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Module 3: The Body's Response to Injury

Segment 2: Basic Shock Physiology

References labeled PEDS contain a pediatric element or primary focus.

Topic: Basic shock physiology

Topic: The cellular environment

Topic: The trauma triad of death

  • Balmer JC, Hieb N, Daley BJ, et al. Continued relevance of initial temperature measurement in trauma patients. Am Surg. 2022;88(3):424-428. doi: 10.1177/00031348211048833 https://pubmed.ncbi.nlm.nih.gov/34732102/.
  • Balvers K, Van der Horst M, Graumans M, et al. Hypothermia as a predictor for mortality in trauma patients at admittance to the Intensive Care Unit. J Emerg Trauma Shock. 2016;9(3):97-102. doi: 10.4103/0974-2700.185276 https://pubmed.ncbi.nlm.nih.gov/27512330/.
  • Ciaraglia A, Lumbard D, DeLeon M, et al. Retrospective analysis of the effects of hypocalcemia in severely injured trauma patients. Injury. 2024;55(5) doi: 10.1016/j.injury.2024.111386 https://pubmed.ncbi.nlm.nih.gov/38310003/.
  • Crosier CJ, Rempson CM, Green A, et al. Hypothermia on trauma center arrival has a much greater impact on outcomes at the extremes of age. J Trauma Acute Care Surg. 2026;doi: 10.1097/ta.0000000000004982 https://pubmed.ncbi.nlm.nih.gov/41972955/.
  • Dandan Z, Yiting W, Shengqiang Z, et al. Systematic review of prediction models for post-traumatic hypothermia risk. Injury. 2025;56(12):112883. doi: 10.1016/j.injury.2025.112883 https://pubmed.ncbi.nlm.nih.gov/41240776/.
  • Ietto G, Franchi C, Soldini G, et al. Beyond the trauma triad of death—New advances in our knowledge of pathophysiology as a basis for new perspectives in support therapy. Life (Basel). 2022;12(3) doi: 10.3390/life12030428 https://pubmed.ncbi.nlm.nih.gov/35330179/.
  • Jose AM, Rafieezadeh A, Zeeshan M, et al. Hypothermia on admission predicts poor outcomes in adult trauma patients. Injury. 2025;56(5):112076. doi: 10.1016/j.injury.2024.112076 https://pubmed.ncbi.nlm.nih.gov/39658434/.
  • Lester ELW, Fox EE, Holcomb JB, et al. The impact of hypothermia on outcomes in massively transfused patients. J Trauma Acute Care Surg. 2019;86(3):458-463. doi: 10.1097/ta.0000000000002144 https://pubmed.ncbi.nlm.nih.gov/30444856/.
  • Shackelton D. Comprehensive strategies for maintaining normothermia in shock patients. JEMS. 2024. 07/09/2024. doi: https://www.jems.com/patient-care/comprehensive-strategies-for-maintaining-normothermia-in-shock-patients/
  • Stein J, Weidemann F, Lefering R, et al. Prognostic impact of body temperature trajectories from emergency department arrival to intensive care unit admission - insights from the TraumaRegister DGU(®). Scand J Trauma Resusc Emerg Med. 2026;34(1) doi: 10.1186/s13049-026-01642-0 https://pubmed.ncbi.nlm.nih.gov/42271505/.
  • Suzuki K, Endo A, Akutsu T, et al. External validation of the revised lethal triad criteria for appropriate strategic decision making. J Trauma Acute Care Surg. 2026;100(1):113-118. doi: 10.1097/ta.0000000000004782 https://pubmed.ncbi.nlm.nih.gov/40905980/.
  • Tzeng WJ, Tseng HY, Hou TY, et al. From death triad to death tetrad: The addition of a hypotension component to the death triad improves mortality risk stratification in trauma patients: A retrospective cohort study. Diagnostics (Basel). 2022;12(11) doi: 10.3390/diagnostics12112885 https://pubmed.ncbi.nlm.nih.gov/36428944/.
  • Walborn AT, Rybar DW, Tong JL. Temperature Management in Trauma Patients. Curr Anesthesiol Rep. 2026;16(1):13. doi: 10.1007/s40140-026-00715-1 https://doi.org/10.1007/s40140-026-00715-1.
  • Xiao L, Zhang L. The lethal triad: Past, present, and future. Chin J Traumatol. 2026;doi: 10.1016/j.cjtee.2026.04.001 https://pubmed.ncbi.nlm.nih.gov/42120237/.