‘You hope it never happens’: Responding to an MCI on Bourbon Street

New Year’s celebrations in New Orleans are always a spectacle, but this year, tragedy struck at 3:15 a.m. A truck barreled into the crowds, triggering what first responders feared was a vehicle-ramming attack. Within moments, New Orleans EMS was in full mass casualty mode — triaging, treating and coordinating with law enforcement amid the unfolding chaos. But things quickly escalated. As Chief Bill Salmeron recounts, responders soon discovered not only multiple critical patients, but also a shootout, a downed suspect and the chilling realization that explosive devices had been planted nearby.

In this gripping episode, Chief Salmeron shares the inside story of how his team handled one of the most intense incidents in recent New Orleans history. He walks through the initial response, communication challenges and how well-drilled interagency coordination played a pivotal role. But beyond the logistics, he also speaks to the emotional toll — how EMS crews handled the psychological weight of triaging patients, working alongside grieving families and processing the magnitude of the event in the days after.

Top quotes

“You don’t see that many fatalities in one place with possible explosives, an active shooter — or at least you shouldn’t in a civilian EMS world — but we do.” — Chief Bill Salmeron

"Anybody can command a scene. You don't have to be a paramedic. You don't have to be a chief or a doctor or whatever it is." — Chief Bill Salmeron

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