Have you ever suddenly become unconscious, dizzy, and have difficulty breathing? Or have you ever seen someone with a serious injury and bleeding profusely? One of the most dangerous conditions that can occur in such situations is hypovolemic shock, which we are going to talk about today. This is a condition that requires emergency medical treatment, so it is very important to be aware of it.
What is hypovolemic shock? Let's understand it simply!
Simply put, hypovolemic shock is when the amount of blood or fluids in your body suddenly decreases so much that your heart is unable to pump blood throughout your body properly. Think of it like a car running out of fuel. Blood is like fuel to our bodies.
This condition usually occurs when more than 20%, or one-fifth, of the total blood volume in our body is lost. This can happen not only from excessive bleeding due to a major injury. Sometimes, severe diarrhea, persistent vomiting, or excessive sweating can also cause this condition, causing a lot of fluid to be lost from the body.
This is a medical emergency, so if you notice symptoms, it is essential to call 1190 or 1990 immediately and seek medical attention.
What is happening to blood pressure at this time?
When hypovolemic shock occurs, the bottom number of your blood pressure, called the diastolic pressure, may initially increase slightly. But as blood or fluid continues to leave your body, the top number, called the systolic pressure, will gradually begin to decrease.
Who is more likely to develop this?
This condition can happen to anyone, especially someone who has been in a major accident and is losing a lot of blood. Also, as we mentioned earlier, someone who is vomiting a lot, has diarrhea, or sweats a lot can also become dehydrated.
How common is this condition?
Overall, any type of shock occurs in less than 1 in 1,000 people. However, hypovolemic shock is the second most common type of shock. In some developing countries, it is most common in young children due to diarrhea.
What happens to the body during hypovolemic shock?
Hypovolemic Shock occurs when the most important organs in our body (for example, the brain, heart, kidneys) do not receive the necessary amount of blood and oxygen. This is like a tree dying without water. Our organs cannot function without blood either.
At this time, our body works very intelligently. With the low amount of blood in the body, it prioritizes supplying blood to the two most vital organs for survival, the brain and the heart . That is why the amount of blood going to the limbs decreases, and the limbs become cold.
On average, a person weighing about 70 kilograms has about 5 liters of blood in their body. That's about 7% of their body weight. In hypovolemic shock, a significant portion of this amount is lost.
What are the four stages of shock?
There are four main scenarios in this situation, depending on the severity.
- Stage 1: This is when you lose about 15% of your blood volume (about 750 milliliters (750 mL) – that's about the size of a large bottle of water). Your blood pressure and heart rate may be normal at this point.
- Stage 2: This is when blood volume is reduced by 15% to 30% (750 mL to 1,500 mL – about two large bottles of water). The heart rate begins to increase, and breathing rate increases.
- Stage 3: Between 30% and 40% of the body's blood volume (1,500 mL to 2,000 mL – about three large bottles of water!) is lost. Blood pressure drops significantly, heart rate and breathing rate increase. Urine output also decreases significantly.
- Stage 4: This is the most severe stage. More than 40% of the body's blood volume (>2,000 mL) has been lost. Blood pressure is very low, heart rate is high, and urine output is almost nonexistent.
What symptoms should we be aware of?
The more blood or fluid is lost from the body, the more severe the symptoms become. Here are some common symptoms of hypovolemic shock:
- Increased breathing rate: Feeling like you are breathing faster than normal.
- Feeling confused or restless: It's hard to concentrate, and you may feel restless.
- Excessive sweating: Suddenly, the body becomes cold and starts sweating.
- Loss of consciousness (fainting): You may suddenly lose consciousness without any physical activity.
- Cold skin: The limbs feel cold to the touch.
- Feeling weak: The body becomes so weak that it is unable to do anything.
- Decrease in body temperature and blood pressure.
- Increased heart rate (increased pulse rate).
If one or more of these symptoms are seen with severe bleeding, it may be hypovolemic shock.
What are the main reasons for this?
The main cause is the loss of a large amount of blood or fluids from the body. This bleeding can occur internally (in a way that we cannot see) or from a visible wound. In addition,
- Burns
- Pancreatitis
- Causes such as excessive sweating, vomiting, or diarrhea can also be contributing factors.
What are the possible ways in which bleeding can occur?
The main bleeding events that can lead to hypovolemic shock are:
- Injuries caused by a serious accident: Things like an accident on the road, a fall from a height, etc.
- During or after surgery (an operation): Some surgeries can cause a little more bleeding.
- Ectopic pregnancy: This is a very dangerous condition, as it can cause bleeding inside the body.
- Aneurysm rupture: This means that a blood vessel weakens, swells like a balloon, and suddenly bursts.
- Digestive tract problems: For example, bleeding due to a stomach ulcer.
How does a doctor detect this?
When you are brought to the hospital, the first thing the doctor or nurse will do is examine you. Then, they may do a few tests to confirm the condition.
- Blood tests: Check to see how low your blood count is and whether organs like your kidneys have been affected.
- Electrocardiogram (ECG): View the functioning of the heart.
- Echocardiogram: A scan of the heart.
- Right heart (Swan-Ganz) catheterization: A special test that measures the pressures in the heart.
- CT scan (Computed tomography - CT) or other radiological tests: To find where the blood is leaking inside the body.
- Endoscopy: Examination of the digestive tract using a tube with a camera.
How to treat it? Things to do immediately!
After you are brought to the hospital by ambulance or other means, the first thing doctors do is put you in an IV line and give you fluids (such as saline) . Then they give you blood if necessary. They also give you medications to bring your blood pressure back to normal.
The most important thing is to treat the problem that caused the shock. For example, stopping the bleeding, or having surgery if you have been injured in an accident. After that, you will be kept in the Intensive Care Unit (ICU) for observation.
What types of medications are given?
Some of the main medications given for hypovolemic shock are:
- Epinephrine (Epinephrine - Adrenalin®)
- Norepinephrine (Norepinephrine - Levophed®)
- Dopamine
- Dobutamine (Dobutamine - Inotrex®)
These medications help restore heart rate and blood pressure.
Are there any side effects of the treatment?
These medications can sometimes cause minor side effects.
- Increased blood pressure and heart rate
- Difficulty breathing
- Headache (headache)
- Heartbeat irregularities
What can we do to reduce this risk?
It's hard to predict and prevent serious accidents. However, there are things we can do to reduce the risk of hypovolemic shock from other causes:
- If you are taking diuretics , take them exactly as prescribed by your doctor. Also, drink plenty of water to avoid dehydration.
- If you have diarrhea or are vomiting, drink plenty of water or a liquid like Jeevani to replenish the fluids lost from your body.
- If you sweat a lot, drink plenty of water to replace the fluid you are losing.
Most importantly: If you see a lot of bleeding, or if you have a cut that cannot be stopped, call 1190 or 1990 immediately, or go to the emergency department of your nearest hospital. Getting help quickly can help control the situation before a large amount of blood is lost.
What happens if you get hypovolemic shock? How long does it take to recover?
Whether you survive this condition and recover depends on several factors. How much blood or fluid was lost, how quickly it happened, other medical conditions you have, and what caused the shock can also play a role.
If you start treatment for shock early, its effects can be reversed. If you are young and the shock is not too severe, you have a good chance of survival. However, sometimes organ damage can lead to a heart attack. If more than one organ fails, the condition is more likely to be fatal. Even with treatment, hypovolemic shock can sometimes be fatal.
How can I take care of myself until I recover?
After you get home from the hospital, you should follow the doctor's instructions exactly. Your body has been through a lot of trauma, so you should rest and recover at home before going to work. Take the medicine your doctor prescribed exactly, and take good care of any wounds.
When do I need to see a doctor again?
The doctor will ask you to come back for follow-up appointments to see how you are doing. Don't miss these appointments, because that's when the doctor can quickly identify any new problems that may arise.
When should you go to an Emergency Treatment Unit (ETU) ?
If you see someone showing symptoms of hypovolemic shock, call 1190 or 1990 immediately. The sooner the person gets help, the better. Until help arrives, lay the person down with their legs elevated about a foot above the rest of the body. Do not move the body, except to raise the legs. If there is bleeding, try to stop it, and keep the body warm.
If you have previously had hypovolemic shock, if your wounds start bleeding again, or if they appear to be oozing, go to the emergency room again.
What are the important questions to ask the doctor?
When you see the doctor, don't forget to ask these questions:
- Will this hypovolemic shock cause long-term effects on me?
- How long will it take for me to fully recover?
- How long do I need to take the medicine you prescribed?
Finally, take-home message
Hypovolemic shock is a medical emergency. However, getting treatment quickly can save your life. Doctors can reverse the condition, but it will take time for you to recover. Especially if the shock is the result of a serious accident, it may take longer to recover. So, follow your doctor's instructions exactly and take good care of yourself and your injuries. Always be careful!
` hypovolemic shock, blood loss, fluid loss, shock, emergency treatment, blood pressure, symptoms
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