and injuries;this, in addition to the two lives Cho tookearlier that morning in a distant dormitory.Beslan Stands AloneMy own experience with school attacks isgreater than I would like it to be. Two of ourorganization’s founding directors led the investigationinto Columbine; I know dozens of thepolice and SWAT team members and leaderswho responded to that attack.I was asked to conduct an assessment of thelaw enforcement response immediatelyafter the siege ended at the Bailey,Colo., school. I know two ofthe Pennsylvania StatePolice SRT team members and leaders at Nickel Mines, and hadcoincidentally been nearby training the York City SWAT Teamwhen the shooting took place, enabling me to contact the operatorsto understand what they had confronted. And when VirginiaTech happened, I was asked to travel there immediately with asmall team of top law enforcement professionals to begin an indepthassessment.But as bad as Norris Hall was, it was not the worst either I, orthe world, had ever seen, for the tragic title of “the worst school attack”belongs to Beslan, Russia. The time I had spent working andstudying in Russia every year for almost two decades—includingannual time spent over 13 years with Russian Airborne and SpecialForces units—proved invaluable to helping me gain entry intothe school immediately after the battle ended. I debriefed dozensof soldiers, government officials and townspeople.Beslan FactsAt Beslan, 49 terrorists took more than 1,200 people, mostlywomen and children, hostage at approximately 9 a.m. on Sept. 1,2004 (the first day of school in Russia, when families typically accompanyschoolchildren to school). Hostages were brutalized inways almost unspeakable. Children were beaten savagely; olderteenage girls were raped, some repeatedly, through the days ofthe siege. Two fathers were murdered immediately in the gymwhere the hostages were originally massed, and another 21 of thelargest adult males and older teenage boys were shot to death.The Beslan terrorists brought upward of 200 explosives intothe school. Many were placed in the gym where the majority ofhostages were held throughout the siege. Others were spreadthroughout the school, with numerous booby traps set in thehallways. Other groups of children were held in separate roomsamidst bombs designed to kill them when a rescueattempt ultimately came.Photo AP / ivan SekretaravDuring the Beslan siege, soldiers,medics and even townspeople joinedin the rescue effort, which quicklyoverwhelmed available forces.Elsevier Public Safety War on Trauma 7
Page 1 and 2: Lessons Learned from a Decade of Co
Page 3 and 4: You check your rig and preparefor a
Page 5: The Department of Homeland Security
Page 9 and 10: In this era of terrorism, all perso
Page 11 and 12: Photo office of medical history/Sur
Page 13 and 14: the patient is flown directly to th
Page 15 and 16: At times, EMS providers may not kno
Page 17 and 18: Delphi®EMTEmergency& MedicalPneuma
Page 19 and 20: These results can be appliedto the
Page 21 and 22: Military rescuers are trained to ut
Page 23 and 24: ConclusionMilitary medicine has con
Page 25 and 26: pain to the distal extremity, somet
Page 27 and 28: with the letters “TK” on their
Page 29 and 30: Identification of Stress SymptomsEm
Page 31: A breakdown of analytical processes

Lessons Learned from a Decade of Conflict - Boekje Pienter

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