Urinary catheterization (tube placed into the bladder to measure urine output)
This list may not be all-inclusive.
Get immediate medical help. In the meantime, follow these steps:
Keep the person comfortable and warm (to avoid hypothermia).
Have the person lie flat with the feet lifted about 12 inches to increase circulation. However, if the person has a head, neck, back, or leg injury, do not change the person's position unless he or she is in immediate danger.
Do not give fluids by mouth.
If person is having an allergic reaction, treat the allergic reaction, if you know how.
If the person must be carried, try to keep him or her flat, with the head down and feet lifted. Stabilize the head and neck before moving a person with a suspected spinal injury.
The goal of hospital treatment is to replace blood and fluids. An intravenous (IV) line will be put into the person's arm to allow blood or blood products to be given.
Medicines such as dopamine, dobutamine, epinephrine, and norepinephrine may be needed to increase blood pressure and the amount of blood pumped out of the heart (cardiac output).
Other methods that may be used to manage shock and monitor the response to treatment include:
Hypovolemic shock is always a medical emergency. However, symptoms and outcomes can vary depending on:
Amount of blood/fluid volume lost
Rate of blood /fluid loss
Illness or injury causing the loss
Underlying chronic medication conditions, such as diabetes and heart, lung, and kidney disease
In general, patients with milder degrees of shock tend to do better than those with more severe shock. In cases of severe hypovolemic shock, death is possible even with immediate medical attention. The elderly are more likely to have poor outcomes from shock.
Gangrene of arms or legs, sometimes leading to amputation
Severe shock can lead to death
Calling your health care provider
Hypovolemic shock is a medical emergency. Call the local emergency number (such as 911) or take the person to the emergency room.
Preventing shock is easier than trying to treat it once it happens. Quickly treating the cause will reduce the risk of developing severe shock. Early first aid can help control shock.
Maier RV. Approach to the patient with shock. In: Fauci AS, Harrison TR, eds. Harrison's Principles of Internal Medicine. 17th ed. New York, NY: McGraw Hill; 2008:chap 264.
Spaniol JR, Knight AR, Zebley JL, Anderson D, Pierce JD. Fluid resuscitation therapy for hemorrhagic shock. J Trauma Nurs. 2007;14:152-156.
Jones AE, Kline JA. Shock. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 4.
Tarrant AM, Ryan MF, Hamilton PA, Bejaminov O. A pictorial review of hypovolaemic shock in adults. Br J Radiol. 2008;81:252-257.
den Uil CA, Klijn E, Lagrand WK, Brugts JJ, Ince C, Spronk PE, Simoons ML. The microcirculation in health and critical disease. Prog Cardiovasc Dis. 2008;51:161-170.
Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.