Which item is NOT part of the classic trauma triad?

• A. Hyperthermia
• B. Coagulopathy
• C. Hypothermia
• D. Acidosis

Answer: (A)

In severe trauma, the dangerous combination you’re watching for is hypothermia, acidosis, and coagulopathy. Hyperthermia isn’t part of this triad. Hypothermia slows the coagulation cascade and impairs platelet function, making bleeding harder to control. Acidosis results from poor tissue perfusion and increased anaerobic metabolism, which also hampers enzymes involved in coagulation and further worsens bleeding. Coagulopathy can be amplified by fluid resuscitation and ongoing blood loss, feeding into a vicious cycle with both hypothermia and acidosis. Because of this interplay, hyperthermia is not a feature of the classic triad; maintaining normothermia helps break the cycle and improve outcomes. In practice, focus is on keeping the patient warm, controlling bleeding, and providing balanced resuscitation to correct coagulopathy and restore perfusion.