Quora Query: What Does “Critical but Grave” Condition Mean?

Great query. I am going to give you a really poor answer, frankly because there aren’t any good ones.

The entire way that we in the intensive care unit (ICU) classify a sick person’s condition is almost totally subjective. So, someone who has been really ill and is now better and ready to leave the ICU for the floor is”Stable, Improved”. Easy.

Someone who is still really sick but not deteriorating could be called “Stable but critical”. Acceptable.

Someone who requires minute to minute management to prevent loss of life or limb could / would be called “Critical, Unstable”. Acceptable.

To my mind these are all pretty useless. What really matters is that we clinicians leave the ICU, go to the waiting room, and talk to the family of the sick person. Telling them in language they can understand – instead of DoctorSpeak – how the person they love is doing.

My experience over some 30 years doing this is that the families will ask the same questions over and over, until they understand. Part of our job is to answer them as often as they need to hear.

This seems at least as important as the very subjective classification system we use.

As to what precisely “Critical but Grave” means…….I / we wouldn’t use that classification term, but to me it means the person is in a world of hurt, and may die.

I hope this helps a bit.


About AJ Layon

AJ Layon was, for 28 years, at the University of Florida College of Medicine, in the Division of Critical Care Medicine, in Gainesville, FL. For the approximately 10 years until September 2011, he was Professor and Chief of Critical Care Medicine at UF; In September of 2011 he became System Director and Co-Chairman of Critical Care Medicine in PA; this ended in 2017. He served as a Physician in the Surgical Group with Médecins sans Frontières (MSF, Doctors without Borders) through 2018 and is presently an intensivist in Florida, struggling through the SARS-CoV-2 crisis. While his interests are primarily related to health care, health care reform, and ethical issues, as a citizen of our United States and our world, he will occasionally opine on issues of our "time and destiny". Follow on Twitter @ajlayon
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