Classes of hemorrhage in trauma

Parameter	Class I	Class II (mild)	Class III (moderate)	Class IV (severe)
Approximate blood loss	<15%	15 to 30%	31 to 40%	>40%
Heart rate	↔	↔ / ↑	↑	↑ / ↑↑
Blood pressure	↔	↔	↔ / ↓	↓
Pulse pressure	↔	↓	↓	↓
Respiratory rate	↔	↔	↔ / ↑	↑
Urine output	↔	↔	↓	↓↓
Glasgow Coma Scale score	↔	↔	↓	↓
Base deficit*	0 to –2 mEq/L	–2 to –6 mEq/L	–6 to –10 mEq/L	–10 mEq/L or less
Need for blood products	Monitor	Possible	Yes	Massive transfusion protocol

* Base excess is the quantity of base (HCO₃–, in mEq/L) that is above or below the normal range in the body. A negative number is called a base deficit and indicates metabolic acidosis.

Reproduced with permission from: Advanced trauma life support student course manual (10th ed), chapter 3, page 49, Table 3.1; Signs and Symptoms of Hemorrhage by Class Table; Published by: American College of Surgeons (Corporate Author) 2018. Copyright © American College of Surgeons. All Rights Reserved.

Graphic 107655 Version 3.0

خرید پکیج

Classes of hemorrhage in trauma