Friday, October 31, 2014

Seeking Meaning.

Dr. Craig Spencer's condition as updated this afternoon:



"Serious but stable," definition, please. Okay.



US practice

A wide range of terms are often used to describe a patient's condition. 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.
...

Serious

Vital signs may be unstable and not within normal limits. Patient is seriously ill. Indicators are questionable. http://en.wikipedia.org/wiki/Medical_state

Wait!

• Serious – Vital signs may be unstable and not within normal limits. Patient is acutely ill. Indicators are questionable. http://outbreaknewstoday.com/dr-spencers-condition-unchanged-tulsa-patient-tests-positive-for-malaria-59961/

On the whole, I think I'd rather be "seriously ill" rather than "acutely ill." I said I think.

Serious: Vital signs may be unstable and not within normal limits. Patient is acutely ill. Indicators are questionable.
http://www.slate.com/articles/news_and_politics/explainer/2009/11/what_does_stable_condition_mean.html
Alright, that's 2-1 for "acutely" ill.

Hey, what about the "stable" part, huh?

Stable means just that, stable: he isn’t becoming Critical nor is his condition improving to Fair.
http://outbreaknewstoday.com/dr-spencers-condition-unchanged-tulsa-patient-tests-positive-for-malaria-59961/
Wait!

Other terms

Other terms used include grave, extremely critical, critical but stable, serious but stable, guarded,[2] satisfactory, and others.

A frequently cited condition is "stable". Typically, stable is not a condition on its own; it is usually qualified with an aforementioned condition. It is commonly used to denote conditions where a patient has a favorable prognosis or stable vital signs. 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.[1] 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.

So! "Serious but stable" means that the patient's vital signs may be "unstable," the patient is "acutely" ill and "indicators are 'questionable,'" he isn't getting better or worse,...the, um, "unstable" nature of his vital signs are..."stable?", he has a "favorable prognosis?," which seems to contradict that his "indicators are 'questionable'" and "stable vital signs" does contradict the part of the definition of "serious" that "vital signs may be unstable"--But which would not contradict that part of the definition of "serious" that vital signs may NOT  be unstable, the alternative to "may;" if something "may be" it also "may NOT be. See?  Probably best not to use "stable" with a condition as the AHA says "especially one that is critical" which Dr. Spencer is NOT, he's "serious," so AHA does NOT "especially" advise against using "stable" in conjunction with "serious," it just "advises" that "stable" NOT  be used in conjunction with "serious;" it's just their advice, there's no law against it or anything, you can do it if you want; Bellevue wanted to so they did. So, that's it...You're welcome.