| Hemorrhagic_shock | |
|---|---|
| Video explanation of shock | |
| Specialty | Emergency medicine |
| Symptoms | Fast heart rate, narrowing pulse pressure, anxiety, cool arms and legs, decreased consciousness, low blood pressure [1] [2] |
| Causes | Trauma, gastrointestinal bleeding, childbirth, ectopic pregnancy, underlying blood vessel problems [2] [3] |
| Diagnostic method | Based on examination and medical imaging [2] |
| Differential diagnosis | Other types of circulatory shock [1] |
| Treatment | Direct pressure, tourniquet use, tranexamic acid, blood products, temperature management, surgery [1] [2] |
| Prognosis | Variable [2] |
| Frequency | Relatively common [3] |
Hemorrhagic shock is a type of hypovolemic shock that occurs due to blood loss. [2] Early symptoms may include a fast heart rate and narrowing pulse pressure. [4] [5] With further blood loss anxiety, cool arms and legs, decreased consciousness, and low blood pressure may occur. [4] Complications may include hypothermia, blood clotting problems, and multiple organ dysfunction syndrome. [6]
The cause of blood loss may include trauma, gastrointestinal bleeding, childbirth, ectopic pregnancy, and underlying blood vessel problems. [2] [7] Bleeding may occur within the body or externally. [2] Significant blood loss can occur within the abdomen, chest, and retroperitoneum. [2] The underlying mechanism involves not enough blood flow to body tissues. [4] A shock index (heart rate/systolic blood pressure) of greater than 1 can indicate who is likely to need blood transfusions. [8] Ultrasound, in the emergency department, may be useful in determining the location of the blood loss. [2]
The initial management is based on ATLS. [4] The primary treatment is stopping the source of bleeding. [2] This may include direct pressure or tourniquet use. [1] Other measures may include tranexamic acid, blood products, and temperature management. [1] In those without a head injury, the blood pressure may be permitted to remain relatively low until surgery can be performed. [2] Hemorrhagic shock is relatively common. [7] About half of deaths due to trauma are due to bleeding and bleeding remains the primary preventable cause of trauma related death. [2] [1] The risk of death or poor outcomes is high. [1]