Hemorrhage Classifications in Trauma

Hypovolemia due to hemorrhage is the most common cause of shock in trauma patients.

Class III hemorrhage is where a decrease in blood pressure begins to occur.

The primary treatment involves stopping the bleeding and administering intravenous fluids such as lactated ringers.

Class I hemorrhage involves a blood loss of approximately 500 mL, equivalent to 15% of the total blood volume.

Pulse pressure is reduced in Class II hemorrhage.

Capillary refill is delayed for more than 2 seconds in Class II hemorrhage.

Class III hemorrhage involves a blood loss of 1500-2000 mL, or 30-40% of blood volume.

Class III hemorrhage includes blood loss of 1500-2000 mL, HR >120, decreased BP, tachypnea RR (30-40), decreased UOP (5-15 mL/hour), anxiety, confusion, and capillary refill > 2 sec.

The treatment for Class III hemorrhage typically involves administering crystalloid solutions and/or blood transfusions.

Class IV hemorrhage involves a blood loss of more than 2000 mL or exceeding 40% of the total blood volume.

Class IV hemorrhage is immediately life-threatening due to the severity of blood loss.

Class IV hemorrhage includes blood loss exceeding 2000 mL, HR >140, RR > 35, potentially immeasurable pulse pressure, negligible UOP, confusion/lethargy, and prolonged capillary refill.

Treatment for Class IV hemorrhage involves administering crystalloid solutions or blood transfusions immediately.