An eight-year-old boy is today in hospital, fighting for his life, after the car he was travelling in left the road and hit a tree.
The accident happened at 5.25pm yesterday on the A194(M) in Sunderland, between Washington Highway and the A1.
For reasons yet to be established, the red Suzuki Ignis which the boy was a passenger in left the road and collided with a tree.
Both the boy and the driver of the car were taken to hospital.
The boy's injuries are serious and potentially life threatening.
The vehicle had travelled from the South Shields area before the collision.
Ryan Tinkler, 29, from Sedgefield, County Durham, was one of the first people on the scene.
He was heading home from work when he came across the accident.
He said: "I was driving southbound on the A194(M) when I saw the red car smoking, up against a tree.
"A bus behind me also pulled over and a load of people got off to help.
"I ran over and helped the people off the bus get the boy and man out of the car.
"We rested the man up against the boot of the car and the boy was laid down on the grass verge. People were asking if anyone knew CPR.
"I work offshore, so I get basic first aid and CPR training. Myself and the gentleman off the bus worked on him for five minutes or so, until a policeman and a nurse turned up.
"They had more first aid experience than myself and took over, and did a great job. Then the paramedics arrived."
Police have appealed for any witnesses to the accident to contact them on 101, quoting reference 864 010717.