Dash-cam video showed a 4-year-old girl hang briefly from the door before she let go, hitting the pavement and rolling into traffic. EMT and volunteer firefighter Ryan Ciampoli, who was driving behind the van when the unthinkable happened Wednesday, said he swerved to signal drivers behind him that something was wrong.
"I didn't believe what I was seeing," Ciampoli told The Washington Post.
He pulled over and ran to the girl, who, he said, was initially unconscious.
"I knelt down and started talking to her," he said. "She put her arm up like, 'Get me.' " The 31-year-old EMT added that first-responders usually do not like to move injured patients - but he needed to get the girl out of the road, so he scooped her up, he said.
Ciampoli said the girl was bloodied, with a broken jaw, broken teeth and lacerations covering her face.
The video shows Ciampoli kneeling in the road, holding the child for a moment before eventually carrying her from the highway.
The child's parents told ABC affiliate KHBS that she needed jaw surgery but is expected to make a full recovery.
Other children in the van alerted the driver, who pulled over in a parking lot, according to an incident report. The driver told police in a statement that the children on board "hollered out and I stopped and started running back" when a vehicle pulled up and the driver told him what had happened, according to the report.
The driver, identified as a pastor at Christian Life Center Church in Harrison, will not face charges in the incident, police told CNN.
Ciampoli, an EMT and volunteer firefighter in Crawford County, Arkansas, said he was off-duty when he witnessed the shocking scene.
He asked a good Samaritan who had stopped to help to try to track down the van and get the license plate number - but the van eventually returned, he said.
The Christian Life Center Church told ABC News that it would not use the Ford F-350 van again. The church did not immediately respond to a request for comment by The Post.
(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)