Emergency medical personnel navigate Mardi Gras crowds in New Orleans

Michael DeMocker, NOLA.com and the Times-Picayune By Michael DeMocker, NOLA.com and the Times-Picayune MardiGras.com
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on February 27, 2012 at 10:01 AM, updated February 27, 2012 at 1:29 PM

During Mardi Gras, EMS sets up its New Orleans command post in Lee Circle — an encampment that includes police, firefighters and various Homeland Security officials. From there, EMS deputy chief Ken Bouvier monitors calls for service and strategically positions emergency responders along parade routes, using both electronic maps and a manual pin board. This is a daunting but vital task as, historically, the biggest challenge to emergency services during Carnival is negotiating the massive crowds amid a dramatic increase in calls for service.

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Over 10 days of Carnival, EMS responded to 2,024 calls for service citywide ranging from stubbed toes to gunshot wounds to patients in full cardiac arrest.

Lundi Gras festivities were in full swing last Monday when a middle-aged Mandeville man suffered a massive heart attack in Woldenberg Park. The man had no history of cardiovascular trouble. But now his heart had stopped completely.

An emergency medical technician from the Aquarium of the Americas was the first to reach him, employing a portable defibrillator to shock his heart. In less than two minutes, paramedics with New Orleans EMS arrived by bicycle and mini-ambulance to continue his care. Soon, he was transported to Tulane Medical Center, where he underwent double bypass surgery.

The next day, on Mardi Gras morning, a woman a block off the parade route also went into cardiac arrest. The route to her Uptown house was blocked on three sides by parades and crowds, but an EMS sprint car and paramedics on bicycles got there and restored her pulse, sustaining life until an ambulance could arrive.

That these two patients were reached in time appears fortunate. That they were reached in time during the most traffic-clogged weekend of the year in New Orleans appears downright miraculous.

“They give up a lot. It is mandatory, long hours,” said Jeb Tate, the EMS liaison to New Orleans Homeland Security. “Lots of these folks don’t get to take their own children to parades.”

Smaller, nimbler vehicles

It’s Fat Tuesday, and EMS supervisor Chris Keller and his partner Barrett Bernard are stuck behind a procession of Mardi Gras Indians on Dryades Street. They’re trying to work their way to the river side of the Zulu parade, where Bouvier fears coverage is thin.

After trailing the mass of humanity for several blocks, the pair finally finds an unblocked escape route and head away from the parade to try another path downtown when they receive a call of a child in distress on the parade route near Martin Luther King Boulevard. They activate their siren and lights, immediately drawing a complaint from an elderly pedestrian that the siren was “too loud.”

Keller maneuvers the SUV down Calliope Street, only to find the feeder lane to St. Charles Avenue reduced to a narrow alley bookended by two illegally parked pickups. They decide to try to squeeze through. Keller manages to pull it off, although Bernard has to pull in the passenger-side mirror to make it. Keller comments a firetruck could never get through there and radios a request for dispatch to send in tow trucks.

Turning on to St. Charles, they are met by a river of humanity filling the Uptown travel lanes. Most are young people who have little or no inclination to make way. They variously wave or smile or glare, the vehicle passing so slowly that several girls stop to check their reflections. A few revelers are so engrossed in their smartphones that they walk right into the path of the wailing, flashing vehicle.

By the time Keller and Barrett get close, they find out other responders had already arrived and determined the call was unfounded. The episode was nonetheless a sobering demonstration of the difficulties emergency medical technicians face during Carnival — especially when they’re in SUVs or full-sized ambulances, the only response vehicles EMS had before Hurricane Katrina. Stuck in their unwieldy vehicles, responders often had to park at the edge of a parade and run to patients, sometimes pushing a stretcher through the crowds.

Since Katrina, EMS has used federal grants to buy small vehicles capable of negotiating the crowded streets more nimbly.

Bicycle teams are one of the newest innovations. Paramedics work in teams of two, dividing equipment between two police mountain bikes that can briefly replicate the care of a full-sized ambulance. They carry travel-sized oxygen tanks, advanced airway equipment, a defibrillator, splints and IVs. The bikes even feature miniature lights and sirens.

EMS also now deploys several mini-ambulances, including the Gator, which looks like a tricked-out golf cart on steroids, and the ASAP, or alternative support apparatus, which has an enclosed back that can shelter and transport a patient. While the mini-ambulances have less capacity and, by law, can’t transport a patient to the hospital, Bouvier finds the new system far more efficient.

“Now when Bourbon Street is packed, we can extract the patient from the Quarter and take them out to one of the ambulances that wait on the perimeter at Rampart or Decatur streets,” he said.

Adds Tate: “With the ability to get through crowds, our response times have significantly improved.”

In the past three years, EMS has partnered with the Red Cross, which has set up aid stations along the parade routes. Emergency medical technicians at the stations are able to treat minor injuries, direct responding ambulances to patients hard to find in the vast crowds, and advise EMS of the severity and urgency of a medical emergency. In 2012, these stations logged 690 patient interactions.

Bead and float injuries

It’s Bacchus Sunday, and Dr. Beth Clement and paramedic Jason Frosch are weaving through ladders and tents and slipping between band members as they search for a teenage girl who suffered an asthma attack while marching with her high school band.

They spot a New Orleans police officer waving them to the river side of St. Charles Avenue, where they take the patient’s vital signs and give her a breathing treatment on the curb while trying to avoid being hit by beads. They then help the stricken teen through the crowd to an ambulance waiting on a side street. Asthma-related emergencies among band members are a frequent Carnival-related call, Bouvier said, as marching up to six miles and blowing on an instrument puts a strain on asthmatics.

A little while later, Clement and Frosch are again negotiating the crowd on St. Charles Avenue to reach a young woman whose foot had been run over by a float, a relatively common ailment during Mardi Gras. Seizure calls are also frequent, typically the result of patients drinking alcohol with their medications.

Inclement weather can also contribute to more calls, ranging from car accidents to bead injuries.

The storm-thinned crowds at the Endymion parade, for instance, led to more generous riders, which can be dangerous.

“We had a lot of facial injuries because float riders had an overabundance of beads, so they threw packs of beads instead of handfuls,” Bouvier said. Revelers suffered fractured teeth, broken noses, split lips and eye injuries.

Now that Mardi Gras 2012 is behind them, members of EMS are already holding meetings to examine what worked and what didn’t as they begin planning for early 2013, which will include not just Mardi Gras but the Super Bowl as well.

“We look at last year’s stats and we make improvements year by year,” Bouvier said. “We start planning right after Mardi Gras for next year.”