A trauma patient has an estimated blood loss of 750 to 1500 mL after blunt trauma. According to the ATLS classification of haemorrhagic shock, which clinical picture corresponds to this volume of loss?

• A Normal blood pressure, heart rate less than 100/min, anxiety
• B Marked hypotension, lethargy, urine output negligible
• C Hypotension, heart rate 120 to 140/min, confusion, urine output 5 to 15 mL/hour
• D Normal blood pressure, tachycardia greater than 100/min, narrowed pulse pressure, anxiety ✓

Explanation

Class II haemorrhage is loss of 15 to 30 percent of blood volume, roughly 750 to 1500 mL in a 70 kg adult. Blood pressure is maintained by vasoconstriction so tachycardia with narrowed pulse pressure is the earliest reliable sign. Hypotension appears only from Class III onward, which kills options C and B as answers for this volume.

Reference: ATLS Advanced Trauma Life Support Student Course Manual, 10th ed.

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