Skip to main content

Hemorrhagic Shock, Emergency Medicine

Theodore C. Chan Reviewed 06/2017
 


Basics

Description

  • Loss of effective circulating blood volume resulting in inadequate perfusion

  • Blood loss exceeds ability to compensate and tissue and organ perfusion decrease. At the tissue level, hyp...

Diagnosis

Signs and Symptoms

  • Class I hemorrhage: Loss of up to 15% of blood volume (up to 750 mL in 70 kg adult):

    • HR <100

    • SBP normal

    • Respiratory rate (RR) 14–20

    • Increased or normal pulse pressure

    • Slight ...

Differential Diagnosis

  • Cardiac tamponade

  • Tension pneumothorax

  • Cardiogenic shock

  • Sepsis

  • Adrenal insufficiency

  • Neurogenic shock

Treatment

  • Treatment should be initiated as soon as shock state recognized while simultaneously identifying underlying bleeding source

  • The goal is to restore tissue and organ perfusion and to control so...

Follow-Up

Disposition

Admission Criteria

All patients with hemorrhage should be admitted to the appropriate service. 

Discharge Criteria

N/A 

Issues for Referral

N/A 

Pearls and Pitfalls

  • Severity of hemorrhagic shock class and volume loss can be determined by vital signs and careful physical exam

  • Fluid resuscitation should balance goal of restoring organ perfusion a...

Additional Reading

  • American College of Surgeons, Committee on Trauma. Advanced Trauma Life Support. 9th ed. Chicago, IL: American College of Surgeons; 2012.

  • Curry  N, Davis  PW. What's new in resusci...

Codes

ICD9

  • 459.0 Hemorrhage, unspecified

  • 865.04 Injury to spleen without mention of open wound into cavity, massive parenchymal disruption

  • 958.4 Traumatic shock

  • 864.05 Injury to liver without mention of o...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×