The following information contains adaptations and excerpts from the US Army Center for Health Promotion and Preventive Medicine (USACHPPM) Tech Guide 244, The Medical NBC Battlebook.

There are two types of blast forces that occur in a nuclear detonation blast wave: direct blast wave overpressure forces and indirect blast wind drag forces. The most important blast effects, insofar as production of casualties will be those due to the blast wind drag forces. The indirect blast injuries and thermal injuries are so predominate that patients with only direct blast injuries make a small part of the patient workload.

Direct Blast Injury. The human body is remarkably resistant to static overpressure, particularly when compared with rigid structures such as buildings. Overpressures that are sub lethal can cause lung damage and eardrum rupture. Eardrum rupture will be the most common injury from overpressure. Direct blast effects can contribute significantly to the immediate deaths and injuries sustained close to the point of detonation.

Indirect Blast Wind Drag Forces. The drag forces (indirect blast) of the blast winds are proportional to the velocities and duration of the winds. The winds are relatively short in duration, but can reach velocities of several hundred kilometers per hour. Injury can result either from flying objects impacting on the body, or from the physical displacement of the body against objects and structures. Because of the violence of the winds associated with even low values of overpressure, mechanical injuries due to flying objects sent into motion by the winds or to violent bodily translation will far outnumber direct blast injuries due to actual compression of the organism. Certain terrain, such as desert, is particularly susceptible to flying objects form the effect of winds. However, the drag forces of the blast winds produced by nuclear detonations are so great that almost any form of vegetation or structure will be broken apart into a variety of flying objects. As a result, large numbers and a great variety of flying objects will be generated in almost any environment. Varied fling object injuries will be common. The drag forces of the blast winds are strong enough to displace even large objects such as vehicles or to cause collapse of large structures such as buildings. These can result in very serious crush injuries. Depending upon the intensity of the drag forces and nature of the environment, humans themselves can become flying objects and be displaced to variable distances and at variable velocities.

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