Hypovolemic Shock

Hypovolemic Shock

Hypovolemic shock is an emergency condition resulting from the loss of large amounts of blood or body fluids, preventing the heart from pumping enough blood around the body. This condition must be treated immediately to prevent organ damage that can result in death.

Hypovolemic shock is generally caused by heavy bleeding due to certain conditions. Hypovolemic shock can also occur in conditions that cause severe dehydration, such as profuse diarrhea and vomiting.

Hypovolemic shock is characterized by a drop in blood pressure, a drop in body temperature, and a pulse that feels fast but weak.

Causes of Hypovolemic Shock

Blood has various functions for the body, namely to help distribute oxygen and nutrients to various organs of the body. Blood also functions to maintain a stable body temperature and form blood clots when bleeding occurs.

Hypovolemic  shock occurs when the heart is unable to circulate blood throughout the body due to loss of more than 15% of blood or fluid volume. As a result, the organs do not get enough oxygen. This condition can lead to organ failure.

Some conditions that can cause bleeding and trigger hypovolemic shock are:

  • Extensive lacerations
  • Fracture
  • Tearing or rupture of an aortic aneurysm
  • Postpartum bleeding
  • Rupture or rupture  of an ectopic pregnancy
  • Bleeding in the chest cavity ( hemothorax )
  • Placental abruption
  • An injury that damages an organ, such as the liver, spleen, or kidney
  • Gastrointestinal bleeding n

Apart from bleeding, the body can also experience hypovolemic shock due to losing too much body fluid. The reasons include:

  • Persistent diarrhea or vomiting
  •  Extensive burns
  • Excessive sweating

Risk factors for hypovolemic shock

Hypovolemic shock is at risk for sufferers of diseases or conditions that can increase the risk of bleeding, including:

  • Diseases of the heart and blood vessels, such as aortic aneurysm
  • Gastrointestinal disorders, such as duodenal ulcers

In addition, injuries from driving accidents, falls from heights, and being stabbed by sharp objects also carry a risk of causing bleeding which can lead to hypovolemic shock.

Symptoms of Hypovolemic Shock

During hypovolemic shock, the heart is unable to pump enough blood around the body. As a result, the following complaints and symptoms will appear:

  • The body feels weak
  • Decreased blood pressure ( hytension )
  • Cold sweat, especially on the palms and feet
  • Infrequent urination or no urination at all
  • The pulse is fast , but feels weak
  • Heart beat
  • Quick breath
  • Skin looks pale
  • Body temperature drops
  • Anxious or agitated
  • dazed
  • Fainting or loss of consciousness

The appearance of signs and symptoms of hypovolemic shock will usually depend on the patient's age, medical history and disease, the underlying cause, how quickly the body loses blood or fluids, and how severe the bleeding is.

When to see a doctor

Immediately call the ambulance service to number 119 or seek help from a doctor or emergency room at the nearest hospital if you find someone who is injured, has heavy bleeding, or has other conditions that can cause hypovolemic shock, such as persistent diarrhea or vomiting.

Diagnosis of Hypovolemic Shock

When a patient arrives with a decrease or loss of consciousness, the doctor will immediately check the respiratory rate, blood pressure, pulse and body temperature. Not only that, the doctor will also do a physical examination to see if there are any obstructions in the respiratory tract.

While carrying out the examination, the doctor will provide initial treatment in the form of fluid resuscitation to stabilize the patient's condition. The doctor will also ask the person who brought the patient to the hospital regarding the incident that the patient experienced.

After the patient is stable, the doctor will carry out investigations to determine the cause of hypovolemic shock. Some of the checks that will be carried out are:

  • Complete blood test  , to confirm reduced blood counts
  • Blood chemistry tests, to check the function of the kidneys and heart muscle
  • Endoscopy , to examine the digestive tract and ensure whether there is bleeding originating from the digestive tract
  • Scanning with X-rays,  ultrasound , or CT scans, to examine areas suspected of bleeding

Hypovolemic shock can also be caused by bleeding that occurs in the body, for example, due to rupture or rupture of an ectopic pregnancy (pregnancy outside the womb). In this case, the doctor will usually do a pregnancy test to be sure.

Treatment of Hypovolemic Shock

Hypovolemic shock is an emergency condition that requires immediate treatment. If you find or are around someone who is bleeding due to an injury, immediately call an ambulance or ask for help from people around you to contact the nearest health facility.

While waiting, there are several things you can do, namely:

First aid

While waiting for an ambulance or before taking the patient to the emergency room, the first aid that needs to be done includes:

  • Position the patient's body on a flat surface and lift the legs about 30 cm, so that the head is lower than the feet.
  • Do not change the patient's position if there is an injury to the head, neck, back or legs, unless the patient is in danger, for example near an explosive object.
  • Do not give any liquid into the patient's mouth and do not remove any object stuck in the patient's body, such as a knife or glass shards.
  • Press the bleeding point using a cloth or towel and make a tight bond with the cloth or towel in the area to minimize the volume of wasted blood.
  • Keep the patient's body temperature warm to prevent  hypothermia , for example by covering it.
  • Stabilize the neck before transferring the patient to an ambulance or other means of transportation, if there is an injury to the neck or head.

Advanced help

After the patient is in the emergency room, medical staff will carry out further assistance which includes:

  • Giving additional oxygen or installing a breathing apparatus, to treat respiratory problems in patients
  • Administration  of intravenous fluids or blood transfusions , to restore the patient's fluid and blood volume to normal levels
  • Emergency surgery, to stop bleeding that occurs outside or inside the body
  • Giving drugs in the form of  dobutamine , dopamine, epinephrine, or  norepinephrine , to increase the heart's ability to pump blood

Hypovolemic Shock Complications

Lack of blood and fluids in the body due to hypovolemic shock can cause the following complications:

  • Organ damage, such as the kidneys or brain
  • Decreased oxygen levels in the body's cells ( hypoxia )
  • Gangrene  (tissue death) of the arms and legs
  • Heart attack
  • Dead

Prevention of Hypovolemic Shock

Hypovolemic shock can be prevented if things that cause severe bleeding or reduced body fluids are treated immediately. Here are some things you can do to prevent hypovolemic shock:

  • Meet the body's fluid needs to prevent dehydration due to vomiting or  diarrhea .
  • Use a helmet, seat belt or other safety equipment when driving or doing activities that pose a risk of injury.
  • Check with your doctor if you experience disturbances in the digestive system, such as diarrhea, stomach ulcers, or bloody bowel movements.
  • Keep your heart  and blood vessels healthy by regularly checking with your doctor if you have heart disease.
  • Do a health check-up ( medical check-up ) to detect diseases or conditions that are at risk of causing hypovolemic shock.
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