In the ATLS 10th edition approach to hemorrhagic shock, Class II hemorrhage is characterized by blood loss of what percentage of estimated blood volume and which hemodynamic parameter change?
- A 30–40% with tachycardia >120 bpm, hypotension, and anxiety
- B 15–30% with tachycardia 100–120 bpm, normal systolic BP, narrowed pulse pressure ✓
- C Up to 15% with normal heart rate and blood pressure
- D Greater than 40% with severe tachycardia, profound hypotension, and altered consciousness
Correct answer: B. 15–30% with tachycardia 100–120 bpm, normal systolic BP, narrowed pulse pressure
Explanation
ATLS 10th edition Class II hemorrhage represents 15–30% blood volume loss (750–1500 mL in 70 kg adult). Characteristically: heart rate 100–120 bpm, blood pressure normal or marginally decreased (catecholamine compensation), narrowed pulse pressure due to increased diastolic pressure from peripheral vasoconstriction, and mild anxiety. Class I is <15% with minimal changes; Class III (30–40%) shows tachycardia >120, falling systolic BP; Class IV (>40%) has life-threatening hemodynamic compromise.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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