http://www.fpnotebook.com/

Hemorrhage Evaluation

General: Blood Volume
1. Adult: 7% (5 Liter blood volume for a 70 kg man)
2. Child: 8-9% (80-90 ml/kg for a child)
Class I Hemorrhage: Minimal Blood Loss
1. Characteristics
  1. Blood Volume Loss <15%
  2. Adult blood loss <750 ml
2. Cardiovascular
  1. Heart Rate normal or mild increase
  2. Pulses normal
  3. Blood Pressure normal
  4. pH normal
3. Respiratory: Rate normal
4. Neurologic: Slightly anxious
5. Skin
  1. Warm and pink
  2. Capillary refill brisk (<2 seconds)
6. Renal: Normal urine output
  1. Adults: >0.5 ml/kg/hour (>30 cc/hour)
  2. Children: >1 ml/kg/hour
  3. Infants <1yo: >2 ml/kg/hour
Class II Hemorrhage: Mild Blood Loss
1. Characteristics
  1. Blood Volume Loss: 15-30%
  2. Adult: 750-1500 ml of blood loss
2. Cardiovascular
  1. Tachycardia
  2. Diminished peripheral pulses
  3. Blood Pressure normal
  4. Normal pH
3. Respiratory
  1. Mild Tachypnea
4. Neurologic
  1. Irritable
  2. Confused
  3. Combative
5. Skin
  1. Cool extremities
  2. Mottling
  3. Delayed Capillary refill
6. Renal
  1. Oliguria
  2. Increased specific gravity
Class III Hemorrhage: Moderate Blood Loss
1. Characteristics
  1. Blood Volume Loss: 30-40%
  2. Adults: 2000 ml blood loss
2. Cardiovascular
  1. Significant Tachycardia
  2. Thready peripheral pulses
  3. Hypotension
  4. Metabolic Acidosis
3. Respiratory: Moderate Tachypnea
4. Neurologic
  1. Irritable
  2. Lethargic
  3. Diminished pain response
5. Skin
  1. Cool extremities, mottling or pallor
  2. Prolonged capillary refills
6. Renal
  1. Oliguria
  2. Blood Urea Nitrogen (BUN) increased
Class IV Hemorrhage: Severe Blood Loss
1. Characteristics
  1. Blood Volume Loss: >40%
2. Cardiovascular
  1. Severe tachycardia
  2. Thready central pulses
  3. Significant hypotension
  4. Significant acidosis
3. Respiratory: Severe Tachypnea
4. Neurologic
  1. Lethargic
  2. Coma
5. Skin
  1. Cold extremities
  2. Pallor
  3. Cyanosis
6. Renal
  1. Anuria

Navigation Tree

Please see the Terms and Conditions. Please also see the privacy statement regarding advertising on this page. Although access to this page is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians.

This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.