From the Research
The answer is d. 400mls, as a 30kg child with type 2 shock would have lost approximately 15% of their blood volume, which is estimated to be around 360ml, rounding to 400ml. To calculate the blood loss, we need to determine the child's total blood volume first. The average blood volume in a child is about 80ml/kg, as stated in various studies, although the exact value can vary slightly 1, 2, 3. For a 30kg child, the total blood volume would be 30kg × 80ml/kg = 2400ml. A 15% blood loss would therefore be 2400ml × 0.15 = 360ml, which rounds to 400ml (option d). This amount of blood loss is significant enough to cause compensatory mechanisms like tachycardia and vasoconstriction, but the child can still maintain blood pressure. Type 2 shock (hypovolemic shock) at this stage shows signs of compensated shock with decreased perfusion but normal blood pressure, indicating the body is still able to compensate for the volume loss. Recent studies have focused on improving the estimation of blood loss and the management of hemorrhagic shock, including the use of novel equations to estimate the degree of bleeding 4 and the importance of permissive hypotension and limited crystalloid resuscitation 2, 3. However, the basic principle of calculating blood loss as a percentage of total blood volume remains a crucial step in assessing the severity of shock and guiding treatment. Given the information provided and the focus on the most recent and highest quality studies, the estimation of blood loss in this scenario is based on the average blood volume and the percentage of loss, leading to the conclusion that the correct answer is 400mls.