Patient arrives in the Emergency Department via ambulance post-motor vehicle crash (MVC). He was a restrained driver and was T-boned by another car on the driver’s side, the vehicle’s airbags were not deployed. During extraction from the vehicle by the firefighters, there was spontaneous combustion of the vehicle and the patient sustained partial-thickness burns to the lower extremities. The patient arrives in the ED in respiratory distress with severe pain to the upper chest and a pneumothorax. The year 4 students must prioritize the patient’s care which entails, prepping for chest tube insertion, pain medication, fluid resuscitation, dressing the burns, and setting up for intubation.