Cardiovascular · UKMLA & AKT
Hypovolaemic shock
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Tachycardia - earliest sign; sympathetic drive compensates for falling stroke volume
- Hypotension - systolic BP <100 mmHg; a late sign in young/fit patients
- Cool, pale, clammy peripheries - peripheral vasoconstriction redirects blood to vital organs
- Prolonged capillary refill (>2 seconds) - reduced peripheral perfusion pressure
- Oliguria (<0.5 ml/kg/hr) - renal vasoconstriction and RAAS activation
- Altered consciousness - confusion/agitation indicates cerebral hypoperfusion (Class III/IV)
- Raised respiratory rate (>20/min) - compensatory response to metabolic acidosis
A young, fit patient may maintain a near-normal BP until 30% of circulating volume is lost - do not be falsely reassured by a preserved blood pressure.
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