Internal soft-tissue injuries may result from deep wounds, blunt trauma, blast exposure, crushing accidents, bone fracture, poison, or sickness. They may range in seriousness from a simple contusion to life-threatening hemorrhage and shock.

Visible Indications
Visible indications of internal soft-tissue injury include the following:

Hematemesis (vomiting bright red blood)
Hemoptysis (coughing up bright red blood)
Melena (excretion of tarry black stools)
Hematochezia (excretion of bright red blood from the rectum)

Hematuria (passing of blood in the urine)
Nonmenstrual (vaginal bleeding)
Epistaxis (nosebleed)
Pooling of the blood near the skin surface
Other Symptoms
More often than not, however, there will be no visible signs of injury, and the Corpsman will have to infer the probability of internal soft-tissue injury from other symptoms such as the following:

Pale, moist, clammy skin
Subnormal temperature
Rapid, feeble pulse
Falling blood pressure
Dilated, slowly reacting pupils with impaired vision

Tinnitus
Syncope
Dehydration and thirst
Yawning and air hunger
Anxiety, with a feeling of impending doom

Figure 4-28.-Applying a tourniquet.