The lethal triad of death in exsanguinating trauma consists of which three derangements?
- A Hypoxia, acidosis, hyperkalaemia
- B Alkalaemia, hyperthermia, thrombocytopenia
- C Acidaemia, hypothermia, coagulopathy ✓
- D Anaemia, hypocalcaemia, alkalosis
Correct answer: C. Acidaemia, hypothermia, coagulopathy
Explanation
The lethal triad comprises metabolic acidaemia from tissue hypoperfusion, hypothermia from exposure and cold fluids, and coagulopathy from factor dysfunction and platelet impairment, each worsening the others. Damage control surgery exists specifically to interrupt this cycle through rapid haemorrhage control, warming, and correction of acidosis. Some authors add hypocalcaemia to describe the lethal diamond, but calcium depletion is not part of the classical triad. Hyperkalaemia and anaemia are consequences, not components of the triad.
Reference: Sabiston Textbook of Surgery, 21st ed.
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