Diagram of a<unk> <unk> es are divided into four classes: primary, secondary, tertiary, and quaternary. Primary<unk> es Primary<unk> es are caused by<unk>  overpressure waves, or shock waves. Total body disruption is the most severe and invariably fatal primary<unk> . Primary<unk> es are especially likely when a person is close to an exploding munition, such as a land mine. The ears are most often affected by the overpressure, followed by the lungs and the hollow organs of the gastrointestinal tract. Gastrointestinal<unk> es may present after a delay of hours or even days.<unk>  from<unk>  overpressure is a pressure and time dependent function. By increasing the pressure or its duration, the severity of<unk>  will also increase. Extensive damage can also be inflicted upon the auditory system. The tympanic membrane (also known as the eardrum) may be perforated by the intensity of the pressure waves. Furthermore, the hair cells, the sound receptors found within the cochlea, can be permanently damaged and can result in a hearing loss of a mild to profound degree. Additionally, the intensity of the pressure changes from the<unk>  can cause<unk>  to the blood vessels and neural pathways within the auditory system. Therefore, affected individuals can have auditory processing deficits while having normal hearing thresholds. The combination of these effects can lead to hearing loss, tinnitus, headache, vertigo (dizziness), and difficulty processing sound. In general, primary<unk> es are characterized by the absence of external<unk> es; thus internal<unk> es are frequently unrecognized and their severity underestimated. According to the latest experimental results, the extent and types of primary<unk> -induced<unk> es depend not only on the peak of the overpressure, but also other parameters such as number of overpressure peaks, time-lag between overpressure peaks, characteristics of the shear fronts between overpressure peaks, frequency resonance, and electromagnetic pulse, among others. There is general agreement that spalling, implosion, inertia, and pressure differentials are the main mechanisms involved in the pathogenesis of primary<unk> es. Thus, the majority of prior research focused on the mechanisms of<unk> es within gas-containing organs and organ systems such as the lungs, while primary<unk> -induced traumatic brain<unk>  has remained underestimated.<unk>  lung refers to severe pulmonary contusion, bleeding or swelling with damage to alveoli and blood vessels, or a combination of these. It is the most common cause of death among people who initially survive an explosion. Secondary<unk> es Secondary<unk> es are ballistic trauma caused by impacts of flying shrapnels and other objects propelled by the explosion. These<unk> es may affect any part of the body and sometimes result in penetrating trauma with visible bleeding. At times the propelled object may become embedded in the body, obstructing the loss of blood to the outside. However, there may be extensive blood loss within the body cavities. Secondary<unk>  wounds may be lethal and therefore many anti-personnel explosive devices are designed to generate fast-flying fragments. Most casualties are caused by secondary<unk> es as shrapnels generally affect a larger area than the primary<unk>  area, because as debris can easily be propelled for hundreds or even thousands of meters. Some explosives, such as nail bombs, are deliberately designed to increase the likelihood of secondary<unk> es. In other instances, the target provides the raw material for the fragments thrown into surrounding, e.g., shattered glass from a<unk> ed-out window or the glass facade of a building. Tertiary<unk> es Displacement of air by the explosion creates a<unk>  wind that can throw victims against solid objects.<unk> es resulting from this type of traumatic impact are referred to as tertiary<unk> es. Tertiary<unk> es may present as some combination of blunt and penetrating trauma, including bone fractures and coup contre-coup<unk> es. Children are at particularly high risk of tertiary<unk>  due to their relatively smaller body weight. Quaternary<unk> es Quaternary<unk> es, or other miscellaneous named<unk> es, are all other<unk> es not included in the first three classes. These include flash burns, crush<unk> es, and respiratory<unk> es. Traumatic amputations quickly result in death, unless there are available skilled medical personnel or others with adequate training nearby who are able to quickly respond, with the ability for rapid ground or air medical evacuation to an appropriate facility in time, and with tourniquets (for compression of bleeding sites) and other needed equipment (standard, or improvised; sterile, or not) also available, to treat the<unk> es. Because of this,<unk> es of this type are generally rare, though not unheard of, in survivors. Whether survivable or not, they are often accompanied by significant other<unk> es. The rate of eye<unk>  may depend on the type of<unk> . Psychiatric<unk> , some of which may be caused by neurological damage incurred during the<unk> , is the most common quaternary<unk> , and post-traumatic stress disorder may affect people who are otherwise completely uninjured.
Blast injury
Microtrauma
Avulsion injury
Barotrauma
Blunt trauma
Penetrating trauma
Closed-head injury
Running injuries