What is Waddell’s Triad of Trauma?

Waddell’s triad is recognized in clinical practice as being associated with high-velocity accidents such as motor vehicle versus pedestrian, or bicycle crashes.

 Waddell’s triad consists of

1. Femur fracture

2. Intra-abdominal or intrathoracic injury

3. Head injury.

These three injuries provide significant loss of blood through internal haemorrhaging, anyone who meets these criteria for Waddell’s triad of trauma should be treated as significantly injured.

Waddell’s Triad is primarily seen in Paediatric Pedestrians versus Motor Vehicles, due to their heigh causing this type of mechanism to first injure their femurs, then abdomen/chest and finally their head.

What is the clinical significance of Waddell’s Triad?

The clinical significance of Waddell’s Triad of Trauma is that it indicates the following warning signs to Doctors and Paramedics alike:

1. If one or two of the three signs are clearly present, the clinician should be wary of the potential of the third sign, even if it has not been identified yet;

2. Large amounts of blood may be lost in the internal cavities and body spaces, therefore patients who have injuries associated with Waddell’s Triad of Trauma should be treated cautiously.

What is an example of Waddell’s Triad of Trauma?

A 5 year old pedestrian who has been hit by a motor vehicle at 60km/h (35 m/h) and been thrown over the bonnet of the vehicle is likely to have injuries consistent with Waddell’s Triad, including: fractured femur/s, abdominal injuries and head injury.