Approximate Deficit (ml) | Decrease in Blood Volume % | Degree | Signs |
0-500 | 0-10 | None | None |
500-1200 | 10-25 | Mild | Slight tachycardia Postural changes in blood pressure Mild peripheral vasoconstriction |
1200-1800 | 25-35 | Moderate | Thready pulse Systolic blood pressure 100-120 90-100 Marked vasoconstriction Diaphoresis Anxiety/restlessness Decreased urine output |
1800-2500 | 35-50 | Severe | Thready pulse >120 Systolic blood pressure <60 Increased diaphoresis Obtundation No urine output |
The symptoms of shock vary from patient to patient and even during the course of illness in an individual. Evaluation of the whole situation is more important than one particular sign or symptom. Table 4-4 provides a generalized overview of the degrees of shock and their symptoms correlated to the approximate volume deficit.
The essence of shock control and prevention is to recognize the onset of the condition and to start treatment before the symptoms fully develop. The following are general signs and symptoms of the development of shock (see figure 4-51):
2. Eyes may be glassy, dull and have dilated pupils (these are also the symptoms of morphine use).
3. Breathing may be rapid or labored, often of the gasping air hunger type. In the advanced stages of shock, breathing becomes shallow and irregular.
4. The face and skin may be very pale or ashen gray; in the dark complexioned, the mucous membranes may be pale. The lips are often cyanotic.
5. The skin feels cool and is covered with clammy sweat. The coolness is related to a decrease in the peripheral 1. circulation. Restlessness and apprehension are early 6. The pulse tends to become rapid, weak, and symptoms, often followed by apathy. thready. If the blood pressure is severely