LAS VEGAS — Twenty-three years after the largest terror attack to ever occur on U.S. soil took the lives of more than 3,000 people, including more than 400 emergency personnel, leaders from the FDNY took the stage at EMS World Expo 2024 to share their reflections and insights.
The panel included:
- Cesar Escobar, assistant chief of EMS operations, FDNY
- Glenn Asaeda, MD, FACEP, FAAEM, DABEMS, chief medical director, FDNY; assistant medical team manager, FEMA New York City Urban Search and Rescue NYTF-1 Team; auxiliary police officer, NYPD
- John Peruggia, MSM, chief of EMS (retired), FDNY; adjunct professor, Metropolitan College of New York
Memorable quotes
- “I had thought that I had seen every imaginable emergency event a first responder could respond to ... On Sept. 11, 2001, I realized I was wrong.” — John Peruggia
- “When you thought it could not get worse, it got worse and worse and worse.” — Dr. Glenn Asaeda
- “We thought we were going to go here and save lives but all we saw was destruction.” — Cesar Escobar
- “The FDNY does not usually call for help. We are the help.” — Cesar Escobar
Top takeaways
Dr. Asaeda, Escobar and Peruggia shared their first-person accounts from the World Trade Center grounds on 9/11 – and what has improved, and continues to improve in emergency response since that unimaginable incident.
1. Controlled response and accountability
Sept. 11, 2001, Escobar, participating in refresher training, in a facility with a direct line of sight to downtown Manhattan, joined a couple dozen fellow paramedics and EMTs in commandeering a NYC public bus to get down to the site.
They were not the only responders to self-deploy.
The attacks occurred right before the FDNY’s shift change, which meant those coming on shift were already in the firehouses, eating breakfast, working out, discussing the prior shift. When the call came out – they all responded. Engines were deploying not just with the documented on-shift crew, but with 10 members. Accountability was impossible, even before the communications went down – the panel shared.
As the event unfolded, and in the days that followed, ambulances were lined up down the highway for a mile – or two – from destinations as far as Canada, Dr. Asaeda shared.
Even civilians rushed to the scene, with doctors and nurses setting up makeshift clinics in blown out storefronts, treating injured responders. State police had to start shutting down roads and moving people away from the scene.
One lesson we’ve learned is you need a plan to control everyone else who wants to come and help during a disaster, Peruggia noted. “If they’re on your scene, you’re responsible for them.”
Having a multi-tiered disaster response plan, which clearly outlines when and how to enlarge the scope of mutual aid response, is essential to a controlled response.
2. Communications and command
Sept. 11, 2001: Peruggia immediately headed to the scene and was in the tunnel to Manhattan when the second plane hit. He donned his gear and walked 6 blocks to check in with FDNY Chief, Peter J. Ganci Jr. Looking to the inferno above, Gancy told Peruggia, “We’re never going to be able to put those fires out. All we can do is hope to save as many people as possible.” He told Peruggia to be careful, watching for falling debris, and those leaping from the towers.
That was the last thing Gancy said to Peruggia. He was killed in the subsequent tower collapse.
When the buildings came down, so did communications, as the antenna for all the broadcast networks in the tri-state area sat atop one of the towers, presenting one of the biggest challenges to the response: there was no way to tell people not to come.
While responders were flooding to the scene, and local hospitals were clearing cafeterias and lobbies for incoming mass casualties, when the towers fell, those inside were killed instantly.
“All of us who responded that day at one point felt a futility – where are the patients?,” Escobar shared.
The lessons learned in how to better plan with, communicated with and train with partner agencies translates to improved mutual aid.
Rather than treating the expected thousands from inside, incoming paramedics and EMTs were treating those fleeing blocks away, and then turning their attention to responders injured from debris or from searching for survivors.
“We stage as we go,” Dr. Asaeda recounted. “Had the buildings stood a little longer, there would have been more EMS casualties.”
3. Specialty training
Sept. 11, 2001: Dr. Asaeda, from the command post, watched people jumping from 90 floors above – and image which haunts him to this day – and realized all the medical training training in the world wasn’t going to be able to help these people.
The communications failure also prohibited commanders from requesting the additional support truly needed. With so many lost or missing after the collapses, what was really needed were search and rescue teams.
“We were on our own for about 72 hours,” Dr. Asaeda noted, while USAR units were stated and ready, but waiting for the order to deploy.
Since 9/11, rescue teams with highly specialized training designed to go into a confined space and provide prolonged care have been established and incorporated into disaster management teams.
“We realized planning and risk assessment are critical for fire and EMS agencies and we need to continually think outside the box,” Peruggia said. “If you’re thinking that could never happen, it could happen. Prepare for it.”
The panel honored those lost in the attacks and through related illnesses – which has surpassed the number of those killed on 9/11, noting, “we will never forget.”
Visit Lexipol and the EMS1 Grants team in booth #3107 in Las Vegas!
