Hemorrhagic shock

Definition

• Global hypoperfusion leading to cellular hypoxia cause by reduced intravascular volume

Pathophysiology

• Reduced intravascular volume → Reduced SV and tachycardia maintain CO initially

Classification

Class	Blood Loss (%)	Volume (mL)	HR	BP	PP	RR
I	< 15	< 750	< 100	N	Normal	14-20
II	15-30	750-1500	> 100	N	Narrow	20-30
III	30-40	1500-2000	> 120	Decreased	Narrow	30-40
IV	> 40	> 2000	> 140	Decreased	Narrow	> 35

Hemorrhagic shock

• Haemorrhagic shock is classified into 4 classed with increasing severity based on haemodynamic and end organ parameters
  • Key feature: May be no significant signs until 1-1.5L of blood loss
• Class 1
• < 750mL blood loss
  • < 15% loss of blood volume
  • HR <100
  • BP normal
  • Pulse P normal or elevated
  • RR 14-20
  • UO > 30ml/hr
  • Slightly anxious
• Class 2
  • 750mL-1500mL blood loss
  • 15-30% loss of blood volume
  • HR >100
  • BP normal
  • PP reduced
  • RR 20-30
  • UO 15-30ml/hr
  • Mildly anxious
• Class 3
  • 1500mL - 2000mL blood loss
  • 30-40% loss of blood volume
  • HR >120
  • BP reduced
  • PP reduced
  • UO 5-15ml/hr
  • Anxious and confused
• Class 4

  • 2000mL blood loss

  • 40% loss of blood volume

  • HR >140
  • BP and PP reduced
  • UO negligible
  • Confused and lethargic](← Definition
  • Global hypoperfusion leading to cellular hypoxia cause by reduced intravascular volume
• Pathophysiology
  • Reduced intravascular volume → Reduced SV and tachycardia maintain CO initially