
Blood loss is a serious issue that can quickly become life-threatening. The human body can compensate for some blood loss by constricting blood vessels to maintain blood pressure and blood flow, but severe blood loss can lead to hypovolemic shock, a life-threatening condition caused by a rapid loss of blood or body fluids. Hypovolemic shock occurs when there is insufficient blood volume to maintain stable vital signs, and it can lead to organ failure and death if left untreated. The amount of blood loss that constitutes a life-threatening injury varies depending on individual factors, but it is generally agreed that losing more than 40% of total blood volume is life-threatening and will likely result in a coma and death without prompt medical intervention.
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What You'll Learn

Blood loss of 15-30% of total blood volume
The human body can compensate for a certain amount of blood loss by constricting the blood vessels in the limbs and extremities, thereby maintaining blood pressure and blood flow. However, beyond a 15% blood volume loss, the body struggles to maintain these vital functions. As blood volume loss climbs, the body may not be able to maintain circulation and adequate blood pressure, leading to hemorrhagic or hypovolemic shock. This occurs when there is decreased intravascular volume, causing a cardiovascular compromise.
A person experiencing such blood loss should receive immediate medical attention. First aid performed by immediate responders can be critical in such situations, and it is important that laypeople are aware of the necessary interventions. The Stop the Bleed® campaign recommends training laypeople to treat blood loss of 165 ml as life-threatening. Strategies such as damage control resuscitation should be employed in conjunction with prompt intervention to control the source of bleeding.
It is important to note that the perception of blood loss and injury severity may vary depending on factors such as the volume and flow of blood loss, as well as the gender of the victim. Studies have shown that laypeople tend to overestimate small volumes of blood loss and underestimate larger volumes. Therefore, understanding how medically untrained bystanders perceive hemorrhage is crucial in developing effective training programs for bleeding control.
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Blood loss of over 40% of total blood volume
The risk of death from blood loss depends on several factors, including the rate of blood loss, the location and size of the blood vessel, and the overall health of the individual. For example, blood loss from a major blood vessel or artery can be challenging to stop and may result in severe blood loss. Similarly, individuals with underlying health conditions or injuries may be more vulnerable to the effects of blood loss.
It is important to recognize the signs and symptoms of severe blood loss, such as dizziness, fatigue, rapid heart rate, low blood pressure, and breathing issues. If an individual is experiencing these symptoms, it is crucial to seek immediate medical attention. First aid for severe bleeding includes calling emergency services, laying the person down, and applying direct pressure to the wound. If the bleeding is from an arm or leg, a tourniquet can be applied to stop the blood flow.
Additionally, hemorrhagic shock, a life-threatening condition, can occur when there is a significant decrease in intravascular volume, leading to cardiovascular compromise. This can be due to severe dehydration or blood loss. Hypotensive resuscitation aims to achieve a systolic blood pressure of 90 mmHg to maintain tissue perfusion and prevent re-bleeding. However, the quantity and type of fluids used are still under debate, and the approach must consider the type of injury, proximity to a trauma center, and definitive hemorrhage control.
In summary, blood loss of over 40% of total blood volume is a severe and life-threatening condition that requires immediate medical attention and intervention. Quick medical treatment is critical, and first aid measures can help stabilize the individual until definitive care is provided.
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Hemorrhagic shock
The condition can develop from internal or external bleeding, and the symptoms may not always be immediately apparent, especially in the case of internal hemorrhaging. When an individual loses a large amount of blood, the body struggles to circulate blood effectively, leading to inadequate perfusion of tissues. This results in a state of shock, as the demand for oxygen by the tissues exceeds the body's ability to supply it.
The signs and symptoms of hemorrhagic shock include low blood pressure, a rapid heart rate, confusion, disorientation, rapid and shallow breathing, and pale and cool skin. As blood loss increases, the symptoms become more severe. At over 40% blood loss, the heart cannot maintain blood pressure or proper pumping, and circulation fails. This can lead to organ failure, coma, and eventually death if aggressive life-saving measures are not taken.
The standard treatment for hemorrhagic shock is intravenous (IV) fluid resuscitation and the administration of blood products. In some cases, medications such as norepinephrine or vasopressin may be given to increase blood pressure. Seeking immediate medical attention is crucial, as those who get help right away have a better chance of avoiding long-term issues and improving their overall outlook.
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Hypovolemic shock
The four stages of hypovolemic shock are as follows:
Stage 1: Loss of approximately 15% of total blood volume (750 mL or about 25 ounces). Blood pressure and heart rate may still appear normal at this stage.
Stage 2: Loss of 15% to 30% of total blood volume (750 mL to 1500 mL or up to almost 51 ounces). The individual's heart rate begins to increase, and they start breathing faster.
Stage 3: Loss of 30% to 40% of total blood volume (1500 to 2000 mL or up to 68 ounces). Blood pressure drops significantly, and the heart rate and breathing become even faster. Urine output decreases.
Stage 4: Loss of more than 40% of total blood volume (more than 2000 mL or 68 ounces). At this stage, the body cannot maintain circulation and blood pressure, leading to organ failure and, eventually, death if aggressive life-saving measures are not taken.
The symptoms of hypovolemic shock include rapid breathing, confusion or anxiety, excessive sweating, pale and cool skin, weakness, low blood pressure, and a fast pulse. It is important to note that these symptoms will become more severe as blood loss increases.
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First aid for life-threatening bleeding
Life-threatening bleeding can be the difference between life and death. It is important to understand how to identify and respond to severe bleeding.
Identifying Life-Threatening Bleeding
To recognise life-threatening bleeding, consider the amount of blood, the volume, and the flow. Bleeding may be life-threatening when the amount of blood is about half of what a soda can contains. For small children or infants, even lesser amounts of blood loss can be life-threatening. Continuous or spurting blood flow is a sign of life-threatening bleeding.
Responding to Life-Threatening Bleeding
If someone is experiencing life-threatening bleeding, your priority is to stop the bleeding. Here are the steps to follow:
- Check the scene for safety and put on protective gloves to prevent infection.
- Apply direct firm pressure to the wound using a sterile dressing or a clean non-fluffy cloth.
- If a foreign object is in the wound, do not remove it as it may be reducing the bleeding.
- If the wound is covered by clothing, remove or cut the clothes to uncover the wound.
- If trained, apply a tourniquet to the limb.
- If the wound is on the scalp, neck, shoulder, groin, or back, use wound packing if trained.
- Keep the person warm and prevent them from getting overheated.
- Monitor their breathing and responsiveness, and give care as needed.
- Call for emergency medical services immediately.
Remember, severe bleeding can quickly become life-threatening, so it is important to act quickly and seek professional help.
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Frequently asked questions
Life-threatening bleeding typically looks like blood squirting or flowing out of a wound rather than coming out as a slow trickle or drip. If blood is flowing continuously, squirting, or pooling, take action immediately.
The amount of blood loss deemed to be life-threatening is equal to half a can of soda in an adult. Bleeding in children and infants can be proportionately less and still be life-threatening. The Stop the Bleed campaign recommends treating 165 ml of blood loss as life-threatening.
Signs of severe internal bleeding may include some combination of the following: Blood coming out of the mouth, eyes, ears, nose, or genital openings. As more blood is lost, the patient may experience drops in blood pressure, increases in heart rate and breathing rate, and confusion and disorientation.
If you see someone bleeding or you are bleeding, put on sterile gloves if available, and carefully uncover the wound. If the blood is squirting or coming out fast, call emergency services while locating a trauma kit, applying direct pressure with a sterile gauze or clean cloth, and elevating the wound. If direct pressure doesn't stop the bleeding after a minute or two and the wound is on an arm or a leg, apply a tourniquet.

























