Hypovolemic Shock

Hypovolemic shock is an emergency condition in which severe blood and fluid loss make the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working.

Causes, incidence, and risk factors

Losing about 1/5 or more of the normal amount of blood in your body causes

hypovolemic shock. Blood loss can be due to: Bleeding from cuts Bleeding from other injuries Internal bleeding, such as in the gastrointestinal tract The amount of circulating blood in your body may drop when you lose too many other body fluids, which can happen with: Burns Diarrhea Excessive perspiration Vomiting

Symptoms
Anxiety or agitation Cold clammy skin Confusion
Decreased or no urine output General weakness Pale skin color (pallor) Rapid breathing Sweating, moist skin Unconsciousness The greater and more rapid the blood loss, the more severe the symptoms of shock.

Signs and tests

An examination shows signs of shock, including: Low blood pressure Low body temperature Rapid pulse, often weak and thready Tests that may be done include: Blood chemistry, including kidney function tests Complete blood count (CBC) CTscan, ultrasound, or x-ray of suspected areas Echocardiogram Endoscopy Right heart (Swan-Ganz) catheterization Urinary catheterization (tube placed into the bladder to measure urine output)

Treatment
Keep the person comfortable and warm (to avoid hypothermia). Have the person lie flat with the feet lifted about 12 inches to increase circulation. However, if the person has a head, neck, back, or leg injury, do not change the person's position unless he or she is in immediate danger. Do not give fluids by mouth. If person is having an allergic reaction, treat the allergic reaction, if you know how. If the person must be carried, try to keep him or her flat, with the head down and feet lifted. Stabilize the head and neck before moving a person with a suspected spinal injury. The goal of hospital treatment is to replace blood and fluids. An intravenous (IV) line will be put into the person's arm to allow blood or blood products to be given. Medicines such as dopamine, dobutamine, epinephrine, and norepinephrine may be needed to increase blood pressure and the amount of blood pumped out of the heart (cardiac output). Other methods that may be used to manage shock and monitor the response to treatment include: Heart monitoring, including Swan-Ganz catheterization Urinary catheter to collect and monitor how much urine is produced

Complications
Kidney damage Brain damage Gangrene of arms or legs, sometimes leading to amputation Heart attack Severe shock can lead to death

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