Had one a few years ago. Roll over MVC with three Pt's. This was a small pickup. Driver was ejected and DOA. 15 year old F, was sitting in middle and 16 year old M sitting in passenger seat. When we arrived, witnesses stated that there was 3 people in truck prior to accident, but the could only find 2 of them. Driver was up against a tree. He had died on impact. Male passenger was dead and trapped on floor board of truck. The top of the truck was almost flat.
When I was checking for a pulse on the male that was trapped, a hand grabbed my wrist! The female was trapped up under the dash board and being crushed by the dead male pt. She could barely talk, due to the male's body crushing against her. We had to work fast at extrication. The female was fading fast and to a point where she could not breath.
Once we cleared the roof and passenger door, we found the males arm was trapped in the dashboard and no way to move his body. I did manage to get a NRB on the female and wedge my arm between the two, enough to let her breath a little. We ended up having to call med control for permission to amputate the males arm, so we could remove the body.
We did get her out and into surgery. She spent 16 weeks in the ICU, before she went home. Her mom stopped me at the ED one night, to give me an update on her daughter. Came to find out that the male in the truck was the Pt's brother. She was having a hard time dealing with having to watch her brothers arm removed, just to get her out. Mom did say that hospital had provided her with a lot of help on the issue.
I explained to mom that I would have loved to sedate the girl, before having to do that. But, without being able to examine the pt, I could not risk giving her any thing. Mom fully understood and thanked all of us that were there that night.
That one was a hard one to manage and hope to never have to make that decision again!