Mass-casualty incidents will always pose challenges to those involved. Every organization has the same goal, and that is to save lives. Research has shown that good preparation and training and an understanding of and respect for the role of all participants in the chain of survival will result in lives being saved. Targeting the avoidable deaths requires well-trained staff to triage patients effectively. Part of that triage is to get the patients to the most appropriate hospital with the most appropriate facilities and medical staff without unnecessary delay. Systems for dealing with mass casualties within the UK have been developed over many years of experience. Can this experience be used by other countries? Most systems around the world have been developed from each country's historical multiagency links; some countries have no multiagency forum and therefore it is questionable how effective they really are. What does the future hold with developing technologies and transport systems giving easy access to worldwide personal travel on a scale never seen before? What about the political, social, and economic impact of natural and manmade disasters? Advanced training such as the Medical Response to Major Incidents (MRMI) course was designed to assist with understanding local capabilities and response. It was also designed to assist and develop networks between emergency responders to maximize cooperation and ultimately to save lives.