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.

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