I knew that watching Gray’s anatomy would come in handy one
day. One episode of the show has a
patient go into surgery due to some traumatic injury. The surgeons keep mentioning a triad and that
the patient won’t survive unless they keep the patient out of danger of this
triad. From what I can deduce, this is
the trauma triad of death.
Besides having an incredibly scary name, the triad essentially
says that there is a relationship between the coagulopathy of blood, metabolic
acidosis, and hypothermia. Being cold
halts the coagulation cascade (meaning that blood won’t clot), which causes
lactic acidosis. The acidosis reduces
heart function and thus the body gets even cooler. This triad of actions causes a downward spiral
in the patient and thus leads to poor patient outcomes.
It’s incredibly important to keep your trauma patients
warm. Ski patrollers exist in a world
where just about every patient is hypothermic.
Keeping the patients cool will only hinder blood coagulation and may
lead to this trauma triad of death. Now,
should you be thinking about this triad when faced with a simple knee
injury? I don’t think so … but you
should still keep your patients warm!
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