Bleeding Bea — Hypovolemic Shock
Tank is empty: tachycardia first, hypotension late
Bea bleeds into her own abdomen where no one can see it. Her heart races to make up the difference for an hour, and by the time her blood pressure falls she has already lost a third of her volume.
Bea loses volume faster than her body can compensate — trauma, GI bleed, burns. Tachycardia and narrowing pulse pressure come first; hypotension is a late sign. Two large-bore IVs, isotonic crystalloid, blood products, and control the source.
Read Bleeding Bea's full story →The story arc
The setup
A car crash leaves her with a splenic injury and no external bleeding to point at.
The turn
Heart rate 124, respirations 26, skin cool and pale, restless — but blood pressure reads 112/88.
The crisis
Blood pressure drops to 80/50, urine output stops, and she becomes confused.
The save
Two large-bore IVs, warmed isotonic crystalloid, type-specific blood and surgery for source control.
NCLEX study section — Hypovolemic Shock
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Cardiovascular
Take this chapter into practice questions on the same topic.