A 5-year-old trauma victim presents with heart rate 170/min, blood pressure 70/40 mmHg, cold extremities with mottled skin, capillary refill 5 seconds, and altered sensorium. Urine output is 0.3 mL/kg/hr. Based on ATLS classification, what class of hemorrhagic shock is this?
- A Class III (blood loss 30-40%) ✓
- B Class II (blood loss 15-30%)
- C Class I (blood loss <15%)
- D Class IV (blood loss >40%)
Correct answer: A. Class III (blood loss 30-40%)
Explanation
Class III hemorrhagic shock (30-40% blood loss) presents with tachycardia, hypotension, altered mental status, markedly prolonged CRT, oliguria, and cold clammy skin. Class I has minimal tachycardia and normal BP. Class II shows tachycardia with narrowed pulse pressure and anxiety. Class IV shows extreme tachycardia, hypotension, lethargy, and anuria. This child's hypotension and altered sensorium indicate significant decompensation consistent with Class III.
Reference: Pediatric Advanced Life Support Provider Manual, American Heart Association 2020 ed.
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Written and medically reviewed by the StethoPrep medical team.