QS Study

Hypovolemic Shock

Hypovolemic shock/cold shock is a type of shock characterized by hypotension, a rapid thready pulse, a cold, clammy skin, intense thirst, rapid respiration, and restlessness. It is a life-threatening situation that results when you lose more than 20 percent (one-fifth) of your body’s blood or fluid supply. This severe fluid loss makes it unattainable for the heart to pump an adequate amount of blood to your body.

Mild symptoms: headache, fatigue, nausea, profuse sweating, dizziness

Severe symptoms: cold or clammy skin, pale skin, rapid breathing, little urine output, weak pulse, blue lips and fingernails, lightheadedness, loss of consciousness etc.

Cause of hypovolemic shock

↓ Blood volume due to –

  • Hemorrhage
  • Surgery
  • Burns
  • Fluid loss due to vomiting or diarrhea.

Compensatory mechanism:

  1. Vasoconstriction
  2. Tachycardia
  3. Venoconstriction
  4. Tachypnea →↓ Thoracic pumping
  5. Restlessness →↑ Skeletal muscle pumping
  6. Movement of interstitial fluid into capillaries
  7. Secretion of epinephrine and non-epinephrine
  8. Secretion of vasopressin
  9. Secretion of glucocorticoid
  10. Secretion of renin, erythropoietin
  11. Increase plasma protein synthesis


Treatment revolves around controlling loss of fluid and blood, replacing what’s been lost, and stabilizing damage that both caused and resulted from the hypovolemic shock.

These include:

  • blood plasma transfusion
  • platelet transfusion
  • red blood cell transfusion
  • intravenous crystalloids