What Is Hypovolemic Shock?
Hypovolemic shock, also known as hemorrhagic shock, is a
life-threatening condition that results when you lose more than 20 percent
(one-fifth) of your body’s blood or fluid supply. This severe fluid loss makes
it impossible for the heart to pump a sufficient amount of blood to your body.
Hypovolemic shock can lead to organ failure. This condition requires immediate
emergency medical attention.
What Causes Hypovolemic Shock?
Hypovolemic shock results from significant and sudden blood or
fluid losses within your body. Blood loss of this magnitude can occur because
- bleeding from cuts or wounds
- bleeding from blunt traumatic injuries due to
accidents or seizure activity
- internal bleeding from the digestive tract or due
to a ruptured ectopic pregnancy
In addition to actual blood loss, the loss of body fluids can
cause a decrease in blood volume. This can occur in cases of:
- excessive or prolonged diarrhea
- severe burns
- protracted and excessive vomiting
- excessive sweating
When heavy bleeding occurs, there isn’t enough blood flow to the
organs in your body. Blood carries oxygen and other essential substances to
your organs and tissues. When your body loses these substances faster than it can
replace them, organs in your body begin to shut down. As your heart shuts down
and fails to circulate enough blood through your body, the symptoms of shock
occur. Blood pressure plummets and there’s a severe drop in body temperature,
which can be life-threatening.
What Are the Symptoms of Hypovolemic Shock?
The symptoms of hypovolemic shock vary with the severity of the
fluid or blood loss. However, all symptoms of shock are life-threatening and need
emergency medical treatment. Internal bleeding symptoms may be hard to
recognize until the symptoms of shock appear, but external bleeding will
be visible. Symptoms of hemorrhagic shock may not appear
immediately. Older adults may not experience these symptoms until the
shock progresses significantly.
- blue lips and fingernails
- low or no urine output
- profuse sweating
- shallow breathing
- chest pain
- loss of consciousness
- low blood pressure
- rapid heart rate
- weak pulse
The sign of external hemorrhaging is bleeding profusely at the
site of injury.
Signs of internal hemorrhaging include:
- abdominal pain
- blood in the stool
- black, tarry stool (melena)
- blood in the urine
- vaginal bleeding (heavy, usually outside of
- vomiting blood
- chest pain
- abdominal swelling
If you have any signs of hemorrhaging or of hemorrhagic shock,
seek medical attention immediately. Have someone drive you to the hospital or
call 911. Don’t drive to the hospital on your own if you’re bleeding profusely
or if you have any symptoms of shock.
Emergency Care and First Aid
Untreated hypovolemic shock will lead to death. Hypovolemic shock
is a medical emergency. Call 911 immediately if you observe a person
experiencing shock symptoms. Until responders arrive:
- Have the person lie flat with their feet
elevated about 12 inches.
- Refrain from moving the person if you suspect a
head, neck, or back injury.
- Keep the person warm.
- Refrain from giving the person fluids by mouth
because of the risk of choking.
Don’t 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 protrudes 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.
What Complications Are Associated with Hypovolemic Shock?
A lack of blood and fluid in your body can lead to the following
- damage to organs such as your kidney or brain
- gangrene of the arms or legs
- heart attack
The effects of hypovolemic shock depend on the speed at which you’re
losing blood or fluids and the amount of blood or fluids you are losing. The
extent of your injuries can also determine your chances for survival. If you
have chronic medical conditions such as diabetes or heart, lung, or kidney
disease, these conditions can increase the likelihood you’ll experience more
complications from hypovolemic shock.
How Is Hypovolemic Shock Diagnosed?
There are often no advance warnings of shock. Instead, symptoms
tend to arise only when you’re already in the throes of the condition. A
physical examination can reveal signs of shock, such as low blood pressure and
rapid heartbeat. A person experiencing shock may also be less responsive when
asked questions by the emergency room doctor.
Heavy bleeding is immediately recognizable, but
internal bleeding sometimes isn’t found until you show signs of hemorrhagic
In addition to physical symptoms, your doctor may use a variety
of testing methods to confirm you’re experiencing hypovolemic shock. These
- blood testing to check for electrolyte
imbalances and kidney function
- computerized tomography (CT) scan or ultrasound
to visualize body organs
- echocardiogram to measure heart rhythm
- endoscopy to examine the esophagus and other
- right heart catheterization to check how blood
- urinary catheterization to measure the amount of
urine in the bladder
Your doctor may order other tests based on your symptoms.
How Is Hypovolemic Shock Treated?
Once at a hospital, a person suspected of having hypovolemic
shock will receive fluids or blood products via an intravenous line. Doctors
may also administer medications that increase the heart’s pumping strength.
Close cardiac monitoring, as well as monitoring your kidney
function, will determine the effectiveness of the treatment you receive.
Common complications of hemorrhagic shock include:
- kidney damage
- other organ damage
Some people may also develop gangrene due to decreased
circulation to the limbs. This infection may lead to amputation of the affected
Overall, your outlook will depend on the amount of blood you lost
and the type of injury you sustained. The outlook is best in healthy patients
who haven’t had severe blood loss.