In hypovolemic shock % of fluid depletion should be
(B) 15-45% # Treatment should be aggressive and directed more by response to therapy than by initial classification.> Class I hemorrhage (loss of 0-15%):* In the absence of complications, only minimal tachycardia is seen.* Usually, no changes in BP, pulse pressure, or respiratory rate occur.* A delay in capillary refill of longer than 3 seconds corresponds to a volume loss of approximately 10%.> Class II hemorrhage (loss of 15-30%):* Clinical symptoms include tachycardia (rate >100 beats per minute), tachypnea, decrease in pulse pressure, cool clammy skin, delayed capillary refill, and slight anxiety.* The decrease in pulse pressure is a result of increased catecholamine levels, which causes an increase in peripheral vascular resistance and a subsequent increase in the diastolic BP.> Class III hemorrhage (loss of 30-40%):* By this point, patients usually have marked tachypnea and tachycardia, decreased systolic BP, oliguria, and significant changes in mental status, such as confusion or agitation.* In patients without other injuries or fluid losses, 30-40% is the smallest amount of blood loss that consistently causes a decrease in systolic BP.* Most of these patients require blood transfusions, but the decision to administer blood should be based on the initial response to fluids.> Class IV hemorrhage (loss of >40%):* Symptoms include the following: Marked tachycardia, decreased systolic BP, narrowed pulse pressure (or immeasurable diastolic pressure), markedly decreased (or no) urinary output, depressed mental status (or loss of consciousness), and cold and pale skin.
10-15%
15-45%
43-63%
70%
Miscellaneous