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Luke Hodgson’s article “How Violent Attacks Are Changing the Demands of Mass Casualty Incidents: A Review of The Challenges Associated with Intentional Mass Casualty Incidents” is an important contribution to the development of homeland security as a profession because it validates that complex homeland security challenges, such as responding to mass casualty incidents (MCIs), can be effectively evaluated and solved by practitioner-academics; those who work in homeland security professions and receive academic training in homeland security and defense and research methods.1

Hodgson’s article identifies the operational and clinical challenges associated with responding to more lethal, more complex, and often deliberate mass casualty incidents, which are characterized by rescuers requiring force protection, multi-agency and multi-disciplinary scene and system management, widely used but flawed triage systems, and obsolete concepts of operations. Hodgson evaluates best practices in the domestic and international models of MCI management and uses evidence to argue convincingly that in today’s dynamic homeland security operating environment, the response to mass casualty incidents, especially deliberate incidents, requires new concepts of operation, clinically validated triage systems, and comprehensive multidisciplinary coordination at the scene and within the EMS system.

Features of Hodgson’s strategies and solutions are generalizable to other complex homeland security and defense challenges. Many of these challenges are effectively solved by practitioner-academics because they can leverage their professional experience with academic research methods and analytic techniques. Numerous homeland security and defense challenges, especially in the post 9/11 and post COVID-19 eras, demand solutions that incorporate the diverse perspectives and expertise of many disciplines. For many professions, such as EMS, fire, and public health, homeland security responsibilities are an overlay on an existing discipline-specific skill set. Dynamic homeland security challenges require that these disciplines adopt practices that are evidence based, verified by evaluation, and that iteratively evolve as adversaries and threats evolve.

How Violent Attacks Are Changing The Demands of Mass Casualty Incidents: A Review of The Challenges Associated with Intentional Mass Casualty Incidents

About the Author

Michael Petrie has 40 years experience in EMS, emergency services, and homeland security, including leading some of California’s highest profile EMS systems. Mr. Petrie currently provides homeland security and emergency management consulting and advisory services for government agencies and offices. Before his retirement from full-time employment, he served as the Monterey County EMS Bureau Chief, the Santa Clara County EMS Chief, and the City and County of San Francisco’s EMS Administrator. His work included numerous homeland security functions, including WMD and mass casualty incident planning and response, intelligence fusion and analysis, capability and threat assessments, and routinely serving in leadership positions in military and civilian operations centers. Mr. Petrie is a certified emergency manager (CEM®), has been a licensed EMT/Paramedic for over forty years, and has been awarded the State of California EMS Authority’s Meritorious Service Medal and Distinguished Service Medal. Mr. Petrie served on the faculty of the University of California, Berkeley as the Director of the CIDER Emergency Management Sciences Program, and at the Naval Postgraduate School’s Center for Homeland Defense and Security (CHDS), where he continues to serve as a thesis adviser. Michael holds a Master’s in Business Administration, a Masters of Arts in Security Studies (Homeland Security) from the Naval Postgraduate School, a graduate certificate in Terrorism Studies from the University of Saint Andrews, and a Graduate Certificate in Geopolitical Economics and International Relations from the London School of Economics and Political Science. He may be reached at


1. Luke Hodgson, “How Violent Attacks Are Changing The Demands of Mass Casualty Incidents: A Review of The Challenges Associated with Intentional Mass Casualty Incidents,” Homeland Security Affairs 17, Article 1 (April, 2021)


Copyright © 2021 by the author(s). Homeland Security Affairs is an academic journal available free of charge to individuals and institutions. Because the purpose of this publication is the widest possible dissemination of knowledge, copies of this journal and the articles contained herein may be printed or downloaded and redistributed for personal, research or educational purposes free of charge and without permission. Any commercial use of Homeland Security Affairs or the articles published herein is expressly prohibited without the written consent of the copyright holder. The copyright of all articles published in Homeland Security Affairs rests with the author(s) of the article. Homeland Security Affairs is the online journal of the Naval Postgraduate School Center for Homeland Defense and Security (CHDS).

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