What Does "Critical Condition" Mean?
The press has described the medical condition of Jessie Arbogast, the 8-year-old mauled by a shark in Florida, as "critical but stable." What do patient descriptions such as "critical" and "stable" mean?
Most hospitals adhere to American Hospital Association guidelines when describing a patient's condition to the media. Those guidelines instruct hospital spokespersons to give out only a one-word description of a patient's condition. The recommended conditions, which are excerpted from the AHA's "General Guide for the Release of Information on the Condition of Patients," are:
Undetermined: Patient awaiting physician and assessment.
Good: Vital signs are stable and within normal limits. Patient is conscious and comfortable. Indicators are excellent.
Fair: Vital signs are stable and within normal limits. Patient is conscious, but may be uncomfortable. Indicators are favorable.
Serious: Vital signs may be unstable and not within normal limits. Patient is acutely ill. Indicators are questionable.
Critical: Vital signs are unstable and not within normal limits. Patient may be unconscious. Indicators are unfavorable.
The term "vital signs" means indicators such as blood pressure, pulse, temperature, and respiration. The one-word descriptions are not medical terms, and they are more art than science. They're based on a doctor's best judgment of a patient's condition, as relayed to hospital spokespersons.
The AHA's "General Guide" adds: "'Stable' should not be used as a condition. Furthermore, this term should not be used in combination with other conditions, which by definition often indicate a patient is unstable." (As one hospital spokesman put it, "You can be dead and be stable.")
So how can Jessie Arbogast's condition be "critical but stable"?