Updated June 2105
Getting ready for Mardi Gras means lots of planning and long hours for the 147 employees of New Orleans EMS. This year, the annual celebration overlapped with another mammoth event: Super Bowl XLVII, held at the Superdome. To accommodate both, city officials pushed back the Carnival parades—the traditional start of Mardi Gras—by a week, then paused the parades for nine days to host the big game, and then picked up the parades again afterward. All told, more than 1 million visitors came to New Orleans between Jan. 25 and Feb. 12 for three weeks of parades, parties and pageantry.
The year leading up to the Super Bowl was a whirlwind for Ken Bouvier, deputy chief of New Orleans EMS, who figures he attended at least one meeting daily with officials from the U.S. Department of Homeland Security, the FBI, police, fire, the NFL and the Superdome to prepare for what was designated a National Special Security Event. “I can’t express how important the planning portion is,” Bouvier says. “The fact that we have a good management team and that we’re a busy service all year long helped us. So did our experience hosting the Super Bowl in 2002. And our partners all played an important part in this being successful.”
Bouvier got his start in EMS in 1974 as a volunteer firefighter-EMT for the Westwego Fire Department outside New Orleans, running his first call on his 18th birthday. He was soon hired to work for the Monsanto Co. agricultural chemical plant in Luling, La., becoming chief in 1984. While chief at Monsanto, Bouvier continued to work part-time as a paramedic for New Orleans EMS. After his retirement from the plant in 2012, he went to work full time for New Orleans EMS.
Bouvier spoke with Best Practices about his nearly 40 years in EMS and what it took to prepare his city of 360,000 for Hurricane Super Bowl/Mardi Gras.
When did you start planning for the Super Bowl?
It was on our radar for a year and a half. The actual coming-down-to-the-wire preparations were the last nine to 12 months. We had representatives who went to Indianapolis [the site of 2012’s Super Bowl] and shadowed EMS there. As soon as they came back, we started talking about what we’d have to do. We attended from five to eight meetings a week for the last six months. The meetings were with Homeland Security, the FBI, police, fire and EMS, the NFL and the Superdome folks.
The NFL actually started arriving here Jan. 3, a month before the game. From then on there was construction. They started closing streets for repairs and tree planting, and there were contractors all around the dome area for a month. We handled people getting hurt on construction sites. Starting on Jan. 28, we had to start providing paramedics at different venues, including the media center and the NFL Experience at the convention center.
What were some of the lessons learned in Indianapolis that helped you in your preparations?
Indianapolis had a written plan, and we tweaked it to fit New Orleans. The folks in Indianapolis told us they had used the written plan from the previous Super Bowl, so the lessons learned each year from Super Bowl to Super Bowl helped us. This was also our 10th time hosting a Super Bowl, so we still had some memories from when we hosted it in 2002.
One specific thing we learned from Indianapolis was to use small specialty vehicles to get through the crowds. In New Orleans, we used SUVs, enclosed ATVs and bicycle medics.
We also learned about the importance of interoperability of communications so that EMS, fire, police, Homeland Security, the FBI, the National Guard and the NFL—everybody involved—knew how to find each other on the radio. And we made sure all the public safety people who mutual-aided with us knew how to hail another agency and tell them which channel to go through.
What was your experience during Katrina?
At the time I was still working at Monsanto as the fire chief. It’s located 15 miles to the west of New Orleans. When the hurricane was threatening New Orleans, EMS Expo was going on in New Orleans. On Friday, Aug. 27, I took the stage at Expo and told people to heed the warnings and start getting out of town. It looked like the city of New Orleans was going to take a direct hit.
On Sunday evening, I had to go to Monsanto. The storm hit early Monday morning. We had moderate damage but no flooding. New Orleans had also survived the hurricane—the issue was when the levies broke, which caused major flooding. I stayed at Monsanto all day Monday. On Tuesday morning, my bosses said, ‘It looks like the city of New Orleans is going to need your help more than we do.’ I went to my part-time job at New Orleans EMS. I was put in charge of all the street ambulances and mutual aid ambulances.
New Orleans EMS was busy evacuating people, sending them out by any means of transportation they could get to, including helicopters. We had calls from people trapped in homes who couldn’t swim. We had the elderly who couldn’t wade through water. We had mentally challenged patients, special-needs patients who had lost power and didn’t have their oxygen or who were in need of kidney dialysis treatment. We got to calls any way we could. We went by boat, in high water trucks or by wading through water.
Our EMTs and paramedics were rescuing people, but they were also victims. At least three-quarters of our personnel either had significant damage to their homes or lost everything they had—their homes, their vehicles, their motorcycles, their belongings. Our people did great. They stayed strong. But they also had a lot of uncertainty. They didn’t know what their future would bring. They couldn’t go home and worry about their own problems; they were forced to work and save other people. Many of them were separated from their families for weeks. If we gave them a day off, a lot of them tried to make it to Texas, where a lot of their loved ones had evacuated to. They’d get off from work, travel all night to see their family and get back in time to get on the truck for the next day.
The first 10 days were really, really tough on New Orleans EMS. You felt like you didn’t have enough supplies, and the federal assistance wasn’t coming fast enough.
Given your experience, how do you feel watching other large disasters, like Superstorm Sandy?
We know firsthand what they were going through. At the beginning, you are overwhelmed. It takes a couple of days for federal assistance to show up. We know what it’s like to be cold, wet and hungry. Every bit of adrenaline you have kicks in. Sometimes you feel like you are doing so much for these people; other times you think you’re not doing enough.
The elderly, the children, the people who live below the poverty level and the mentally challenged, they suffer the most. Some of them can’t evacuate prior to a storm because they don’t have money to do so, they don’t have good transportation, or they don’t have the knowledge to know how to use public transportation. There are lots of challenges when it comes to people being able to leave. It could be as simple as their tires aren’t good enough to let them drive very far. They take a chance by staying put.
Who is your hero in EMS?
Dr. Norman McSwain, a trauma surgeon in New Orleans. He was heavily involved with establishing EMS in the city and is founder of the prehospital trauma life support program. He’s the kind of guy who wants to show younger people in this profession how to take care of patients. He’s always believed in what we do in the field, and he has a passion to share his knowledge with other people.
He used to go to the Talladega races in Alabama and volunteer his time to make sure that if drivers got into wrecks, somebody was there to care for them. He taught EMTs and paramedics how important it is to be ready for trauma patients.
[According to the National EMS Museum, as director of trauma surgery at Charity Hospital in New Orleans, McSwain remained at the hospital to care for patients during Hurricane Katrina and its aftermath crisis, and waded through floodwaters to try to find help for those trapped without food or water. When the hospital was evacuated, McSwain was one of the last to leave.]
What’s a leadership mistake that you’ve made?
When I was the NAEMT president [from 2004 to 2006], I had a gentleman who served on a committee. He got a little relaxed and wasn’t getting along with anybody. I relieved him of his duties, and I did it by an e-mail rather than a phone call. He said, ‘You called me to offer me the position, but you relieved me of my duties without facing me and talking to me directly.’ Even with today’s modern communications, when you have something to tell someone, good or bad, talk to them in person, or pick up the phone if you can’t talk to them face to face.
Being a manager is a privilege. You have to have people earn your trust. The way that comes about is by helping them to be better people, and to always thank them when they work hard and do a good job. If you do that, when they decide to relax or get lazy in their job or aren’t up to their peak performance, it’s easier to reprimand them. If you only talk to them when they are doing something wrong, they’re not going to respect you.
Your department has a position called ‘patient advocate.’ What does that person do?
Years ago, we had a paramedic go on to nursing school and become an R.N. She wanted to come back to New Orleans EMS and help out in some way, and we made her a patient advocacy coordinator.
We have a problem with homeless and mentally ill people living under the bridges and in abandoned homes since Katrina. Some of these people routinely call EMS as their life net. They have no insurance, and they maybe don’t have the knowledge to get help another way. Some call 911 a couple times a day.
We identify who these people are. She goes out, under the bridges and in the abandoned homes, and meets those people on their turf. She tries to feel out if they’re ill, traumatized, mentally ill or just poor. We flag them in our system. If one of them calls 911, the supervisor and patient advocate coordinator are notified. She will call the hospital, give them a heads-up that the patient is coming in, and tell them that they may not need to take up a hospital bed. Instead, they might need to go to the psych ward, they may need their medicines or a meal, or to have their social worker contacted.
What do you think is the biggest threat or opportunity in EMS on a national level?
All cities are expecting departments to do more with less. Everything has become more expensive—fuel, medical supplies, ambulances, electronics. Heart monitors used to do a few things, now they do a lot, and they are more expensive. Stretchers used to be manual, now they work on batteries, which we have to pay for. Almost everything in the prehospital setting is becoming more expensive, while budgets are becoming smaller because of the economy.
Today, running EMS is a business. If you’re not making money, your system is going to fail. You cannot run emergency services in the red or you’re going to fold.
We run a city service here, but we have to make sure we run it cost-effectively, and make sure at the end of the day we were responsible to the tax payers and that we gave them the best service.
What advice would you give a young person considering EMS as a career?
Do it. The greatest reward is when you know that your knowledge as an EMT or paramedic was shared with somebody else and you gave them a second chance at life.
We don’t get into this business for medals, awards and plaques to hang on the wall. Our greatest reward is when we see a person walk out of the hospital in good health, knowing that without our knowledge and our help, they wouldn’t be able to do that.
