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.