HJNO Mar/Apr 2025

HEALTHCARE JOURNAL OF NEW ORLEANS I  MAR / APR 2025 9 Editors Note: On Jan. 1, 2025, around 3:15 a.m., a 42-year-old U.S. citizen, army veteran from Texas, drove a rented pickup truck around a barricade and into revelers on Bourbon Street in New Orleans. He then exited the truck and engaged in a shootout with the police before being fatally shot. Fifteen people were killed, including the suspect. At least 35 were injured, including two police officers who were shot. The FBI is investigating this as an act of terrorism, noting that the driver had pledged allegiance to ISIS in videos recorded shortly before that attack. The emergency department at University Medical Center (UMC) received 30 victims. UMC is the only Level 1 trauma center in the New Orleans region and minutes from the French Quarter. US Healthcare Journals’ chief editor, Dianne Marie Normand Hartley, met with members of UMC’s trauma team and moderated a roundtable discussion about the New Year's Day terrorist attack from a healthcare perspective. Dianne Hartley, Editor Good afternoon to each of you. Thank you for being here today. I know going over this terrorist attack again is probably not an easy topic for many of you. We appreciate you doing this. The work you did matters, and so are the lessons that we can learn from it. That's why we're here today. With that being said, would you please go around the table and introduce yourselves? Give your name, your title, and your credentials. Meghan Maslanka, MD I'mMeghanMaslanka, and I'm an emergency and disaster medicine physician. I'm the director of emergency management at University Medical Center. Misty Dufrene, RN My name is Misty Dufrene, I'm one of the charge nurses in the ED. Patrick Greiffenstein, MD My name is Patrick Greiffenstein. I am a trauma surgeon and surgical intensivist, and the medical director for the trauma ICU. Jeffery Elder, MD Jeffrey Elder. I'm an emergency physician and chief medical officer at University Medical Center. Elizabeth Lacy Elizabeth Lacy. I'm the EMS outreach coordinator, and I'm a paramedic. Jeanne Marie Baudouin Hi, I'm Jeanne Marie Baudouin, and I'm the emergency management coordinator here at UMC. Editor Today's conversation is more than just about what happened inside the doors of UMC that night; it's about what hospitals, emergency responders, and policy makers need to understand when it comes to mass casualty preparedness. I want this to be a conversation not only about the challenges you faced, but also the strengths, the lessons, and the real takeaways that can shape and prepare us for the next crisis. Throughout this discussion, I'll encourage you to think about the healthcare industry as a whole. What should hospitals, trauma centers, and even local and state leaders be doing differently? What worked, what didn't, and what should we change? This is meant to be a discussion. And with that, let's start by walking through those first critical moments. Can you walk us through the moment when we received that first alert that a mass casualty incident (MCI) was unfolding? Who got the call? Jeffery Elder, MD It was a busy night for those who were in the ED working, and they had police who were already here with other patients up front by our triage area. They started to hear things on the radio that something was going on in the French Quarter. That was the initial alert that something was going on. And actually, while one of our residents was out there hearing this, somebody came up and started knocking on the door to the EMS ambulance entrance. It turns out they had nothing to do with what was happening in the French Quar- ter, but it got everybody a little bit startled as they were starting to figure out that something was happening out in the French Quarter. That was really the first notification that something was happening, until, ulti- mately, we were notified by EMS via radio — which is something we deal with all the time — that there was something going on out in the field, that they had multiple vic- tims. We were going to declare internally what we call a small MCI — a mass casualty incident — with a limited number of patients. Editor Thank you. Jeanne Marie, when did you hear? Were you the next call? Jeanne Marie Baudouin We are very fortunate to have a mass communication system. We have it set up to alert and notify groups of people based on the scale and intensity of the incident. I initially received the notification at about 3:18, I think when that first one went out in the morning. It said that it was a small MCI, so not being on site for that alert, knowing our ED is very capable and that we see a lot of traumas throughout the night is kind of, “Hey, this is happening,” but we don't really need to go into “full hands-on deck” or anything like that. Our house supervisor who works with our attendings and our charge nurses in the ED to assess the criticality of everybody coming in with that flow then realized that this was going to be a larger event. So, a secondary notification was sent out, which increased it from a small MCI to a large one. When I got that notification, which was about 45 minutes later, I called and said, "Hey, what are we looking at?" Initially it was, "We're not sure howmany people we have coming. There was an incident." And that's when we