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Untreated hypovolemia or excessive and rapid losses of volume may lead to hypovolemic shock. [7] Signs and symptoms of hypovolemic shock include increased heart rate, low blood pressure, pale or cold skin, and altered mental status. When these signs are seen, immediate action should be taken to restore the lost volume.
The severity of hemorrhagic shock can be graded on a 1–4 scale on the physical signs. The shock index (heart rate divided by systolic blood pressure) is a stronger predictor of the impact of blood loss than heart rate and blood pressure alone. [11] This relationship has not been well established in pregnancy-related bleeding. [12]
The annual incidence of shock of any etiology is 0.3 to 0.7 per 1000, with hemorrhagic shock being most common in the intensive care unit. Hypovolemic shock is the most common type of shock in children, most commonly due to diarrheal illness in the developing world. [4]
Internal bleeding (also called internal haemorrhage) is a loss of blood from a blood vessel that collects inside the body, and is not usually visible from the outside. [1] It can be a serious medical emergency but the extent of severity depends on bleeding rate and location of the bleeding (e.g. head, torso, extremities).
Waterhouse–Friderichsen syndrome (WFS) is defined as adrenal gland failure due to hemorrhages in the adrenal glands, commonly caused by sepsis.Typically, the bacteria responsible for triggering the bleeding is Neisseria meningitidis.
A hemorrhagic infarct is determined when hemorrhage is present around an area of infarction. Simply stated, an infarction is an area of dead tissue or necrosis. [1] When blood escapes outside of the vessel (extravasation) and re-perfuses back into the tissue surrounding the infarction, the infarction is then termed a hemorrhagic infarct (infarction). [1]
One must also consider the possibility of multiple types of shock being present. For example, a trauma patient may be hypovolemic from blood loss. This patient could also have tension pneumothorax due to trauma to the chest. [22] Vital signs in obstructive shock may show hypotension, tachycardia, and/or hypoxia.
Hypovolemia is a massive decrease in blood volume, and death by excessive loss of blood is referred to as exsanguination. [2] Typically, a healthy person can endure a loss of 10–15% of the total blood volume without serious medical difficulties (by comparison, blood donation typically takes 8–10% of the donor's blood volume). [3]