In hypovolemic shock % of fluid depletion should be

(B) 15-45% # Treatment should be aggressive and directed more by response to therapy than by initial classification.> Class I hemorrhage (loss of 0-15%):* In the absence of complications, only minimal tachycardia is seen.* Usually, no changes in BP, pulse pressure, or respiratory rate occur.* A delay in capillary refill of longer than 3 seconds corresponds to a volume loss of approximately 10%.> Class II hemorrhage (loss of 15-30%):* Clinical symptoms include tachycardia (rate >100 beats per minute), tachypnea, decrease in pulse pressure, cool clammy skin, delayed capillary refill, and slight anxiety.* The decrease in pulse pressure is a result of increased catecholamine levels, which causes an increase in peripheral vascular resistance and a subsequent increase in the diastolic BP.> Class III hemorrhage (loss of 30-40%):* By this point, patients usually have marked tachypnea and tachycardia, decreased systolic BP, oliguria, and significant changes in mental status, such as confusion or agitation.* In patients without other injuries or fluid losses, 30-40% is the smallest amount of blood loss that consistently causes a decrease in systolic BP.* Most of these patients require blood transfusions, but the decision to administer blood should be based on the initial response to fluids.> Class IV hemorrhage (loss of >40%):* Symptoms include the following: Marked tachycardia, decreased systolic BP, narrowed pulse pressure (or immeasurable diastolic pressure), markedly decreased (or no) urinary output, depressed mental status (or loss of consciousness), and cold and pale skin.