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FOUR people are dead and about 150 others are injured after an Amtrak train collided with a truck and derailed - as terrifying video shows blood-covered passengers escaping through windows.

The eastbound train traveling to Chicago struck a dump truck at a crossing in Mendon, Missouri, 100 miles northeast of Kansas City, on Monday afternoon.

Chilling video from the Amtrak derailment shows blood-covered passengers escaping through the windowsCredit: Twitter/Dax McDonald
The train struck a dump truck at a crossing in Mendon, MissouriCredit: Twitter/Dax McDonald
The train, which departed from Los Angeles, was traveling to ChicagoCredit: Amanda Diehl Drinkard/Facebook
Four people were killed in the crash and derailmentCredit: AP:Associated Press
Officials said 150 rail passengers suffered injuries ranging from minor to severeCredit: AP:Associated Press

Amtrak said in an updated statement to The Sun that eight cars and two locomotives derailed after the crash.

There were approximately 275 passengers and 12 crew members on board with four confirmed fatalities, including three rail passengers and the truck driver, the Missouri State Highway Patrol said.

On Tuesday, the MSHP said at least 150 passengers were transported to 10 area hospitals for injuries ranging from minor to severe.

Horror images showed survivors standing on top of rail cars, which ended up on their side in the derailment.

Rob Nightingale, who was one of the passengers on the train, got emotional while describing the harrowing experience to ABC News.

Nightingale explained to the outlet that he was dozing off during a nap when he felt a "jolt" as the train began "rocking and flickering".

"There was a jolt, then I woke up, and then the train started rocking and flickering. And it seemed like a normal jolt. But then I could definitely feel it come off the tracks.

"And then, it just kept going," he told the outlet, as his voice began to crack.

"Then it started to tip on my side, and I saw the ground coming towards me. So I shimmed myself against the wall because I was afraid the glass would shatter and I would get stuck underneath.

"Then it stopped, and it was just silence. Everyone was in shock. I climbed through my door, to the hallway up until the room next to me, which is above me, and then I saw people climbing through those windows."

Nightingale said he saw a little girl crying and her family trying to comfort her, adding that he saw several people covered in blood.

He went live on Facebook shortly after the accident.

In a phone interview with CNN, Nightingale said that those in the dining car and observation deck had the hardest time getting to safety.

"It hit something major to cause ... every car to go off," he said.

A second passenger told the Daily Beast that there was "plenty of people taken away by paramedics."

“They’ve got every rescue helicopter and crew here from every direction,” a shaken Ron Goulet told the Beast.

“We are in Chariton County, Missouri. The train toppled over on its side. Every seat was sold out full, and they were packing people into the observation car because they were so full.

"There are plenty of people on backboards being taken [away] by paramedics.”

Amtrak confirmed to The Sun that crew members were also hurt in the derailment.

"We are deeply saddened to learn that the Missouri State Highway Patrol is now confirming that three people, two passengers and the truck driver, have lost their lives as a result of this grade crossing incident," the agency said.

"There are also several reported injuries among the passengers and crew members traveling on the train.

"We are grateful for the support from the local authorities who provided assistance and resources for our customers and employees."

The National Transportation Safety Board sent a 14-member team to investigate the derailment.

Amtrak said it would fully support the NTSB with the investigation with additional details to come.