Hypovolemic shock

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Shock - hypovolemic

Get immediate medical help. In the meantime, follow these steps:

• Keep the person comfortable and warm (to avoid hypothermia).
• Have the person lie flat with the feet lifted about 12 inches to increase circulation. However, if the person has a head, neck, back, or leg injury, do not change the person's position unless he or she is in immediate danger.
• Do not give fluids by mouth.
• If person is having an allergic reaction, treat the allergic reaction, if you know how.
• If the person must be carried, try to keep him or her flat, with the head down and feet lifted. Stabilize the head and neck before moving a person with a suspected spinal injury.

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The goal of hospital treatment is to replace blood and fluids. An intravenous (IV) line will be put into the person's arm to allow blood or blood products to be given.

Medicines such as dopamine, dobutamine, epinephrine, and norepinephrine may be needed to increase blood pressure and the amount of blood pumped out of the heart (cardiac output).

Other methods that may be used to manage shock and monitor the response to treatment include:

• Heart monitoring, including Swan-Ganz catheterization
• Urinary catheter to collect and monitor how much urine is produced

Hypovolemic shock is always a medical emergency. However, symptoms and outcomes can vary depending on:

• Amount of blood volume lost
• Rate of blood loss
• Ilness or injury causing the loss
• Underlying chronic medication conditions, such as diabetes and heart, lung, and kidney disease

In general, patients with milder degrees of shock tend to do better than those with more severe shock. In cases of severe hypovolemic shock, death is possible even with immediate medical attention. The elderly are more likely to have poor outcomes from shock.

• Kidney damage
• Brain damage
• Gangrene of arms or legs, sometimes leading to amputation
• Heart attack

Hypovolemic shock is a medical emergency! Call the local emergency number (such as 911) or take the person to the emergency room.

Review Date: 01/14/2010
Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).