Medical state

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Medical states or medical conditions are used to describe a patient's condition (that is, their clinical status) in a hospital. These general terms are most commonly used in information given to the news media, and are rarely used as clinical descriptions by physicians, who in their daily business describe medical problems more precisely.

Either or both of two aspects of the patient's state may be reported. First, the patient's current state may be reported, e.g., as being good or serious. Second, the patient's short-term prognosis may be reported, e.g., that the patient is improving, is getting worse, or that no immediate change is expected (stable).

Stable is a frequently-used term that is not properly a condition as such, but a qualifier commonly used to denote conditions where a patient has stable vital signs.[1]

United States[edit]

A wide range of terms are often used to describe a patient's condition in the United States. The American Hospital Association advises physicians to use the following one-word conditions in describing a patient's condition to those inquiring, including the media.[2]

Undetermined
Patient awaiting physician and/or 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 seriously ill. Indicators are questionable.
Critical
Vital signs are unstable and not within normal limits. Patient may be unconscious. Indicators are unfavorable.
Dead
Vital signs are persistently absent.

Other terms[edit]

Other terms used include grave, extremely critical, critical but stable, serious but stable, guarded,[3] satisfactory, and others.

The American Hospital Association has advised doctors not to use the word "stable" either as a condition or in conjunction with another condition, especially one that is critical, because a critical condition inherently implies unpredictability and the instability of vital signs.[2] Despite this, "critical but stable" conditions are frequently reported, likely because the word "critical" in mainstream usage is often used to denote a condition that is severe and immediately life-threatening.

The use of such condition terminology in the U.S. media has increased since the passing of the HIPAA in 1996. Concern for patient privacy and desire to avoid litigation associated with its breach have prompted doctors and hospitals to use these terms as an alternative to disclosing specific medical conditions.

Definitions vary among hospitals, and it is even possible for a patient to be upgraded or downgraded simply by being moved from one place to another, with no change in actual physical state. Furthermore, medical science is a highly complex discipline dealing with complicated and often overlapping threats to life and well-being. In the case of possibly life-threatening illness, a patient may be treated by a dozen or more specialists, each with their area of medical expertise. It is to be expected that there will be a range of opinion concerning that patient's immediate condition.[4]

United Kingdom[edit]

Each National Health Service (NHS) trust has its own guidance for statements to the press. The Department of Health's code of practice has no official definitions of the standard phrases in use. Terms typically used by NHS trusts include:[5][6]

  • Deceased
  • Critical
  • Critical but stable
  • Serious
  • Stable
  • Satisfactory
  • Comfortable
  • Progressing well
  • Discharged

The release of patient information to the press is strictly controlled in the NHS. The Department of Health publishes a guideline to NHS Trusts.[7] In general, no information can be released without patient consent, unless there are exceptional circumstances. If consent is withheld, the hospital cannot state even that to the press, as it would confirm that the patient was receiving treatment.

See also[edit]

References[edit]

  1. ^ "Virginia shooting: hospital says Steve Scalise in 'critical condition' – latest". The Guardian. 14 June 2017. Retrieved 15 June 2017.  "Stable" is not mutually exclusive with "critical". Stable merely means that no immediate change is anticipated.
  2. ^ a b American Hospital Association; (2003-02-01). AHA : Advisory : HIPAA Updated Guidelines for Releasing Information on the Condition of Patients. American Hospital Association. Retrieved and archived on 2008-01-28.
  3. ^ "Former President Bush remains in ICU with lingering fever". CBS News. 27 December 2012. Retrieved 30 December 2012. 
  4. ^ "What does it mean when a patient is in 'critical' or 'serious' condition? Archived 2007-12-16 at WebCite", The Straight Dope, 18 October 1999. Accessed on 10 January 2011.
  5. ^ Royal Free Hampstead NHS Trust: condition checks webcite archived 16 December 2007
  6. ^ Ashford & St. Peter's Hospitals NHS Trust Policy for Handling Press Enquiries webcite archived 16 December 2007
  7. ^ Confidentiality: NHS Code of Practice - supplementary guidance: public interest disclosures, 22 November 2010