On Thursday afternoon, a new, state-of-the-art bridge collapsed at Florida International University, crushing cars beneath it.

The Miami bridge fell onto parked cars, so there was probably no warning, and the injuries will probably be “crush injuries,” said Dr. Jon Krook, a surgeon who treated patients after an August 2007 bridge collapse in Minneapolis.

“In general, if you’re in a steel case, you’re more protected in it than outside of it,” Krook said, referring to the steel structure of a vehicle. But a car is likely of little protection when hundreds of tons of falling cement are working with gravity to become even heavier in mass.

Krook said the injuries are probably going to be more life threatening and severe at FIU than in the accident a decade ago. He predicted “broken bones, head injuries, muscle getting crushed”—which can lead to rhabdomyolysis, a breakdown of muscles that leaks the protein myoglobin into the bloodstream, which can damage the kidneys.

Speed is of the essence in removing the victims, Krook said. He likened the situation to the aftermath of an earthquake, where buildings crumble onto people and lives can be saved if people are quickly moved from beneath the debris.

In the Minneapolis accident, the cars fell from the I-35W Mississippi River Bridge (officially called Bridge 9340) 115 feet into the river, which meant the injuries were different. “They were all in their cars and went straight down,” Krook explained. “It was a sudden deceleration.”

As a result of the free fall, the victims’ spines took the brunt force of the fall. “Almost everyone had lumbar spine fractures because it took all the force,” he told The Daily Beast. As for severity, “it depended on how people took the fall.”

That said, the toppling of the debris simultaneously meant that some people in the Minneapolis case got trapped in debris and had to be pulled out.

Krook said it’s important to remember that while physical injuries can be healed over time, the psychological trauma of going through a bridge collapse—having a structure you inherently trusted to be steady and to support your transport from one point to another and not fall on you—is devastating and could last a lifetime.

Patients from the I-35W Mississippi River bridge collapse are still suffering from post traumatic stress disorder, he said. “It’ll be important to help them [patients] deal with these things.”