Saturday, April 17, 2010

Classic Triads

Beck’s ,Cushing's ,Waddell's triads:
Beck’s triad
Beck's triad was described by the thoracic surgeon Calude S. Beck in 1935. It's components are:

1. Distended neck veins
2. Distant heart sounds
3. Hypotension

i.e. rising venous pressure, falling arterial pressure, and decreased heart sounds found in the presence of pericardial tamponade.

Cushing's triad (not to be confused with the Cushing reflex) is a sign of increased intracranial pressure. It is the triad of:

1. Hypertension (progressively increasing systolic blood pressure)

2. Bradycardia

3. Widening pulse pressure (an increase in the difference between systolic and diastolic pressure over time)

Cushing's triad suggests a cerebral hemorrhage in the setting of trauma or an space occupying lesion (e.g. brain tumor) that is growing and a possible impending fatal herniation of the brain. Cushing's triad is named after an American neurosurgeon Harvey Williams Cushing (1869-1939).

Waddell's triad
is recognized in clinical practice as associated with high-velocity accidents such as motor vehicle, auto-pedestrian, or bicycle crashes

Waddell's triad consists of

1. Femur fracture
2. Intra-abdominal or intrathoracic injury
3. Head injury,