Three teenagers are "extremely lucky" to be alive after a single-vehicle crash near Narromine.
Emergency services including one Toll Rescue Helicopter were called to Haberworth Road about 17 kilometres south of the town, after three teenagers were involved in a crash shortly after 3pm on Thursday afternoon.
Police were told the vehicle crossed onto the wrong side of the road and rolled, before the driver was ejected from the vehicle.
The driver, a 17-year old woman, was treated on scene by NSW Ambulance paramedics before she was airlifted to the Westmead Children's Hospital where she underwent surgery on Friday morning.
Two female passengers of the vehicle, aged 16 and 17, were also taken to Dubbo Hospital suffering minor injuries.
Police established a crime scene, which was examined by specialist police from Metropolitan Crash Investigation Unit, who have begun an investigation. The vehicle has been towed for forensic examination.
NSW Ambulance Inspector Paul Boje said the three teenagers were "extremely lucky".
"Paramedics were confronted by a chaotic scene but were able to quickly locate, assess and treat the three teenagers for a number of injuries," he said.
"While the young patients suffered a number of injuries, they were extremely lucky this accident didn't end in tragedy - had the car left the road, it could have been a very different outcome."
Inspector Boje said it was a "stark reminder" to take care on the road at all times. "Circumstances can change in an instant," he said.
NSW Police region traffic operations coordinator, Sergeant Shannon Pendlebury said at this stage they were unsure what caused the crash.
"We're keeping an open mind, however with one of the occupants ejected, we are looking at the issue of occupant restraints, seatbelts and whether they were worn at the time," he said.
In NSW since 1971, it has been mandatory to wear seatbelts. According to NSW police each year on average there are about 30 drivers and passengers killed and 220 injured who had not been wearing a seatbelt.
"If an occupant can remain inside the vehicle during a collision, they have a much greater chance of survival," Sergeant Pendlebury said.
"Like we saw yesterday, the injuries of the one person who was ejected [from the vehicle] are far more serious than those that remained in the vehicle.
"So we would encourage all drivers before they take off, not only to check themselves but their passengers that they're all strapped in."
Police are appealing for anyone who may have witnessed the crash, or has dashcam or mobile footage to contact Dubbo police or Crime Stoppers.