The Trauma Triad of Death describes three conditions that contribute to worsening outcomes in severely injured trauma patients:

• Hypothermia
• Acidosis
• Coagulopathy

These three conditions create a cycle that rapidly worsens hemorrhage, shock, and patient deterioration. As bleeding continues, patients become colder, more acidotic, and less able to form effective clots. 

Modern trauma research has expanded this concept into the Trauma Diamond of Death, recognizing the role of calcium in clot formation, cardiac function, and cellular activity.

The Trauma Diamond of Death includes:

• Hypothermia
• Acidosis
• Coagulopathy
• Hypocalcemia

Providers may not be able to correct every component of the Triad or Diamond in the field, but they can slow progression by controlling hemorrhage, supporting oxygenation and perfusion, preventing heat loss, and rapidly transporting the patient to definitive care.

Remember: Once the Triad begins to develop, deterioration can accelerate quickly. Early recognition and intervention are critical.