For the revelers of New Orleans, this was far from a happy new year.
As the world now knows, early on New Year’s Day, a tragic vehicle-borne attack unfolded on Bourbon Street in the French Quarter, a place familiar to many of us who have traveled to the site for EMS World Expo.
The assailant bypassed a police barricade in a rented Ford F-150 pickup truck, speeding into the crowd on the sidewalk before opening fire. The grim toll (currently) stands at 15 dead, including the driver himself, and over 30 injured, including two police officers with gunshot wounds and victims of the devastating blunt and crushing trauma that a 6,500-pound vehicle, moving at up to 65 MPH, can inflict.
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After crashing the vehicle, the driver, Shamsud-Din Jabbar, exited and engaged in a shootout with police officers, during which he was fatally shot.
While first responders’ actions that night were swift and decisive, this tragedy also serves as a stark reminder of the evolving nature of threats EMS systems face and the importance of reflecting on global patterns and lessons learned. To help other EMS systems prepare for such incidents, I’ve identified key considerations and strategies to enhance planning, training and response.
Prevention through design
Vehicle-borne terrorist attacks aren’t unique to New Orleans. Similar attacks in Berlin, London, Barcelona and Jerusalem, to name but a few, highlight the adaptability of those who wish to cause harm. Cities must prioritize physical barriers, such as reinforced bollards or strategically placed heavy vehicles, to protect high-traffic pedestrian zones.
EMS leaders can advocate for city planning that incorporates these defenses in high-risk areas, especially during large public gatherings. Prevention is the first line of defense, and investing in these measures can drastically reduce casualties before a response is even required.
These physical improvements are not only preventative but also a visible assurance to the public that their safety is prioritized.
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Integrating EMS into counter-terrorism planning
EMS systems must be integrated into broader counter-terrorism strategies to ensure a coordinated approach to emerging threats. Collaboration with law enforcement, fire departments and city planners can identify vulnerabilities and create comprehensive response plans tailored to their jurisdiction’s unique risks.
Joint exercises simulating vehicle-borne attacks and active shooter scenarios should become a standard practice. These exercises help responders build familiarity with interagency protocols, improve communication under stress, and ensure a unified response when it matters most.
Real-life simulations can also highlight potential gaps in resource allocation and communication channels.
Lessons from similar incidents
Examining global examples of vehicular attacks offers valuable insights into how to manage similar incidents. Effective crowd flow management, multilingual communication strategies in tourist-heavy areas, and accessible medical supplies can make a significant difference in the outcome of an incident.
For example, after the Berlin Christmas market attack, the city increased its public safety measures, including implementing enhanced medical supply caches in high-risk areas. Agencies should study such after-action reports to adapt best practices and create more resilient systems.
Post-incident analysis
After-action reviews (AARs) are critical for evaluating what worked, what didn’t and how future responses can improve. These reviews should include all responding agencies, creating a holistic understanding of the event and a clear plan for addressing identified gaps.
Sharing findings with other jurisdictions amplifies the learning process, ensuring that no lessons go unheeded. Publicly sharing non-sensitive findings also builds trust with the community by demonstrating a commitment to continuous improvement. Every AAR is an opportunity to make the next response even stronger.
Psychological resilience for responders
Finally, the psychological toll of responding to such devastation cannot be overstated. For some responders, this may have been the most devastating event of their careers – whether long or short.
Many responders carry the emotional weight of these events long after the scene is cleared. Agencies must prioritize mental health support, offering peer support programs, critical incident stress debriefing (CISD) teams and access to professional counseling.
Encouraging an open dialogue about mental health and – in the case of NOLA – good trauma stewardship reduces stigma and fosters a supportive culture. Leaders should model resilience by participating in these programs themselves, showing their teams that seeking help is a sign of strength, not weakness.
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New Orleans EMS: Rising above New Year’s Eve chaos
I have no doubt NOLA did what most major cities do on New Year’s Eve: understand the traditional holiday demand on their system, staff up and stand by to deal with the excesses of the event. Tragically, the usual injuries of alcohol versus gravity were replaced with unimaginable chaos.
This article isn’t written from the comfort of a quarterback’s armchair. I’m fortunate to work journalistically closely with the leadership of New Orleans EMS, and I know the stellar quality of those in charge. They lead an EMS system on top of its game. I’m confident they all lived up to their training philosophy and dealt professionally with what was presented to them.
Leaders and providers were called to act immediately and decisively: to get in, treat and get out. The absolute blanket of HIPAA, combined with respect for those we treat, means there won’t be a press conference where the NOLA EMS Chief provides a detailed, media-facing clinical description of each patient. But I have no doubt that every effort was made to save those who could be saved and to offer dignity to those who could not.
As we reflect on this tragedy, we reaffirm our commitment to preparedness and resilience. EMS is, at its heart, a profession built on these qualities – both for the communities we protect and for the individuals who stand ready to respond, no matter the circumstance. Every incident reinforces the importance of evolving our practices to meet new challenges.
New Orleans responders did what they always do: they stood up, stepped in and performed with professionalism and expertise. Their dedication ensures that clinical order could be restored amid the chaos. While their efforts may not dominate the headlines, it is their quiet resilience that gives hope to communities in their darkest moments.
