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Triad of death: the importance of temperature monitoring in trauma patients
Matthew Keane Charge nurse, Emergency department, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, Essex
Multiple organ failure is a significant complication in traumatic injury, and can be exacerbated by a failure to adequately monitor and control trauma patients’ core body temperature in emergency departments (EDs). Nearly half of trauma patients are hypothermic on arrival at emergency departments, often due to factors beyond the control of emergency service responders and during on-scene resuscitation attempts. This article examines the physiology of the ‘triad of death’ –hypothermia, metabolic acidosis and coagulopathy – to highlight the importance of monitoring and maintaining normothermia, or normal body temperature, which is between 36.0C and 37.2C, in trauma patients to improve outcomes. It also describes some rewarming interventions that can help to save the lives of patients with multiple injuries. Major traumatic injury is the leading cause of death in people under 40 years of age in the UK. Among major trauma patients, 75% are male and 98% of injuries are caused by blunt force such as falls or road traffic incidents (
Emergency Nurse. 24, 5, 19-23. doi: 10.7748/en.2016.e1569
Correspondence Peer reviewAll articles are subject to external double-blind peer review and checked for plagiarism using automated software
Conflict of interestNone declared
Received: 16 March 2016
Accepted: 07 July 2016