Definition
Hypovolemic shock is a condition that occurs when the body loses more than 20% of its blood or fluid supply, leading to decreased oxygen and nutrient delivery to vital organs. It occurs when your body's blood loss exceeds 15% of its total fluid content. Due to a lack of blood, the heart cannot pump blood around the body properly.
Hypovolemic shock is a critical and potentially deadly medical condition that demands urgent medical care. If left untreated, this condition will cause multiple organ failures, including critical organs. Some studies show that more than 82% of people who experience hypovolemic shock will die within 24 hours if they do not receive proper and timely treatment.
Causes
There are several causes of hypovolemic shock, including:
- Rapid blood loss is caused by an injury or tearing of the large arteries. Tears in the body's large arteries can be caused by accidents, cuts, broken bones around the pelvic bone, and internal bleeding in the digestive tract
- Burns. Human skin is a barrier, preventing excess water from escaping the body. When a person's skin layer is damaged as a result of extensive burns, the barrier is damaged, allowing a large amount of fluid to be released through the process of evaporation, potentially leading to fluid loss from the body, leading to hypovolemic shock
- Frequent massive diarrhea and vomiting in large quantities. Large amounts of fluid loss from diarrhea or vomiting can cause a reduction in body fluids. If the lost fluid is not replaced immediately, it can result in hypovolemic shock
Risk factor
Several conditions can increase a person's risk of developing hypovolemic shock, such as:
- Frequent massive diarrhea or vomiting in large amounts without adequate fluid intake. In fact, in these circumstances, adequate fluid intake must be administered immediately to replace lost fluids
- Trauma or injury to the arteries. The possibility of hypovolemic shock increases if the injured artery is large enough. This type of injury typically occurs in car accidents
- Dehydrated people. This is related to the loss of salt in the body. The more salt is lost, the more water passes out of the body through urine, which can eventually lead to hypovolemic shock
Symptoms
Symptoms of hypovolemic shock may vary. The most common symptoms include:
- Thirst
- Muscle cramps
- Drastic drop in blood pressure
In some cases, hypovolemic shock causes abdominal or chest pain, confusion, drowsiness, and agitation. Agitation is an unpleasant state in which the sufferer feels agitated, confused, tense, irritable, and restless. Hypovolemic shock can reduce blood flow throughout the body, particularly to the brain.
More specifically, the symptoms that appear in hypovolemic shock can be grouped based on the amount of blood volume lost, such as:
Mild
In mild degrees of blood loss, people who experience hypovolemic shock have blood loss of less than 20 percent of the total volume of body fluids. This condition is difficult to diagnose because blood pressure and breathing patterns remain within normal ranges. The most visible symptom is a change in skin color, which becomes paler. Sufferers may also experience sudden feelings of anxiety.
Moderate
A moderate degree of blood loss involves 20-40% of the total volume of fluid in the body. In this condition, people experience symptoms such as increased heart rate and respiratory rate. These symptoms may be accompanied by anxiety, restlessness, and excessive sweating. Blood pressure is usually within normal ranges. However, diastolic blood pressure readings tend to rise.
Severe
A person is diagnosed with severe hypovolemic shock if they have lost more than 40% of their total fluid volume. In this condition, people will experience an increase in heart rate to more than 120 times per minute, and rapid breathing to more than 30 times per minute. The sufferer will experience increased mental disturbances, including anxiety and agitation. Furthermore, systolic blood pressure readings will be lower.
In severe cases, the systolic blood pressure measurement will drop dramatically, resulting in symptoms such as loss of consciousness, excessive sweating, pale skin, and cold touch.
Remember that all severity levels require prompt and appropriate treatment to avoid complications.
Diagnosis
The doctor will make a diagnosis based on observations and examinations. In general, people in shock will find it difficult to answer questions. However, if you are fully conscious, the doctor may ask about any previous medical conditions or overall health.
The doctor will then conduct a physical examination, including your temperature, pulse, breathing, and blood pressure. Your doctor will also examine your skin's color and temperature
Your doctor may conduct additional tests to confirm the diagnosis, such as laboratory and imaging tests.
Laboratory tests are done to determine the severity and cause. This is accomplished by obtaining a blood sample. Urine samples will be collected for analysis in certain cases, such as injury or trauma and pregnancy.
Imaging examinations are carried out when the patient is stable. These may include ultrasounds, X-rays, or CT scans. In the case of long bone fractures, a radiographic examination is required.
In some cases, such as hypovolemic shock caused by abdominal trauma or injury, your doctor will recommend a FAST ultrasound. This examination is performed as soon as possible for stable and unstable patients. This is because there are large arteries in the abdomen which, if torn, can cause fatal complications.
Management
Hypovolemic shock can occur in people who have been injured in an accident. When you find people in an accident, you can take pre-hospital care. This is accomplished by not moving or lifting the victim carelessly, if there is a neck injury, this is done to prevent worsening. Contact the nearest hospital immediately so that the patient can receive immediate medical care. Late delivery of the patient to the hospital can adversely affect the patient's condition.
At the hospital, the medical team will take several steps to ensure that all organs in the body receive adequate oxygen intake, control and stop any bleeding, and replace lost fluids or blood. A fluid replacement or blood transfusion will be administered through an IV or vein to replace lost blood and improve circulation. In addition, management will be implemented to stabilize the condition and avoid complications.
In some cases, interventional or surgical measures may be required for treatment. Your doctor will also prescribe medications to improve heart function and antibiotics to prevent bacterial infections and complications.
Complications
Complications that can occur in cases of hypovolemic shock include bacterial infections, damage to the kidneys and other organs, and death. Complications in the form of infection are more likely to occur in patients who experience hypovolemic shock due to injury.
Prevention
Drive carefully and wear a seat belt or helmet. If you experience vomiting or diarrhea, drink plenty of fluids right away to avoid hypovolemic shock.
When to see a doctor?
If you experience any of the above symptoms, see a doctor immediately for proper treatment. This condition is life-threatening and must be treated immediately.
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- dr Nadia Opmalina