Page 32 - SyI Quarterly 9 final

Education and Learning

Approved Training Provider Insight:

Why are casualties left

waiting for so long to receive

emergency medical attention?

By Richard Pendry MSyI, Pendry Risk Management

After the Bourgh Market attack in 2017 that left eight dead and nearly 50 injured, the
London Ambulance Service medics were unable to access some casualties for over two
hours.

But this is not the only time that emergency first aid had been delayed to victims of a
terrorism. Manchester Arena bombing victims ‘felt abandoned’ by the emergency services,
was a recent declaration made to the inquiry looking into the terror attack, with some
victims bleeding for hours before their injuries were treated by emergency professionals.

The average response time for the ambulance service for a category one call involving a
life-threatening incident is between 7 – 15 minutes. The average response time for the fire
brigade is 8 minutes. So why then was there a delay of over two hours in dealing with some
of the casualties in the Borough Market and Manchester Arena attacks?
The delay occurred because Operation Plato was enacted on both occasions. Op Plato is the
tactic used by the security services when dealing with a Marauding Terrorist Attacks (MTAs).
MTAs are fast-moving, violent attacks where assailants move through a location aiming to
kill as many people as possible. Most deaths during such an incident occur within the first
few minutes before police are able to respond and neutralise the perpetrators.

When Op Plato is enacted, various protocols automatically come into play. One of these is
that under a duty-of-care provision, only designated operators should be allowed into a HOT
zone – an area where the attackers are thought to be at large. The operators in question are
normally counter terrorism Specialist Firearms Officers (CTSFOs) who’s primary objective
would be to neutralise the threat so that the paramedics can then go about their business
in safety. It is for this very reason, that casualties at Borough Market and Manchester Arena
were denied in some instances, lifesaving attention.

MTAs are not a new phenomenon. They originated in the hight threat environments of Iraq
and Afghanistan but then, they were known under a different name: The Complex Attack.
The Taliban utilised the attack methodology in Afghanistan ruthlessly. The Complex used on
a regular basis on both hard and soft targets to devastating effect.

The attack methodology would go something like this: the lead attacker wearing a suicide
vest would blow themselves up at the main gate. The explosion created an opening that
allowed the other attackers - also armed with suicide vests and automatic weapons - to rush
in. The tactic was well rehearsed with military precision, the speed of the attack allowing

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