Abstract: When disaster strikes resulting in mass casualties, the number of victims rapidly exceeds locally available intervention resources thereby necessitating exceptional response arrangements. When these tragic and traumatizing large-scale events occur, the public expects the local disaster response entities to be on hand to provide much needed assistance. Whereas the ultimate goal of any emergency medical response is to obtain the best possible intervention for the greatest number of casualties, research indicates that the efficacy of the emergency medical services (EMS) organization’s response to past major incidents in Nairobi County, Kenya, has been inefficient.