Emergency services had their hands full rescuing the occupants of vehicles involved in a freak accident on the N12, near the Edenvale off-ramp, on Wednesday evening.
The spokesperson for Netcare 911, Shawn Herbst, said a loaded truck crashed into a bus and several other vehicles.
"When medics arrived on the scene, patients were scattered throughout the area surrounding the crash site. Emergency personnel from Emer-G-Med, Netcare 911 and other private and government services assessed at least 43 patients. Most had sustained injuries ranging from minor to moderate.
"However, four patients had sustained serious injuries," said Herbst.
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Netcare, Emer-G-Med and government services airlifted the four critically injured people, while patients who sustained moderate and minor injuries were transported by ambulances.
The spokesperson for Ekurhuleni's disaster and emergency management, Erick Maloka, told News24 the injured were transported to various hospitals, including Milpark, Tambo Memorial and Joburg General Hospital.
Maloka said authorities were at the scene, and some routes were temporarily closed.
The cause of the crash is under investigation.