A 30-year-old trauma patient has BP 80/60 mmHg, HR 140/min, estimated blood loss 2.5 L. He is conscious and anxious. According to the ATLS haemorrhagic shock classification, which class does he represent?

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

Explanation

ATLS Class III haemorrhagic shock involves blood loss of 1500-2000 mL (30-40% blood volume), presenting with HR >120/min, BP decreased, pulse pressure narrowed, anxious/confused mental status, and decreased urine output (5-15 mL/hour). This patient — hypotensive with HR 140 and estimated 2.5 L loss — fits Class III. Class IV involves >2000 mL loss with profound hypotension, HR >140, and lethargy/obtundation. Management requires blood transfusion.

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

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