J Spec Oper Med. 2022 Jun 1;22(2):110-115. doi: 10.55460/UL89-SC0Z.
The coagulopathy associated with trauma is a complex and convoluted process that is still poorly understood. However, there are recognized contributors to acute traumatic coagulopathy (ATC) and trauma induced coagulopathy (TIC) that are universal. They are hypothermia, acidosis, and coagulopathy, also known as the lethal triad. Recently, with new understanding of hypocalcemia's role in trauma mortality, the term lethal diamond has been coined to underscore calcium's importance. Prehospital providers often unknowingly exacerbate ATC and TIC with excessive crystalloid administration and poor hypothermia prevention. This article will serve as an overview of the physiologic and iatrogenic drivers of ATC and TIC, and will discuss how they can be prevented, assessed, and treated.
创伤相关的凝血功能障碍是一个复杂而棘手的过程，目前仍知之甚少。然而，有一些公认的因素会导致急性创伤性凝血病（ATC）和创伤性凝血功能障碍（TIC），这些因素是普遍存在的。它们是低体温、酸中毒和凝血病，也被称为致命三联征。最近，随着人们对低钙血症在创伤死亡率中的作用的新认识，术语“致命钻石”被用来强调钙的重要性。院前提供者经常在不知不觉中通过过度输注晶体液和预防低体温不当来加重 ATC 和 TIC。本文将概述 ATC 和 TIC 的生理和医源性驱动因素，并讨论如何预防、评估和治疗它们。
