Management of Hemorrhagic Shock for pre-hospital providers

Contractility

This is the force of contraction, or how hard the pump is working to move the blood through the body. In simpler terms, adequate fluid has to be moved to the heart (preload); the heart has to have enough strength and force (contractility) to overcome the afterload and circulate the blood through the body. Inadequate cardiac output causes reduced oxygen delivery. 

The final piece of the process for oxygen delivery is oxygen carrying capacity. This is the blood itself and the hemoglobin by which oxygen attaches to the red blood cells. Hemorrhage in particular affects the body's ability to carry oxygen to the end-organ tissues by physically reducing the amount of oxygen it can carry secondary to exsanguination.