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Assessment of patient's condition in acute blood loss

Central nervous system (CNS): loss of 25% VCB — a consciousness is clear, 30-40% — sleepiness, indifference to people around, thirst, more than 40% — depression of central nervous activities, adynamia, apathy, may be a hypoxic coma as well.

Colour of skin and body temperature: cool pale skin, acrocyanosis are the evidences of pronounced peripheral vascular spasm. After pressing on the nail, capillaries of the nail bed are slowly being filled that also speaks of microcirculatory disorder. Marbled skin points to decentralization of blood circulation.

Heart rate CHR): 120-130 per min — characterizes a massive blood loss without compensation of VCB deficit and sufficient therapy.

Arterial pressure (AP): is a conventional criterion of hemodynamics state. A cardiac output should be considered as the main criterion.

A decrease of VCB index by 15% from a due value does not cause a change of APsyst. At the same time an elevation of APdiast. and a decrease of pulse pressure are observed.

Central venous pressure (CVP): decreases as a result of diminution of venous return to the heart.

Diuresis: decreases down to 20-15 ml/hour and even to a complete anuria.

A decrease of Ht index does not occur right after a blood loss, but a few hours later.

A decrease of concentration of fibrinogen and thrombocytes in blood points to a development of DIC, and addition of elongation of blood clotting time to the signs, enumerated above, is the evidence of developed thrombohemorrhagic syndrome.

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