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Table 2 American College of Surgeons Advanced Trauma Life Support (ATLS) classification of blood loss* based on initial patient presentation. Table reprinted with permission from the American College of Surgeons [84]

From: The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition

  Class I Class II Class III Class IV
Blood loss (ml) Up to 750 750–1500 1500–2000 >2000
Blood loss (% blood volume) Up to 15 % 15–30 % 30–40 % >40 %
Pulse rate (bpm) <100 100–120 120–140 >140
Systolic blood pressure Normal Normal Decreased Decreased
Pulse pressure (mmHg) Normal or increased Decreased Decreased Decreased
Respiratory rate 14–20 20–30 30–40 >35
Urine output (ml/h) >30 20–30 5–15 Negligible
CNS/mental status Slightly anxious Mildly anxious Anxious, confused Confused, lethargic
Initial fluid replacement Crystalloid Crystalloid Crystalloid and blood Crystalloid and blood
  1. *For a 70 kg man