MRCEM Notes

Types of shock

Below is an outline of the ATLS classification of haemorrhagic shock:


Class of ShockBlood LossClinical Features
Type 1
  • 15% or less
  • <750ml
  • May have normal BP and heart rate
  • Resp rate 12 to 20
  • Type 2
    • 15 to 30%
    • 750 to 1500ml
  • Pulse 100 to 120
  • Resp rate 20 to 30
  • Normal BP typically
  • Type 3
    • 30 to 40%
    • 1.5 to 2 litres
  • Pulse 120 to 140
  • Urine output 5-15mls/hr
  • Resp rate >30
  • Hypovolaemic
  • May have signs agitation
  • Type 4
    • More than 40%
    • More than 2 litres
  • Pulse >140
  • Resp rate >35
  • Hypovolaemic
  • Likely drowsy, confused, possible loss of consciousness
  • May be anuric
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