From chaos to command: Lessons from the New Year’s Day tragedy in New Orleans

In this sobering episode of EMS One-Stop, host Rob Lawrence sits down with Chief Bill Salmeron of New Orleans EMS to discuss the tragic events that unfolded on New Year’s Day 2025, when a vehicle plowed through crowds in the French Quarter, resulting in 15 fatalities and 57 injuries, including two police officers.

Chief Salmeron provides a detailed account of the incident, the immediate EMS response, and the coordinated efforts with law enforcement and hospitals to manage the mass casualty incident.

The conversation also delves into the psychological impact on EMS personnel, the value of training and preparedness, and lessons learned from handling such a large-scale event.

Chief Salmeron emphasizes the importance of communication, mutual aid and the mental wellbeing of first responders, offering insights into how New Orleans EMS plans to support its teams in the long recovery process ahead.

Key quotes from the episode

• “You don’t teach that level of decision-making in EMT class. Telling a family member or police officer that you can’t help their loved one is one of the hardest things you’ll ever do.” — Chief Bill Salmeron
• “The recovery from an incident like this doesn’t take days or weeks – it takes years.” —Rob Lawrence
• “I told my team to go back to headquarters. I needed to put eyes on every single one of them and make sure they were OK.” — Chief Bill Salmeron
• “Situational awareness and incident command are critical. It’s about restoring order from chaos.” —Rob Lawrence
• “What we do is a unique calling. It’s critical to appreciate and take care of each other and ourselves.” — Chief Bill Salmeron
• “This episode is a masterclass for anyone planning for mass casualty incidents. Listen, learn and prepare.” —Rob Lawrence

Timeline

00:21 – Introduction to the episode and overview of 2025’s challenging start, including the New Year’s Day tragedy in New Orleans
01:22 – Chief Salmeron describes the initial setup and EMS operations in the French Quarter
03:26 – Incident details: the truck’s path, immediate EMS response, and the scale of injuries
06:01 – Incident command and mutual aid coordination, including the deployment of 13 ambulances
09:43 – Managing hospital capacities and patient transport logistics during the MCI
15:11 – The discovery of explosive devices and the role of EMS in securing and retreating from the scene
23:01 – Post-incident response: staff debriefings, mental health support and lessons learned
33:31 – Preparing for future events like the Super Bowl and Mardi Gras under heightened security
41:06 – Five key takeaways for leading and managing mass casualty incidents
50:28 – Closing thoughts and appreciation for first responders’ dedication and resilience

Additional resources

• New Orleans EMS