Medical responses to fatal earthquakes have to be rapid to save lives. Here we report the QLARM alert that was issued less than an hour after the magnitude 7.3 Kermanshah, Iran, earthquake of 2017 and the following medical response. The near-real-time estimates of fatalities were 520, on average, and it took official and news reports about 2 days to settle on a minimum of 630 fatalities as a final count. The response of various Iranian agencies was rapid and effective, facilitated by the relatively small area of the disaster (radius of about 50 km). Although this disaster was not large enough to require international first responders to rush to the scene, it is clear that in very large earthquake disasters, a fast, accurately informed response saves lives. For international teams to be of optimal use, the locations and functionality levels of health facilities should be known. This information could be included in the earthquake alerts, but the necessary worldwide data on hospitals are currently not available.