A 70 kg trauma patient has lost an estimated 2.1L of blood with BP 90/70 mmHg, HR 130/min, RR 28/min, and confusion. According to ATLS classification, what class of hemorrhagic shock is this, and what is the estimated percentage blood volume loss?

• A Class I; 10-15% blood loss
• B Class II; 15-30% blood loss
• C Class IV; >40% blood loss
• D Class III; 30-40% blood loss ✓

Explanation

ATLS hemorrhagic shock classification: Class I (<750mL, <15% — no symptoms); Class II (750-1500mL, 15-30% — HR >100, anxiety, slight BP drop); Class III (1500-2000mL, 30-40% — HR >120, BP drop, confusion, decreased UO); Class IV (>2000mL, >40% — HR >140, BP markedly low, lethargic, confused). This patient with ~2.1L blood loss (≈30% of 70 kg patient's ~5L blood volume = 30%), tachycardia >130, hypotension, tachypnea, and confusion fits Class III. Class III hemorrhagic shock typically requires blood transfusion and likely surgical intervention.

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

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Written and medically reviewed by the StethoPrep medical team.