23 Questions
What is the primary cause of acidosis in trauma patients?
Hemorrhagic shock
What is the effect of hypothermia on blood clotting?
It deteriorates the function of the humoral coagulation cascade
What is the relation between the three factors of the trauma triad of death?
They are highly interrelated and create a vicious circle
What is the role of clinically induced hypothermia in traumatic cardiac arrest?
It plays a significant role in improving clinical outcomes
What is the effect of temperature on platelet function?
It influences platelet function
What are the chances of survival for severely injured patients with the trauma triad of death?
Lower
What is the primary cause of traumatic brain injury?
Trauma
What is the estimated percentage of major trauma patients who have hypothermia upon admission to the emergency department?
Up to two-thirds
What is the minimum Injury Severity Score (ISS) required to classify as major trauma?
15 or greater
What is the benefit of hypothermia in patients with traumatic brain injury?
It protects against the effects of hypoperfusion and hypoxic injury
What is the minimum body temperature required to classify as hypothermia?
35 ◦ C or less
What is the current trend in the frequency of hypothermia in major trauma patients upon admission to the emergency department?
It is decreasing
What is the estimated percentage of deaths worldwide due to major trauma?
10%
What is the primary goal of treatment in the prehospital setting for hypothermia patients?
To prevent further cooling
What is the treatment of choice for hypothermia-induced coagulation disorder in trauma patients?
Active rewarming
What is a common cause of hypothermia in trauma patients?
Environmental exposure
What is the result of hypothermia in trauma patients?
Higher in-hospital mortality, higher transfusion requirements, and longer length of stay
What is the relationship between hypothermia and coagulation?
Hypothermia is associated with coagulopathy
What is the term that describes the combination of acidosis, hypothermia, and coagulopathy?
Lethal triad of death
When did the expression of the 'lethal triad of death' appear in scientific articles?
1999
What is the result of the combination of acidosis, hypothermia, and coagulopathy?
A substantial rise in mortality
What is the effect of hypothermia on mortality in severely injured patients?
Mortality increases with the degree of hypothermia
What is the focus of this report?
The physiological process in hypothermic trauma patients
Study Notes
Hypothermia in Trauma
- Hypothermia in trauma patients is a common condition, present in up to two-thirds of patients upon admission to the emergency department.
- It is defined as a body temperature of 35°C or less.
Coagulation
- The combination of hypothermia, acidosis, and coagulopathy is known as the trauma triad of death, which decreases the chances of survival in severely injured patients.
- Acidosis is usually caused by diminished organ perfusion in shock, primarily hemorrhagic shock in trauma.
- Hypothermia affects blood clotting in different ways, including:
- Deterioration of the humoral coagulation cascade with decreasing temperatures
- Influence on platelet function
- Treatment of hypothermia should start in an early stage, including prevention of further cooling and active rewarming.
Clinical Outcomes
- Hypothermia in trauma patients leads to higher in-hospital mortality, higher transfusion requirements, and longer length of stay.
- Mortality increases with the degree of hypothermia in severely injured patients.
- Clinically induced hypothermia might improve outcomes by protecting against the effects of hypoperfusion and hypoxic injury in selected cases, such as patients suffering from traumatic brain injury (TBI) or traumatic cardiac arrest.
Risk Factors and Prevention
- Risk factors for hypothermia in trauma include:
- Severity of injury
- Prehospital anesthesia or intubation
- Low environmental temperature or wet clothing
- Administration of cold fluids
- Modern hemostatic, goal-directed resuscitation with warm fluids can reduce the occurrence of hypothermia.
This quiz explores the impact of hypothermia on clinical outcomes in trauma patients, including those with traumatic brain injury. It also delves into the role of clinically induced hypothermia in traumatic cardiac arrest.
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