Patient condition terminology: Do you really know what ‘critical’ means?

Photo: Quinn Dombrowski via Flickr

Photo: Quinn Dombrowski via Flickr

Some words are so familiar that it’s easy to assume you know what they mean – especially terms for a patient’s condition. Words such as “stable” and “critical” make it into health news all the time, but what do they really mean?

In light of the African Ebola epidemic, and the first diagnosis of Ebola on American soil, reporters should understand terms commonly used to describe a patient’s medical state or condition.

First, health writers should understand “vital signs” and what providers mean when they refer to vital signs as being normal. According to Medline Plus, “vital signs” include heart beat, breathing rate, temperature and blood pressure. “Normal” vital signs change with age, physical fitness, gender, weight and overall health, but for the average healthy adult at rest, “normal” means:

  • Blood pressure: 90/60 mm/Hg to 120/80 mm/Hg
  • Breathing: 12 – 18 breaths per minute
  • Pulse: 60 – 100 beats per minute
  • Temperature: 97.8 – 99.1 degrees Fahrenheit / average 98.6 degrees Fahrenheit

Those standards provide the basis of understanding what kind of condition a patient is in. In this brief on privacy regulations, the American Hospital Association (AHA) recommends that all providers use the following definitions when describing a patient’s condition:

Undetermined: The patient has not yet been assessed, diagnosed or treated.

Good: The patient’s vital signs are stable and within normal limits. He or she is conscious and comfortable, with excellent indicators for recovery.

Fair: The patient’s vital signs are stable and normal, and the patient is conscious, but he or she might be uncomfortable. Indicators for recovery are favorable.

Serious: The patient is very ill, and might have unstable vital signs outside the normal limits. Indicators are questionable.

Critical: The patient has unstable vitals that are not normal, and could be unconscious. Indicators for recovery are unfavorable.

Treated and released: The patient was treated but not admitted to the hospital.

Treated and transferred: The patient received treatment at one facility and was then transferred to another facility.

It’s important to note that these terms exist for the people providers talk to, not providers themselves. Physicians and other health professionals use them to communicate with the media and patients’ families, but they don’t often think in such stark terms when actually treating patients. That means you might hear ambiguous terms like “stable but critical.”

Bearing in mind that hospital officials don’t have to answer, don’t be afraid to ask for more information.  Ask how the patient’s vital signs are, or about the indicators for recovery. Ask about the patient’s comfort level and if he or she is conscious.

Also, when covering the Ebola epidemic, remember that the UK’s National Health Service uses a different array of patient-condition terminology. Much of western Africa is formerly Commonwealth, so make sure to ask specific questions about patient conditions when interviewing anyone from western Africa or the United Kingdom.

(Hat tip to Scott Hensley for suggesting the topic.)

(Correction: The previous version read “Breathing: 12 – 8 breaths” In the section on normal vital signs. It now shows the correct range, 12 – 18 breaths per minute. Special thanks to Joanne Silberner for pointing out the error.) 

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