Acute Traumatic Coagulopathy: the lethal triad of trauma

Mark Howells, Bridie Jones

    Research output: Contribution to journalArticlepeer-review


    Trauma is the leading cause of death for people in the UK and North America, especially for those aged 15–24 years. However, if early management regimes of permissive hypotension, high-flow oxygen and administration of tranexamic acid are applied, mortality risk can be reduced significantly. Acute traumatic coagulopathy (ATC) is an internal process that is initiated by significant or massive trauma because of hypoperfusion resulting in hypovolaemic shock, activation of protein C, platelet dysfunction and disruption to the endothelial glycocalyx. ATC can be exacerbated by hypothermia, acidosis and dilution coagulopathy—the ‘lethal triad’ of trauma. This article discusses the pathophysiology of ATC and treatment strategies via the management of the lethal triad.

    Original languageEnglish
    Article number8
    Pages (from-to)284-288
    Number of pages4
    JournalJournal of Paramedic Practice
    Issue number12
    Publication statusPublished - 15 Dec 2018


    • trauma
    • lethal triad
    • Acute Traumatic Coagulopathy
    • Hypothermia
    • Acidosis


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