Page 1 of 1: 0.5 Litre Blood Loss

dr_saurabh · Credits: 7235 My Scrapbook

Hiiiiiii,

There's a question .....

0.5 Litre blood loss in 30 minutes in a normal healthy man produces :-

1) Rise in Heart rate with Fall in B.P.

2) Predominantly a Rise in Heart Rate

3) Fall in BP Fall in Heart Rate

4) Normal BP with slightly raised Heart Rate ??

Would 4) th be the most appropriate answer ??

what are the criteria for mild/ moderate / severe hemorrhage ??
Is it <10 % / 10- 15 % / > 15 %

pajitmenon · Credits: 1107 My Scrapbook

HI!! yes the ans . is choice d... why? see below
ALL THE BEST

HEMORRHAGE EVALUATION
General: Blood Volume
Adult: 7% (5 Liter blood volume for a 70 kg man)
Child: 8-9% (80-90 ml/kg for a child)

Class I Hemorrhage: Minimal Blood Loss
Characteristics
Blood Volume Loss <15%
Adult blood loss <750 ml
Cardiovascular
Heart Rate normal or mild increase
Pulses normal
Blood Pressure normal
pH normal
Respiratory: Rate normal
Neurologic: Slightly anxious
Skin
Warm and pink
Capillary refill brisk (<2 seconds)
Renal: Normal urine output
Adults: >0.5 ml/kg/hour (>30 cc/hour)
Children: >1 ml/kg/hour
Infants <1yo: >2 ml/kg/hour

Class II Hemorrhage: Mild Blood Loss
Characteristics
Blood Volume Loss: 15-30%
Adult: 750-1500 ml of blood loss
Cardiovascular
Tachycardia
Diminished peripheral pulses
Blood Pressure normal
Normal pH
Respiratory
Mild Tachypnea
Neurologic
Irritable
Confused
Combative
Skin
Cool extremities
Mottling
Delayed Capillary refill
Renal
Oliguria
Increased specific gravity

Class III Hemorrhage: Moderate Blood Loss
Characteristics
Blood Volume Loss: 30-40%
Adults: 2000 ml blood loss
Cardiovascular
Significant Tachycardia
Thready peripheral pulses
Hypotension
Metabolic Acidosis
Respiratory: Moderate tachypnea
Neurologic
Irritable
Lethargic
Diminished pain response
Skin
Cool extremities, mottling or pallor
Prolonged capillary refills
Renal
Oliguria
Blood Urea Nitrogen (BUN) increased

Class IV Hemorrhage: Severe Blood Loss
Characteristics
Blood Volume Loss: >40%
Cardiovascular
Severe tachycardia
Thready central pulses
Significant hypotension
Significant acidosis
Respiratory: Severe tachypnea
Neurologic
Lethargic
Coma
Skin
Cold extremities
Pallor
Cyanosis
Renal
Anuria
-------------------------------------------------------------------------------------

Indications for Fluid Therapy:
Signs of shock
Mottled or pale color
Cool skin
Diminished peripheral pulses
Delayed capillary pulses despite normal Ambient temp
Mental status changes
Oliguria
Shock may be present despite normal Blood Pressure
Available Fluids for Volume Expansion
Crystalloid Isotonic Solution
Colloid Solution
Blood Products
Inadequate improvement after 2 crystalloid boluses

Monitoring Reassess systemic perfusion after each bolus
Dosing
Bolus Volumes given rapidly (<20 minutes)
Adult: 1-2 Liter Bolus IV
Child: 20 ml/kg LR or NS IV or IO
Repeat dosing
May require 2-3 boluses within first hour
Septic shock may require 4 boluses in first hour
Technique: Children
Use 35-50 cc syringe attached to inline 3-way stop-medicine
Precautions
Use only LR or NS for initial boluses
Do not use dextrose solutions
Induces osmotic diuresis
Results in Hypokalemia
Worsens ischemic brain injury

nadu · Credits: 17278 My Scrapbook

hi pajit,

please give the referance of the above classes of hemorrhage.

dr_saurabh · Credits: 7235 My Scrapbook

Thanks again....

Guest · Credits: 77790 My Scrapbook My Reading List 262569 Books

dear dr.
these r from my notes i had made to clear AIPGE test. made from sabiston( single vol book), baily and love , harrison, and lees /miller anesthesia.
all the best

anuj · Credits: 4672 My Scrapbook

grt work man...keepit up

kannan · Credits: 6918 My Scrapbook

hi doc,

That was a uesful piece of info , thanks

sebino · Credits: 178 My Scrapbook

wow!

omkarc · Credits: 5282 My Scrapbook

nice work pajit

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