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The militants included a large number of foreign fighters: Of the 100 Islamic State extremists that were killed this week, 26 came from outside Iraq, the general said. Russian-speaking foreigners, most likely Chechens, were among the best snipers, he added, though he did not think highly of the Islamic States infantry tactics.

Nobody, however, questioned their proficiency in making and using explosives.

They cant drive car bombs at us anymore, so they hide bombs in abandoned vehicles or just try to run up to us and blow themselves up, he said.

The Iraqi military searches civilians as they try to escape the remains of the city. Men who have sought to flee have been told to remove their shirts, and some strip down to their underwear to show that they are not hiding a bomb. Believing that women are less likely to be screened as carefully, the Islamic State has been using female suicide bombers.

Three members of a CTS battalion dispatched to Mosul from Basra, in southern Iraq, were killed in the recent suicide attacks, the units commander said.

The fact that some militants have managed to get their hands on Iraqi uniforms means that the CTS has to be especially vigilant. We know our guys well, and can tell when its them, General Saadi said.

He also insisted that he was not surprised by the recent spate of suicide attacks. Tips from civilians and drones flown by the Iraqi forces, he said, had given him valuable intelligence. Still, all 17 of the recent bombers, he acknowledged, succeeded in blowing themselves up.

At the trauma stations a short drive from the front, it was clear that the Islamic States bombs were claiming their share of victims: among them, an Iraqi soldier who was already dead when he arrived Wednesday morning at a triage point run by Global Response Management, a nonprofit organization.

Alex Potter, a nurse at the center, said she could gauge the flow of the battle for Mosul from the casualties that arrived. A surge in gunshot wounds to Iraqi troops was an indication that they were making another push against Islamic State positions. Civilians with limbs and torsos crushed by debris were a sign of airstrikes. Suicide bomb blasts often resulted in severe burns and worse.

The casualties arriving from the bombings in recent days had been half civilians, half Iraqi military, said Pete Reed, an emergency medical technician who runs the Global Response Management. The majority of suicide vest attacks in the past few days have been by females, he added.

At another nearby trauma center run by the Iraqi Army and CADUS, a humanitarian organization based in Germany, an Iraqi Humvee rushed up, straight from battle in the old city. Anxious Iraqi soldiers unloaded their comrade wrapped in a thick, blood-soaked blanket.

A gaping bullet hole was in the back of the soldiers head, the work of an Islamic State sniper. The doctors quickly pronounced the soldier dead, and he was lifted into a black body bag. His name and unit were inscribed on a strip of paper that was taped to the outside. A small bag containing his possessions and athletic shoes was placed alongside. He was soon taken away, and a small pool of blood was wiped from the floor.

Follow Michael R. Gordon on Twitter at gordonnyt.

Muhammad Nashat Mahmud contributed reporting.

A version of this article appears in print on July 7, 2017, on Page A4 of the New York edition with the headline: In Mosuls Endgame, Escape Proves Harrowing and Surrender Unlikely.

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No Escape From Mosul, and Unlikely Chance of Surrender - New York Times