Hypovolemic shock
Shock - hypovolemicHypovolemic shock is an emergency condition in which severe blood or other fluid loss makes the heart unable to pump enough blood to the body. This type of shock can cause many organs to stop working.
Shock
Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. Lack of blood flow means the cells and organs do n...
Read Article Now Book Mark ArticleCauses
Losing more than 15 to 20 percent of the normal amount of blood in your body causes hypovolemic shock.
Blood loss can be due to:
- Bleeding from serious cuts
- Bleeding from other injuries
- Internal bleeding, such as in the gastrointestinal tract
The amount of circulating blood in your body also may drop when you lose too much body fluid from other causes. This can be due to:
- Burns
- Diarrhea
- Excessive perspiration
- Vomiting
Symptoms
Symptoms may include:
- Anxiety or agitation
Anxiety
Stress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...
Read Article Now Book Mark Article - Cool, clammy skin
- Confusion
Confusion
Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembe...
Read Article Now Book Mark Article - Decreased or no urine output
Decreased or no urine output
Decreased urine output means that you produce less urine than normal. Most adults make at least 500 milliliters of urine in 24 hours (a little over ...
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- Pale skin color (pallor)
Pale skin color
Paleness is an abnormal loss of color from normal skin or mucous membranes.
Read Article Now Book Mark Article - Rapid breathing
Rapid breathing
Hyperventilation is rapid and deep breathing. It is also called overbreathing, and it may leave you feeling breathless.
Read Article Now Book Mark Article - Sweating, moist skin
Sweating
Sweating is the release of liquid from the body's sweat glands. This liquid contains salt. This process is also called perspiration. Sweating helps...
Read Article Now Book Mark Article - Unconsciousness (lack of responsiveness)
Unconsciousness
Unconsciousness is when a person is unable to respond to people and activities. Doctors often call this a coma or being in a comatose state. Other c...
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The greater and more rapid the blood loss, the more severe the symptoms of shock.
Exams and Tests
A physical exam will show signs of shock, including:
- Low blood pressure
Low blood pressure
Low blood pressure occurs when blood pressure is much lower than normal. This means the heart, brain, and other parts of the body may not get enough...
Read Article Now Book Mark Article - Low body temperature
- Rapid pulse, often weak and thready
Tests that may be done include:
- Blood chemistry, including kidney function tests and those tests looking for evidence of heart muscle damage
- Complete blood count (CBC)
Complete blood count
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
Read Article Now Book Mark Article - CT scan, ultrasound, or x-ray of areas known or suspected to be injured
CT
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
Read Article Now Book Mark Articlex-ray
X-rays are a type of electromagnetic radiation, just like visible light. An x-ray machine sends individual x-ray waves through the body. The images...
Read Article Now Book Mark Article - Echocardiogram - sound wave test of heart structure and function
Echocardiogram
An echocardiogram is a test that uses sound waves to create pictures of the heart. The picture and information it produces is more detailed than a s...
Read Article Now Book Mark Article - Electrocardiogram
- Endoscopy - tube placed in the mouth to the stomach (upper endoscopy) or colonoscopy (tube placed through the anus to the large bowel)
Endoscopy
Endoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...
Read Article Now Book Mark Article - Right heart (Swan-Ganz) catheterization
Right heart (Swan-Ganz) catheterization
Swan-Ganz catheterization (also called right heart catheterization or pulmonary artery catheterization) is the passing of a thin tube (catheter) into...
Read Article Now Book Mark Article - Urinary catheterization (tube placed into the bladder to measure urine output)
In some cases, other tests may be done as well.
Treatment
Get medical help right away. In the meantime, follow these steps:
- Keep the person comfortable and warm (to avoid hypothermia).
Hypothermia
Hypothermia is dangerously low body temperature, below 95°F (35°C).
Read Article Now Book Mark Article - Have the person lie flat with the feet lifted about 12 inches (30 centimeters) to increase circulation. However, if the person has a head, neck, back, or leg injury, do not change the person's position unless they are in immediate danger.
- Do not give fluids by mouth.
- If person is having an allergic reaction, treat the allergic reaction, if you know how.
Allergic reaction
Allergic reactions are sensitivities to substances called allergens that come into contact with the skin, nose, eyes, respiratory tract, and gastroin...
Read Article Now Book Mark Article - If the person must be carried, try to keep them 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. One or more intravenous (IV) lines will be placed to allow blood, blood products, or fluids to be given.
Intravenous
Intravenous means "within a vein. " Most often it refers to giving medicines or fluids through a needle or tube inserted into a vein. This allows th...
Read Article Now Book Mark ArticleMedicines such as epinephrine or norepinephrine may be needed to increase blood pressure and the amount of blood pumped out of the heart (cardiac output).
Outlook (Prognosis)
Symptoms and outcomes can vary, depending on:
- Amount of blood/fluid volume lost
- Rate of blood/fluid loss
- Illness or injury causing the loss
- Underlying chronic medical conditions, such as diabetes and heart, lung, and kidney disease, or related to injury
In general, people with milder degrees of shock do better than those with more severe shock. Severe hypovolemic shock may lead to death, even with immediate medical attention. Older adults are more likely to have poor outcomes from shock.
Possible Complications
Complications may include:
- Kidney damage (may require temporary or permanent use of a kidney dialysis machine)
Kidney damage
Injury to the kidney and ureter is damage to the organs of the upper urinary tract.
Read Article Now Book Mark Article - Brain damage
- Gangrene of arms or legs, sometimes leading to amputation
- Heart attack
- Other organ damage
- Death
When to Contact a Medical Professional
Hypovolemic shock is a medical emergency. Call the local emergency number (such as 911) or take the person to the emergency room.
Prevention
Preventing shock is easier than trying to treat it once it happens. Quickly treating the cause will reduce the risk of developing severe shock. Early first aid can help control shock.
References
Angus DC. Approach to the patient with shock. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 92.
Dries DJ. Hypovolemia and traumatic shock: nonsurgical management. In: Parrillo JE, Dellinger RP, eds. Critical Care Medicine: Principles of Diagnosis and Management in the Adult. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 26.
Maiden MJ, Peake SL. Overview of shock. In: Bersten AD, Handy JM, eds. Oh's Intensive Care Manual. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 15.
Puskarich MA, Jones AE. Shock. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 3.
Review Date: 11/2/2023
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.