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.
| More: Tragedy on Bourbon Street: EMS lessons from New Year’s Eve attack
Key takeaways
1. Preparation is key
Mass casualty incidents demand extensive preparation, including comprehensive incident action plans (IAPs), regular training and inter-agency coordination. Annual refreshers and full-scale exercises, such as those conducted by New Orleans EMS before Mardi Gras and Super Bowl events, can significantly enhance response efficiency.
2. Know your partners
Effective collaboration with law enforcement, fire services, hospitals and federal agencies is critical during an MCI. Building strong, pre-established relationships and understanding each agency’s capabilities and protocols are essential to streamline communication and resource sharing during emergencies.
3. Incident command saves lives
A clear, practiced incident command structure allows teams to manage chaos and allocate resources effectively. Training EMS personnel to step into command roles when needed ensures the continuity of leadership from the first unit on the scene to the arrival of senior commanders.
4. Prioritize mental health support
The emotional toll of MCIs on EMS personnel is immense. Agencies must provide immediate and long-term mental health resources, including professional counselors experienced in first responder trauma. Regular debriefings, trauma huddles and access to support systems help mitigate long-term PTSD risks.
| More: How to recognize, help a struggling team member
5. Adapt and innovate in real time
MCIs often require rapid decision-making and flexibility. Whether doubling up patients in ambulances, coordinating with mutual aid units or adapting transport routes based on hospital capacity, responders must be ready to think creatively while adhering to training and protocols.
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
