Hemorrhagic Shock Shock is a condition of inadequate tissue perfusion, which results in decreased amount of oxygen in the vital tissues and organs (Metrng 2010, Klabunde 2010, Sarathy 2010, Spaniel et al. 2007). It reduces the rate of elimination of waste products of metabolism. Causes are heart attack, severe or sudden blood loss from injury or severe illness, blood poisoning from major infections, large decrease of body fluids, and exposure to extreme heat or cold for long duration. The American College of Surgeons classified shock into four, namely distributive, obstructive, cardiogenic, and hemorrhagic (Metrng, Klabunde, Sarathy & Spaniel et al.).

Hemorrhagic shock is a serious and life-threatening condition, which affects all body systems (Sarathy 2010). Cardiac output is reduced and depriving tissue of adequate oxygen. Hemorrhagic shock is further classified into four, according to the amount of blood lost. In Class I hemorrhage, there is a 15% or less blood loss with no other signs. In Class II hemorrhage, blood loss is 15-30% with definite tachycardia and tachypnea and decreased pulse pressure. It is Class III hemorrhage when the blood loss is 30-40% and all typical signs and symptoms of shock are evident. More than 40% blood loss is Class IV (Sarathy).

The clinical signs of hemorrhagic shock differ according to the volume of blood loss or Class (Medtrng 2010). In Class 1 or less than 15% blood loss, there are only slightly increased heart rate, local swelling and bleeding. In Class 2, the heart rate and diastolic...

In Class 3, All these signs are present and, in addition, there are hypotension, confusion, acidosis, and decreased urine output. And the clinical signs of Class 4 are refractory hypotension, refractory acidosis and death. Other common signs are a continuing decrease in systolic and diastolic blood pressure; skin coldness and paleness; cyanosis; fast but weak and thready pulse rate; shallow and fast breathing, accompanied by a grunt; subnormal temperature; oliguria or reduced renal blood flow caused by vasoconstriction on account of reduced cardiac output; and uneasiness, stupor and unconsciousness (Metrng).
Increased Heart Rate vs. Decreased Blood Pressure

Hemorrhagic shock usually develops from a traumatic event, which leads to an acute loss of blood from the intravascular space (Spaniel et al. 2007). The condition severely affects the body's ability to provide sufficient tissue perfusion and oxygenation after the loss of blood. The reduction of circulating blood volume diminishes the return of blood from the veins to the heart and the end-diastolic volume or preload. The reduction in turn lessens myocardial muscle fiber length, contractility of the heart and its output. This decrease in cardiac output results in inadequate cellular oxygen supply and impaired tissue perfusion (Spaniol et al.). This result is hypovolemia.

This acute blood loss also results in compensatory responses, which affect all the body's organ systems. The initial…