Hypovolaemic shock occurs due to a reduction in intravascular volume leading to insufficient oxygen delivery to cells. This results in metabolic acidosis, endoplasmic reticulum swelling, mitochondrial damage, and cell death if untreated. Initial management involves fluid resuscitation to restore intravascular volume and oxygen delivery. Further treatment is aimed at controlling bleeding, preventing complications like hypothermia and coagulopathy, and monitoring for signs of adequate perfusion and organ function during resuscitation. Surgical intervention may be needed to definitively stop blood loss.