On a summer morning, emergency medical services (EMS) and the fire brigade are alerted to a severe traffic accident on a highway. On a downhill stretch, a 3.5-ton delivery van with a roof cabin has collided with a truck at the end of a traffic jam. Upon arrival of the EMS, the vehicle is wedged under the trailer of the truck, the entire driver’s cabin of the 3.5-tonner has shifted backwards on the chassis, and the A-pillars of the passenger cabin are deformed. With the help of a spreader, the passenger door can still be opened and a care opening created, so that the first arriving EMS physician gets access to the trapped, approximately 25-year-old, slim patient, who is awake and responsive. The airway is clear, some blood is flowing from the nose, blood can also be seen on the deployed airbag. Breathing is unobstructed, the breathing sounds are the same on both sides at a breathing rate of 18/min, the oxygen saturation measured by pulse oximetry is 98%.