ATLS Haemorrhagic Shock Classification — FRCA Final MCQ

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ModerateTrauma & Emergency AnaesthesiaATLS Haemorrhagic Shock ClassificationFRCA Final

A 30-year-old man (ASA I) is hit by a car at 40 mph. He has bilateral femoral fractures, a pelvic fracture, and is haemodynamically unstable (HR 140, BP 70/40, GCS 15). Estimated blood loss is 3-4 litres. According to ATLS, what class of haemorrhagic shock is he in?

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Correct answer: A — Class III

ATLS classification of haemorrhagic shock: Class I (<750 mL, <15%): HR normal, BP normal; Class II (750-1500 mL, 15-30%): tachycardia, normal BP, narrowed pulse pressure; Class III (1500-2000 mL, 30-40%): tachycardia, hypotension, confused; Class IV (>2000 mL, >40%): tachycardia/bradycardia, severe hypotension, lethargy. This patient with bilateral femoral and pelvic fractures (each femur ~1500 mL, pelvis ~3000 mL potential), tachycardia 140, hypotension, but normal GCS is most consistent with Class III. However, the clinical picture may progress to Class IV.

Reference: ATLS – 2018 – 10th edition; NICE – 2023 – NG39 Major trauma