Hemorrhagic shock in medicine is called extensive blood loss, an unexpected exit of blood from the bloodstream. This phenomenon usually develops rather rapidly and can lead to serious consequences, up to a tragic outcome. What are the signs of diagnosing hemorrhagic shock, and what help can others provide to a person with sudden bleeding?

Causes of hemorrhagic shock

The root causes of hemorrhagic shock are various injuries, injuries, operations, etc.

Note. According to medical statistics, hemorrhagic shock in obstetrics occupies the first place in the frequency of occurrence.

Abundant acute hemorrhage occurs in expectant mothers in case of:

  • rupture of the fallopian tube - the consequences of an ectopic pregnancy;
  • uterine rupture;
  • some types of uterine bleeding;
  • the so-called acute fatty liver of pregnant women.

The consequences of this condition can be:

  • the development of cancer of the female genital organs;
  • sepsis, accompanied by tissue necrosis;
  • apoplexy of the ovary.

Hemorrhagic shock is also considered as the result of delayed or improperly selected therapy for such conditions / diseases as:

  • cholera;
  • diabetes;
  • peritonitis;
  • sepsis;
  • oncological disease;
  • osteomyelitis;
  • prolonged stay in an environment with high air temperature;
  • pathology that provokes the dehydration of the body, etc.

Indirect causes of shock are:

  • Incorrect assessment of bleeding features - volumes or speed.
  • Wrong way to replace lost blood.
  • Incorrect / belated error correction during blood transfusion.
  • Belated / wrong choice of medications that can stop blood loss.

What determines the severity of the development of a shock condition

The basis of the disruption of the body during hemorrhagic shock is a sharp decrease in blood volumes distributed through the vessels. A decrease in the amount of blood provokes a spasm in these very vessels. The result is the transition of tissue fluid into the bloodstream, which helps to thin the blood, disrupt its microcirculation in the organs.

Lack of timely assistance threatens global disruptions of microcircular processes and threatens human health and even human life.

The intensity of blood loss depends on a number of determining factors:

  • body stamina;
  • immunity fortresses;
  • state of the nervous system (it is directly involved in the control of vascular tone);
  • pathologies of the heart and so on.

Signs and clinical symptoms

Typical symptoms of hemorrhagic shock are:

  • general weakness of the body;
  • nausea accompanied by dry mouth;
  • dizziness;
  • atypical pallor of the skin;
  • cooling hands, feet;
  • loss of consciousness;
  • difficulty in forming the right amount of urine;
  • increasing shortness of breath, malfunction of the respiratory rhythm;
  • increasing swelling.

Hemorrhagic shock: degrees

There are 4 stages of hemorrhagic shock:

  1. An alternative name is compensated or ischemic hypoxia phase. Deficiency of total circulated blood (BCC) - 15%. Blood pressure reaches a mark above 100 mm Hg. Art. venous - normal. Additional symptoms are weak pallor of the skin, the pulse is reduced to 80 - 90 beats / min, the hemoglobin level is 90 g / l and higher.
  2. The alternative name is decompensated. Deficiency of bcc 15 - 30%. This condition is rated as moderate. The patient has dizziness, weakness, darkening in the eyes. Blood pressure drops to 80 - 90 mm Hg. Art. The pulse is fast - 110 - 120 beats / min, hemoglobin drops to 80 g / l or less.
  3. The alternative name is irreversible. Deficiency of bcc - 30 - 40%. The main clinical symptoms are confused consciousness, lethargy, and increased pallor of the skin. Blood pressure drops below 60 - 70 mm Hg. Art. The heart rate, on the other hand, jumps to 130 - 140 beats / min.
  4. The deficit of BCC reaches high levels - more than 40%. A strong inhibition of vital functions is observed, consciousness is lost, pressure, both venous and arterial, may not occur.

Determination of blood loss

Clarify the extent of the deterioration of the patient and the amount of blood loss is acceptable in two ways.

According to Negovsky (based on the total body weight of the patient):

  • I Art. - 0.5 l, 7 ml / kg;
  • II Art. - 0.8 - 1.2 l, 11 - 17 ml / kg;
  • III st. - 1.5 - 2 l, 21.4 - 28.6 ml / kg;
  • IV Art. - from 2.5 l.

In terms of blood loss. There are 3 degrees:

  • mild - a decrease in bcc from 20%;
  • average - decrease in bcc from 35 - 40%;
  • severe - a decrease in bcc from 40%.

First aid and emergency

The main purpose of the manipulation at the stage before direct hospitalization for hemorrhagic shock is to temporarily stop blood loss in all possible ways.

You should call the resuscitation team or bring the patient to the hospital on your own.

First aid is based on the following principle:

  1. Ensuring the proper content of gas exchange and airway.
  2. The use of a special apparatus of the nasogastric tube.
  3. Placing a catheter on several peripheral vessels.

Hemorrhagic shock treatment

For emergency care, intensive care is organized, subject to a preliminary diagnosis.

Treatment of hemorrhagic shock is carried out according to the following scheme:

  1. Conducting tests aimed at determining the level of glucose in plasma or ketone bodies in urine.
  2. To reduce intracranial pressure, Furosemide and Dexamethasone are used.
  3. In order to prevent the occurrence of hypoglycemia, theanine or glucose solution is intravenously administered to the patient.

Note. In the event of a diagnosis of hemorrhagic shock, the patient is shown an indispensable systematic monitoring of the ECG.

Directly drug therapy is carried out after stabilization of the patient's condition.

Typical agents used in these cases are:

  1. Restoration of cell membranes - Vitamin C, Troxevasin.
  2. Maintaining the muscles of the heart - Riboxin, Mildronate.
  3. Normalization of blood coagulability - "Contrical", "Prednisolone", "Dexamethasone".

What complications are possible?

The following complications can be observed in patients who have hemorrhagic shock:

  • systematic adhesion of red blood cells;
  • ischemia;
  • coma;
  • gastric fibrillation;
  • asystole.

Note. After suffering a hemorrhagic shock and profuse blood loss, patients in some cases develop pathologies of the endocrine system or internal organs. These factors can provoke subsequent disability of the patient.

Hemorrhagic shock is a sudden and extremely serious condition that can significantly worsen a person’s health and endanger his life. Pregnant women should be especially attentive to their well-being, because not one, but two whole lives depends on their state of health. The shock state of the exit of blood from the vessels develops quite rapidly, so the provision of timely first aid for hemorrhagic shock largely determines the future outcome of the situation.

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