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Hemorrhagic Shock in Emergency Medicine Differential Diagnoses

  • Author: William P Bozeman, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
Updated: May 06, 2016
Contributor Information and Disclosures

William P Bozeman, MD Professor, Director of Prehospital Research, Department of Emergency Medicine, Wake Forest University School of Medicine

William P Bozeman, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, National Association of EMS Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Trevor John Mills, MD, MPH Chief of Emergency Medicine, Veterans Affairs Northern California Health Care System; Professor of Emergency Medicine, Department of Emergency Medicine, University of California, Davis, School of Medicine

Trevor John Mills, MD, MPH is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians

Disclosure: Nothing to disclose.

Additional Contributors

Daniel J Dire, MD, FACEP, FAAP, FAAEM Clinical Professor, Department of Emergency Medicine, University of Texas Medical School at Houston; Clinical Professor, Department of Pediatrics, University of Texas Health Sciences Center San Antonio

Daniel J Dire, MD, FACEP, FAAP, FAAEM is a member of the following medical societies: American Academy of Clinical Toxicology, American Academy of Pediatrics, American Academy of Emergency Medicine, American College of Emergency Physicians, Association of Military Surgeons of the US

Disclosure: Nothing to disclose.


Tom Scaletta, MD President, Smart-ER (; Chair, Department of Emergency Medicine, Edward Hospital; Past-President, American Academy of Emergency Medicine

Tom Scaletta, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

  1. Gutierrez G, Reines HD, Wulf-Gutierrez ME. Clinical review: hemorrhagic shock. Crit Care. 2004 Oct. 8(5):373-81. [Medline]. [Full Text].

  2. Wilson M, Davis DP, Coimbra R. Diagnosis and monitoring of hemorrhagic shock during the initial resuscitation of multiple trauma patients: a review. J Emerg Med. 2003 May. 24(4):413-22. [Medline].

  3. National Center for Injury Control and Prevention. Ten Leading Causes of Death by age group. Center for Disease Control and Prevention. Available at

  4. Cocchi MN, Kimlin E, Walsh M, Donnino MW. Identification and resuscitation of the trauma patient in shock. Emerg Med Clin North Am. 2007 Aug. 25(3):623-42, vii. [Medline].

  5. Bickell WH, Wall MJ, Pepe PE, et al. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med. 1994 Oct 27. 331(17):1105-9. [Medline].

  6. Ross SW, Christmas AB, Fischer PE, Holway H, Walters AL, Seymour R, et al. Impact of common crystalloid solutions on resuscitation markers following Class I hemorrhage: A randomized control trial. J Trauma Acute Care Surg. 2015 Nov. 79 (5):732-40. [Medline].

  7. Delano MJ, Rizoli SB, Rhind SG, Cuschieri J, Junger W, Baker AJ, et al. Prehospital Resuscitation of Traumatic Hemorrhagic Shock with Hypertonic Solutions Worsens Hypocoagulation and Hyperfibrinolysis. Shock. 2015 Jul. 44 (1):25-31. [Medline].

  8. Mitra B, Gabbe BJ, Kaukonen KM, Olaussen A, Cooper DJ, Cameron PA. Long-Term Outcomes of Patients Receiving Massive Transfusion After Trauma. Shock. 2014 Jun 21. [Medline].

  9. Holcomb JB, Tilley BC, Baraniuk S, Fox EE, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA. 2015 Feb 3. 313 (5):471-82. [Medline].

  10. Stancil SA. Past and current trends in intravenous therapy for hemorrhagic shock. Air Med J. 2014 Jul-Aug. 33 (4):172-5. [Medline].

  11. Jacob M, Kumar P. The challenge in management of hemorrhagic shock in trauma. Med J Armed Forces India. 2014 Apr. 70 (2):163-9. [Medline].

  12. Tsang BD, Panacek EA, Brant WE, Wisner DH. Effect of oral contrast administration for abdominal computed tomography in the evaluation of acute blunt trauma. Ann Emerg Med. 1997 Jul. 30(1):7-13. [Medline].

  13. Ward KR, Ivatury RR, Barbee RW, Terner J, Pittman R, Filho IP. Near infrared spectroscopy for evaluation of the trauma patient: a technology review. Resuscitation. 2006 Jan. 68(1):27-44. [Medline].

  14. Furmaga W, Cohn S, Prihoda TJ, Muir MT, Mikhailov V, McCarthy J, et al. Novel markers predict death and organ failure following hemorrhagic shock. Clin Chim Acta. 2015 Feb 2. 440:87-92. [Medline].

  15. Gonzalez EA, Moore FA, Holcomb JB, Miller CC, Kozar RA, Todd SR. Fresh frozen plasma should be given earlier to patients requiring massive transfusion. J Trauma. 2007 Jan. 62(1):112-9. [Medline].

  16. Rossaint R, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E, et al. The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition. Crit Care. 2016 Apr 12. 20 (1):100. [Medline].

  17. Roberts I, Shakur H, Ker K, Coats T. Antifibrinolytic drugs for acute traumatic injury. Cochrane Database Syst Rev. 2011 Jan 19. 1:CD004896. [Medline].

CT scan of a 26-year-old man after a motor vehicle crash shows a significant amount of intra-abdominal bleeding.
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