Hypovolemic shock

Definition

Hypovolemic 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.

Alternative Names

Shock - hypovolemic

Causes

Losing about one fifth or more of the normal amount of blood in your body causes hypovolemic shock.

Blood loss can be due to:

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:

Symptoms

Symptoms may include:

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:

Tests that may be done include:

In some cases, other tests may be done as well.

Treatment

Get medical help right away. In the meantime, follow these steps:

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, blood products, or fluids to be given.

Medicines 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:

In general, people with milder degrees of shock tend to 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:

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, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 98.

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, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 6.


Review Date: 11/13/2021
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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