“Signal 24 parade route” is police radio lingo for a medical emergency during a Mardi Gras parade. When Mardi Gras parades roll, calls for emergency services double. Mobile paramedics cruise parade route parameters with ears tuned for Signal 24 calls.

“Bonked on the head by a coconut is our most unique injury. We get a couple of 9-1-1 coconut calls every Mardi Gras Day as Zulu rolls. One year we had at least half a dozen,” said Dr. Jeff Elder, head of Emergency Medical Services for New Orleans. “Even the lighter weight hollowed out coconuts can give rise to an egg hematoma if you are hit on the head hard enough.”

From head trauma to stomped toes, multiple parade route injuries all come to the Mardi Gras. Veteran parade goers know the elementary rules to preserve life and limb. Be vigilant to avoid head and eye trauma from flying throws along the parade routes. If two people catch the same beads, beware of painful finger injuries from twisted strands of beads. In tight quarters a foot is the best way to claim that coveted doubloon over sacrificing some fingers to a rival’s boot. Fortunately, most parade route injuries are minor, but not all.

“Most major injuries along the parade route are caused by doing stupid things while drunk. Hopefully, we will never see a repeat what happened during the Endymion parade last year. That was a special zone problem,” continued Dr. Elder referring to the mass trauma scene that occurred on the Saturday night before Mardi Gras 2017 in Mid City.

A 25-year-old man plowed his out-of-control pickup truck into a crowd watching the Endymion parade near the intersection of Orleans and Carrollton Avenues. The impaired truck driver had an alcohol level three times the legal limit. Multiple bystanders helped treat and triage the injured according to Dr. Elder who was interviewed afterwards on a nationally televised CNN segment. The incident sent 21 people to hospitals and injured others who hobbled away independently.

Broken wrists, hips and ankles, along with various degrees of scrapes to major lacerations occur. Besides the occasional parade goer run over by a float or some other vehicle, Dr. Elder said serious reoccurring injuries are caused by jumping over fences and other barriers. Besides broken bones, jumping over wrought iron fences separating many of the sidewalks from front yards especially uptown lead to serious leg, thigh, and scrotum wounds that hurt even to write about.

“People climbing over fences are very prone to injury. We see people impaled on fences with the spike penetrating their inner thigh or scrotal area. Unless someone has pulled them off the fence before we get there, we saw off the spike and rush them to the big trauma center with the spike intact. It can be dangerous to pull out an impaled spike on the street. It could be blocking a large lacerated blood vessel.”

Eye injuries caused by projectiles from the floats are another painful way to end the parade-watching experience. According to data published by Tulane physicians back in 2000, 50 percent of all eye injuries were due to trauma from beads compared to 11 percent by doubloons. Diagnoses include corneal abrasions, hemorrhages, lid lacerations, and structural damage to the globe of the eye. While many injuries were considered minor, some 20 percent were classified as severe.

Falls off floats are not as common as they formerly were thanks to mandated rider harnesses. Falls on but not off floats also occur. Riders descending for nature call trips to lower level portable potties are prone to stumbles and falls. Alcohol intake propels tumbles down inside float ladders.

Even with intact rider harnesses, an occasional masker bends over too far, tumbles, and dangles against the side of the float. The safety harness at least keeps the rider from rolling underneath the float, but falls off the floats still occur. Near the end of the Krewe of Thoth parade in 2017, a masker prematurely unhooked his safety belt. As he leaned over to hand over a bag of beads, he tumbled off the float sustaining a head injury. In the there is always a silver lining department, one carnival aficionado commented online: “He fell off at the end, and not at the beginning. So, he still had his day.”

Decades ago, Dr. Kenneth Sear, a young orthopedist who later reigned as Rex, was riding a horse in the Rex parade. A rider fell off a float breaking some bone on Napoleon Avenue in front of the then Southern Baptist Hospital. Duke Sear rode his horse right up the emergency room ramp, splinted the broken bone in the ER, and then returned to the parade on his horse. Several Mardi Gras later, a woman was on a float in Metairie that caught on fire. She jumped off sustaining a nasty knee fracture that Dr. Lee Moss spent a Mardi Gras afternoon putting back together again.



Ladder safety at parades
For years, parents mounted seating platforms for children on step ladders planted curbside before parades. A surging crowd knocked one of these ladders over during a truck parade on St. Charles Avenue in 1981. The eight-year-old boy on the ladder died, crushed between the cab and the trailer of the float. Today a city ordinance mandates that all ladders be structurally sound and set back at least 6 feet from the street curb. Fastening two or more ladders together is prohibited. Nola.gov/nola/media/Mayor-s-Office/Files/29897_CERTIFIED.pdf

Ambulance diversions
In an emergency, you might not get a ride to your hospital of choice. Most of the time ambulance drivers bend over backwards to make sure women in labor get to their hospital of choice. EMS providers know all the tricks to ensure that major trauma still goes to University Medical Center, but persons with other problems are likely routed to the most accessible emergency room. Nola.gov/ems

Legal remedies following parade throw injuries
Good luck. A state law dating back to Governor Edward Edwards protects float riders who hand out coconuts in good faith. And a lady knocked silly by a bag of beads at the Endymion Extravaganza in 2012 lost a legal battle for damages with an appeal court ruling citing the “Mardi Gras immunity statute.” Law.justia.com/cases/louisiana/fourth-circuit-court-of-appeal/2015/2014-ca-1096.html