Napoleonic wars (1812): Thousands of French soldiers died of cold-related complications in Russia, some accounts describing sudden collapse likely from hypothermia-induced cardiac arrest.
WWII & Korean War: Military medicine advanced understanding of cold injuries; hypothermia deaths often followed this “lethal diamond” pathway.
Modern trauma care: The “triad of death” (hypothermia, acidosis, coagulopathy) evolved into a broader diamond model when CNS failure/arrhythmias were included.
“lethal diamond” (or “death diamond”) has sometimes been used to describe the four major cold-related killers that occur in hypothermia. Each point of the “diamond” represents a mechanism by which hypothermia becomes fatal:
- Arrhythmias (Cardiac Arrest)
- Hypothermia sensitizes the heart to fibrillation.
- ECG hallmark: Osborn (J) waves.
- Below ~28 °C → risk of ventricular fibrillation and asystole.
- Coagulopathy & Hemorrhage
- Cold impairs clotting enzymes and platelet function.
- Hypothermia + trauma is especially lethal (“trauma triad of death”: hypothermia, acidosis, coagulopathy).
- Metabolic Failure / Acidosis
- Reduced enzymatic activity, impaired oxygen delivery, lactic acidosis.
- Energy failure → multi-organ dysfunction.
- CNS Depression
- Progressive decline in brain activity → confusion, stupor, coma.
- Loss of shivering in deep hypothermia worsens decline.
Together, these four “corners” form the Hypothermia Lethal Diamond:
Arrhythmia – Coagulopathy – Metabolic Failure – CNS Depression → Death.
Snapshot
=
No comments:
Post a Comment