Hypovolemic Shock

The body needs the right balance of fluids, electrolytes, and blood in order to make the cardiovascular system function. When there is a serious imbalance, through the loss of blood or bodily fluids, it can cause the cardiovascular system to shut down, sending the body into shock. 

Hypovolemia is a decrease in the volume of blood in the body that can compromise the body's ability to pump blood and oxygen throughout the body. Hypovolemia is often treatable and avoidable. However, when doctors and healthcare workers make mistakes, it can cause a patient to go into hypovolemic shock, damaging organs and tissues. If not treated, hypovolemic shock can lead to death. 

Hypovolemia 

Hypovolemia is Latin for low volume, which refers to the physical condition of low blood volume or loss of bodily fluids. Hypovolemic shock is one of the main categories of physiological shock. Hypovolemic shock through loss of blood is known as hemorrhagic shock. However, hypovolemic shock can also be caused by severe dehydration or an imbalance of fluids in the body. There may be a number of causes of hypovolemia, including: 

  • Trauma
  • Burn injuries
  • Diuretics
  • Excessive sweating 
  • Vomiting
  • Diarrhea
  • Inadequate fluid intake
  • Infection
  • Inadequate electrolyte intake

Signs and Symptoms of Hypovolemia

Depending on the level of hypovolemia, the signs and symptoms can occur over time or more quickly with rapid blood or fluid loss. Some types of mild hypovolemia can be corrected by increasing fluid intake. However, more serious medical issues may require medical treatment and monitoring to prevent permanent damage from hypovolemia. 

Hypovolemia can manifest differently in different people, based on age, overall health, other underlying medical conditions, or medication. When hypovolemia is not treated, it can lead to hypovolemic shock. Some signs and symptoms of hypovolemia may include: 

  • Dry mouth
  • Dry mucous membranes
  • Thirst 
  • Headache
  • Fatigue
  • Weakness
  • Dizziness
  • Reduced urine output
  • Pale or cold skin
  • Rapid heart rate (tachycardia)
  • Low blood pressure (hypotension)
  • Cold extremities
  • Slow capillary refill
  • Altered mental status

How Hypovolemic Shock Affects the Body

With an imbalance in fluid volume or blood volume, the body's sympathetic response attempts to compensate for low blood volume by increasing the heart rate, increasing cardiac contractility, and peripheral vasoconstriction. Initially, diastolic pressure may increase with vasoconstriction then systolic may continue to drop. 

Blood is diverted from other tissues and organs to the more important areas, like the brain and heart. When cells in the body are deprived of oxygen, they may switch from aerobic metabolism to anaerobic metabolism. This produces lactic acid drive increases. As the process continues, tissue death may set in and increase lactic acidosis. Eventually, the victim may suffer organ failure and death.

Causes of Hypovolemic Shock

Hypovolemic shock is generally caused by loss of proper kidney function, loss of bodily fluids, loss of blood, or build-up of fluids in empty spaces in the body. Trauma can cause hypovolemic shock through the loss of blood or loss of fluids. 

Loss of fluids can occur through gastrointestinal illness, resulting in vomiting and diarrhea. Excessive sweating can also cause dehydration and lead to hypovolemia. Burn injuries can also lead to hypovolemic shock through the loss of bodily fluids. The more serious the burn injuries, the greater the risk of fluid loss and hypovolemia. 

Kidney disease is also a common cause of hypovolemia. Kidney disease can result in increased urination or overdiuresis. Overuse of diuretics can cause the body to lose sodium and impair reabsorption of salt and water. 

Diagnosis and Treatment of Hypovolemic Shock in the Hospital

Doctors are supposed to be trained in recognition of hypovolemic shock and understand treatment options to help the patient recover and minimize tissue damage from shock. Abnormal lab results should be an indicator to doctors that something is wrong. Patients at risk of hypovolemic shock, may show abnormal levels of:

  • Blood urea nitrogen (BUN) 
  • Serum creatinine
  • Hematocrit
  • Hemoglobin
  • Sodium
  • Calcium
  • Chloride
  • Potassium

With treatment of hypovolemic shock, time may be of the essence. Any delays may increase the risk of damage, including ischemic injury of vital organs, multi-system organ failure, and death. Treatments for hypovolemic shock generally include fluid replacement. Fluid replacement in hypovolemic shock may include blood products, water, saline solution, or other fluid and electrolyte balanced formulas. 

Hypovolemic Shock and Medical Malpractice

Hypovolemic shock can be caused by medical malpractice. Causes of hypovolemic shock because of a doctor's negligence or mistake may include: 

  • Administration of the wrong medication,
  • Prescribing the wrong medication, 
  • Prescribing the wrong dosage of medication, 
  • Failure to diagnose hypovolemia,
  • Infection, or
  • Failure to diagnose kidney disease. 

Even if hypovolemic shock was caused by some other event, like a car crash or gastrointestinal illness, failure to properly treat the patient may result in permanent injury or death. 

Doctors owe a duty of care to their patients. Generally, doctors must provide the same level of care that any other reasonable doctor in the same field with similar qualifications would provide. If the doctor fails to meet that standard of care, which causes injury or harm, the doctor may be liable for damages. 

Death Caused by Hypovolemic Shock

When a loved one goes for medical treatment, you expect them to be cared for and treated by competent doctors and caring healthcare staff. Unfortunately, too many families get notice that their loved one is in serious condition or has passed away. The family may find it hard to get answers after a loved one passed away after medical treatment. 

A wrongful death lawsuit is a way for family members to make sure the hospitals and healthcare system is held accountable for mistakes and negligence. After filing a wrongful death claim, those entitled to damages can seek expenses related to the care and treatment of the deceased prior to their death, as well as damages suffered by the family members after losing a loved one.

Hypovolemic Shock and Medical Malpractice Attorneys

If you suffered an injury under a doctor's care related to hypovolemic shock, you should talk to an experienced medical malpractice attorney about getting compensation for your injuries, medical bills, and pain and suffering. Do not hesitate to contact Gilman & Bedigian today for a free consultation.

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