A soldier within a vehicle ("mounted") may suffer a number of injuries if a blast occurs. An enclosed space allows pressure waves to be reflected, resulting in prolonged exposure to pressure. Severe torso injuries can result from pure axial loading.
Non-compressible torso hemorrhage (NCTH) refers to bleeding associated with mediastinal, thoracic and abdominal trauma.
Injuries to mediastinal contents may involve:
(1) the heart
(2) the thoracic aorta, pulmonary and other major arteries
(3) superior vena cava
Injuries to other thoracic structures:
(1) the lung with hemothorax or pneumothorax
(2) rib and sternal fractures
Head and traumatic brain injury
Intra-abdominal injuries:
(1) abdominal aorta and other major arteries
(2) liver, spleen and/or kidneys
(3) injury to the GI tract
(4) damage to inferior vena cava and other major veins
Fractures in the extremities including the calcaneus (deck-slap fractures)
Mediastinal injury is the strongest predictor of mortality. Mortality is usually associated with a new injury severity score >= 50.
