We have all been to numerous car accidents and most of them while unique in their own rights are still pretty standard as far as tactics go. Scene saftey, stabilize vehicle, access patient(s), extrication or remove.
I came across this picture and have been thinking about how we would approach this situation. Not something you see everyday . . . heck I'm not even sure how they got in this predicament.
But lets use our imagination, training, experience and knowledge and see how we would approach this scene and deal with the complications it presents.