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Classification of hemorrhagic shock in children[1]

Classification of hemorrhagic shock in children[1]
  Class I Class II Class III Class IV
Blood volume loss* Up to 15% 15 to 30% 30 to 40% ≥40%
Pulse rate Normal Mild tachycardia Moderate tachycardia Severe tachycardia
Blood pressure Normal/increased Normal/decreased Decreased Decreased
Capillary blanch test Normal Positive Positive Positive
Respiratory rate Normal Mild tachypnea Moderate tachypnea Severe tachypnea
Urine output 1 to 2 mL/kg/hour 0.5 to 1.0 mL/kg/hour 0.25 to 0.5 mL/kg/hour Neglibible
Mental status Slightly anxious Mildly anxious Anxious/confused Confused/lethargic
Fluid replacement (3:1 rule) Crystalloid Crystalloid Crystalloid% blood Crystalloid% blood
* Assume blood volume to be 8 to 9% of body weight (80 to 90 mL/kg).
Reference:
  1. Lavoie M, Nance ML. Approach to the injured child. In: Fleisher & Ludwig's Textbook of Pediatric Emergency Medicine, 7th ed, Bachur RG, Shaw KN (Eds), Lippincott Williams and Wilkins 2016.
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