My talk focuses on mine and my colleagues experiences and learning of attending major incidents in London. I would also discuss learning from other incidents that have happened in the UK in the past few years including Manchester and Southport. The purpose of my talk is to highlight the true reality of attending such events and the long term impact it can have on clinicians. I would also discuss the role of critical care clinicians, critical thinking and decision making especially at events involving a large number of patients with penetrating injury.