The hemorrhaging trauma patient is suffering from three distinct pathophysiological processes that are collectively known as the trauma triad. [4] (See Figure 1.) The triad consists of the following three processes:
- Acidosis – a condition in which the by-products of anaerobic metabolism have created enough toxic by-products to lower the body's pH.
- Hypothermia – a condition defined as a core temperature less than 95 degrees F.
- Coagulopathy – a condition that in trauma represents states of hyper and hypo coagulation.
Each of these processes can independently lead to death if not corrected. However, each of these elements can enhance the action of the other elements, accelerating the process of dying for the patient. For example, hypothermia inhibits the normal action of the clotting cascade and contributes to the worsening coagulopathy. The coagulopathy leads to an inability to form a clot, therefore promoting blood loss and reducing oxygen delivery. That reduction in oxygen delivery contributes to the development of acidosis.
Figure 1:
