There is no substitute for regularly having mass casualty drills to be prepared for the worst. I vividly remember the United Airlines DC-10 crash at Sioux City, IA in the 1989. The local EMS agency had practiced a plane crash scenario shortly before and was unbelievably prepared for what happened. I was an ambulance medic in a Des Moines, IA suburb at the time and the flight was initially to be diverted to the Des Moines airport. I know that Sioux City was far better prepared for what happened.