What is the classification of hemorrhage according to the American College of Surgeons? Is it a good guide for deciding whether to transfuse a patient?
The American College of Surgeons’ classification distin-guishes four categories according to the importance of blood loss and the resulting clinical changes. It is presented in Table 81.2.
While this classification is helpful in estimating the severity of hypovolemia, its weakness lies in that it does not distinguish between intravascular volume loss and decrease in oxygen-carrying capacity. The need for trans-fusion should be based on clinical judgment and depends, among other things, on the patient’s hematocrit before the blood loss occurred and after crystalloid or colloid administration, and on whether control of bleeding is achieved.