When a multiple patient incident occurs in a remote location, significant challenges are presented to the Emergency Medical Services (EMS) system. Emergency medical services systems need to have the capability to respond effectively to major incidents anywhere within the service area.

On 2 September, 1988, some time after 1400H, a Gray Line of Alaska tour bus overturned at milepost 132 on the Taylor Highway in the interior region of Alaska. The bus rolled from a soft shoulder down a hill as it attempted to pass a large truck going the opposite direction. The accident location was 220 air miles east of Fairbanks, a city of about 60,000 population.