A 30-year-old woman sustains a road traffic accident with multiple pelvic fractures. On arrival she has HR 128/min, BP 88/60 mmHg, respiratory rate 26/min, and is confused. Estimated blood loss is approximately 2.5 litres. According to ATLS classification, she is in:

• A Class I haemorrhagic shock
• B Class II haemorrhagic shock
• C Class III haemorrhagic shock ✓
• D Class IV haemorrhagic shock

Explanation

ATLS Class III haemorrhagic shock corresponds to a blood loss of 1.5-2.0 litres (30-40% of blood volume) with HR 120-140, BP <90 mmHg, reduced pulse pressure, tachypnoea (30-40 breaths/min), and altered mental status (anxiety, confusion). Class II involves 750-1500 mL loss (tachycardia but normal BP). Class IV is life-threatening with greater than 2 litres lost and BP unrecordable. Initial management requires blood transfusion and damage control resuscitation with a 1:1:1 ratio of pRBC:FFP:platelets.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.