What Is Hemorrhagic Shock?
Hemorrhagic shock occurs when the body begins to shut down due to
large amounts of blood loss. People suffering injuries that involve heavy
bleeding may go into hemorrhagic shock if the bleeding isn’t stopped
Common causes of hemorrhagic shock include:
- severe burns
- deep cuts
- gunshot wounds
According to the National
Trauma Institute, hemorrhagic shock is the second leading cause of death in
people with traumatic injuries. Hemorrhagic shock is one of many kinds of
medical shock, which are different from emotional (non-medical) shock.
What Causes Hemorrhagic Shock?
When heavy bleeding occurs, there’s not enough blood flow to the
organs in your body. Blood carries oxygen and other essential substances to
your organs and tissues. When heavy bleeding occurs, these substances are lost
more quickly than they can be replaced and organs in the body begin to shut
As your heart shuts down and fails to circulate an adequate
amount of blood through your body, symptoms of shock occur. Blood pressure
plummets and there’s a massive drop in body temperature, which can be life-threatening.
Signs of Hemorrhagic Shock
All symptoms of shock are life-threatening and should be treated
as a medical emergency. Symptoms of hemorrhagic shock may not appear
- blue lips and fingernails
- low or no urine output
- profuse (excessive) sweating
- shallow breathing
- chest pain
- loss of consciousness
- low blood pressure
- rapid heart rate
- weak pulse
External hemorrhaging (bleeding)
will be visible. Symptoms of internal bleeding, however, may be hard to
recognize until symptoms of shock appear.
Signs of internal hemorrhaging include:
- abdominal pain
- blood in the stool
- blood in the urine
- vaginal bleeding (heavy, usually outside of
- vomiting blood
- chest pain
- abdominal swelling
Seek medical attention immediately if you have any signs of
hemorrhaging or of hemorrhagic shock. Have someone drive you to the hospital or
call 911. DO NOT drive to the
hospital on your own if you’re bleeding profusely or if you have any symptoms
Emergency Care and First Aid
Call 911 if someone is bleeding heavily or has symptoms of shock.
If the person doesn’t have a head injury, neck injury, or spine injury, lay
them on their back with their legs elevated 12 inches from the ground. Do not
elevate their head.
Remove any visible dirt or debris from the injury site. DO
NOT remove embedded glass, a knife, stick, arrow, or any other object
stuck in the wound.
If the area is clear of debris and no visible object is
protruding from it, tie fabric such as a shirt, towel, or blanket around the
site of injury to minimize blood loss. Apply pressure to the area. If you can,
tie or tape the fabric to the injury. Wait for emergency personnel arrive.
How Is Hemorrhagic Shock Diagnosed?
There are often no advance warnings of shock. Instead, symptoms
tend to arise only when you’re already experiencing shock. A physical
examination can reveal signs of shock, such as low blood pressure and rapid
heartbeat. Someone in shock may also be less responsive when asked questions by
an emergency room doctor.
While heavy bleeding is immediately recognizable, internal
bleeding sometimes isn’t found until someone shows signs of hemorrhagic shock. Shock
requires immediate attention, so treatment may begin before diagnosis. If the
reason for shock is not obvious or it’s internal, various tests may be used to
diagnose the cause, including:
- blood tests
- computed tomography (CT) scan
- magnetic resonance imaging (MRI)
Your doctor may order a complete blood count test after
addressing the site of the bleeding. These results will let them know whether a
blood transfusion is necessary. Your doctor may also order a blood transfusion
without doing a complete blood count test if there’s a large amount of blood
loss from the injury.
A blood transfusion is given by transferring donor blood into
your body using an IV. You may be given medications, such as dopamine, to
increase your blood pressure.
Some people may also develop gangrene due to decreased
circulation to the limbs. This infection may result in amputation of the
Common complications of hemorrhagic shock include:
- kidney damage
- other organ damage
Your outlook will depend on the amount of blood you lost and the
type of injury you sustained. The outlook is best in healthy people who haven’t
had severe blood loss.