You’re
a first responder at an accident scene; there is blood everywhere. How much blood can you lose and how much
blood has the victim lost? Both are good
questions and something that emergency first aid providers need to know to deliver
critical care.
The human body contains approximately 5 of blood, about equal to a twelfth
of the body’s weight. The National
Institutes of Health, state that a 154-pound (70 kg) man has between 5 and 6
liters of blood in his body, while a smaller woman has between 4 and 5 liters
in her body.
The American College of Surgeons’ divides bleeding into four classes:
· A class I hemorrhage, or a “minor blood loss” is
any up to 15% of the body’s total blood volume, or 750 cubic
centimeters/milliliters. A hemorrhage 10%
is 500 cubic centimeters/milliliters, or half of a liter.
· A class II hemorrhage, considered to be a “moderate
blood loss”, is any loss between 15 to 30% of the body’s total blood volume, or
about 750 to 1500 cubic centimeters/milliliters. This amount of bleeding causes the victim to develop
tachycardia, a heart rate over 100 beats per minute. Additionally, the victim’s body reacts to this
level of blood loss by narrowing the blood vessels in the limbs, reducing the blood
flow and increasing the blood pressure.
The victim’s skin will become pale and cold to the touch.
· Class III hemorrhage, or “severe blood loss”
involves losing between 30 to 40% of the body’s total blood volume, 1,500 to 2,000
cubic centimeters/milliliters.
The victim’s skin will
be cold, clammy, or sweaty, and their skin will be pale or ashen, particularly
on the extremities, as the body diverts the remaining blood away from the skin
to the brain and heart. The victim’s blood
pressure will drop rapidly; their heartbeats will increase to over 120 beats
per minute. They will become confused if
conscious and the victim will go into hypovolemic shock, due to the reduced
blood flow interrupting the adequate delivery of oxygen and nutrients to the
body’s organs. The early effects of
shock are reversible, but they can quickly become irreversible, causing organ
failure and death. At this level of
bleeding, blood transfusion are a necessity.
· Class IV bleeding, or a “life-threatening
blood loss”, is a loss of more than 40% of the body’s total blood volume, this
is more than 2,000 cubic centimeters/milliliters. At this point, the victim will be ashen,
grey, or cyanotic (bluish in color). Their
heartrate will be greater than 140 beats per minute and their pulse will be
very weak or absent, and they are likely to be lethargic, comatose, or
unconscious.
· A blood loss of 50% or more of the body’s
total blood volume, bleeding of 2,500 cubic centimeters/milliliters or more is
typically fatal.
For first responders, judging blood loss by the amount of blood on the
ground or on the victim can be misleading, but estimating the amount blood lost
by the victim’s symptoms will allow you to guess what class of hemorrhage you
are dealing with, and what care your victim requires.
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Sources
Haug,
Thomas; “Controlling bleeding”, [© 2026 Slideshare from Scribd], https://www.slideshare.net/slideshow/controlling-bleeding-50321125/50321125,
accessed February 14, 2026
Holland,
Kimberly; “How Much Blood Can You Lose Without Severe Side Effects?”, February
26, 2022, https://www.healthline.com/health/how-much-blood-can-you-lose,
accessed February 14, 2026
Holland,
Kimberly; “Bleeding to Death: What Does It Feel Like, How Long Does It Take,
and Am I at Risk?”, July 28, 2018, https://www.healthline.com/health/bleeding-to-death?utm_source=ReadNext,
accessed February 14, 2026
Marrone,
M.; Bellantuono, L.; Stellacci, A.; Misceo, F.; Silvestre, M.; Zotti, F.;
Dell'Erba, A.; Bellotti, R.; “Haemorrhage and Survival Times: Medical-Legal
Evaluation of the Time of Death and Relative Evidence”, Diagnostics (Basel), Feb 15, 2023; Vol. 13,
No. 4, page 732, https://pmc.ncbi.nlm.nih.gov/articles/PMC9955172/,
accessed February 14, 2026
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