ICU · Resuscitation & shock

Hypovolaemic & Haemorrhagic Shock

Also known as Haemorrhagic shock · Hypovolaemic shock · Damage control resuscitation · Massive transfusion protocol · Damage control surgery · Trauma-induced coagulopathy · Lethal triad · Permissive hypotension · ATLS shock classification · Fluid responsiveness

Hypovolaemic and haemorrhagic shock — blood loss reduces preload and cardiac output. The four ATLS classes guide recognition (a classic teaching tool with known limitations), progressing from compensated to decompensated shock. Hypotension is a LATE sign — the body compensates with tachycardia and vasoconstriction before blood pressure falls, and many bleeding patients are normotensive. Modern management is damage control resuscitation: permissive hypotension until bleeding is controlled (except TBI — higher blood-pressure thresholds apply), balanced blood-product resuscitation, damage control surgery, and early TXA. Lactate and base deficit are the recommended markers of bleeding and shock.

Checked against its sources on 2 Oct 2026