What is the initial treatment for hypovolemic/hemorrhagic shock?

• A. Oxygen, two large-bore IVs, cardiac/O2 monitoring; control hemorrhage; crystalloid infusion (3 L) or blood
• B. Observation and rest
• C. Oral fluids only
• D. Vasopressor infusion without fluid resuscitation

Answer: (A)

Think of hypovolemic shock as a deficit of circulating volume. The priority is to restore that volume and stop ongoing blood loss so tissues can be perfused again. Start with high-flow oxygen to maximize what little oxygen is delivered, establish two large-bore IV lines for rapid access, and quickly control the hemorrhage. Begin rapid volume resuscitation with crystalloids or blood products, guided by ongoing monitoring of vitals and perfusion. Continuous cardiac monitoring is important as you resuscitate.

Vasopressors without volume resuscitation aren’t first-line here because they constrict blood vessels and can worsen tissue perfusion when the intravascular volume is depleted. Soothing or delaying fluids, or relying on oral fluids or observation alone, won’t correct the core problem in this scenario.