Several children are facing "traumatic injuries" including limb amputations after a school bus carrying 45 children flipped following a collision with a truck near Melbourne.
Now a man has been charged with dangerous driving as many primary school-aged children face multiple surgeries and a long road to recovery.
Around 3:40pm on Tuesday, when children were heading home from Exford Primary School, the school bus was allegedly struck from behind by a truck while it was turning right.
The collision caused the bus to flip on its side, trapping dozens inside.
Witnesses and emergency services scrambled to pull the children from the wreckage.
Eighteen children were taken to hospital, seven with serious injuries, following the collision.
The male driver of the bus was also taken to hospital with non-life-threatening injuries.
Of the 18 children, CEO Bernadette McDonald said nine children between the ages of five and 11 were admitted to the Royal Children's Hospital on Tuesday, many of whom are facing extensive surgeries.
Seven children remain at the hospital in serious condition, including one in intensive care. Two have since been discharged.
"The children have suffered multiple and traumatic injuries including partial and complete amputations of arms, multiple crushed limb injuries, severe lacerations to head and body, head injuries, glass shard injuries and three patients are currently receiving spinal support," McDonald told media on Wednesday.
"Some of these patients will require returns to theatres and multiple surgeries in the coming days and coming weeks."
She said the children's parents were not able to be reunited with them until the early hours of Wednesday morning.
Australia's Prime Minister Anthony Albanese gave his heartfelt sympathies to the children and their parents.
"My heart breaks for the young students affected by the terrible crash in Melbourne," Albanese said.
"Australians are thinking of these brave children and their families. We give thanks for the medical professionals and emergency services personnel who were there for them at such a difficult time."
Major collision investigation unit Detective Senior Sergeant Paul Lineham said the scene was "absolutely horrific".
He said it appeared the bus driver had seen the truck approaching him from behind and tried to accelerate to get out of its path.
Det Snr Sgt Lineham told radio station 3AW the bus driver's actions may have lessened the actual impact of the truck itself.
On Wednesday afternoon, Victoria Police said they have charged the truck driver, a 49-year-old man, with four counts of dangerous driving causing serious injury.
He will appear before Melbourne Magistrates' Court on Wednesday afternoon.
