Wednesday, 14 June 2017 20:28

Rep. Scalise in Critical Condition: What is “Critical?"

Written by Dr. Daliah Wachs
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Rep. Scalise in Critical Condition: What is “Critical?" Essdras M Suarez / Zuma Press

Wednesday morning, Rep. Steve Scalise and 5 others were gunned down during a baseball practice at the Eugene Simpson Stadium Park in Alexandria, VA while they were prepping for a charity event that was to be held the next day.

 

Reports say Rep. Scalise was “shot in the hip” and “shot in the calf”, but had been stable upon initial treatment in the hospital.  Currently we are told by MedStar Washington Hospital Center at approx. noon PT, that the House Majority Whip  “was critically injured and remains in critical condition.”

 

Rep. Mo Brooks who was at the scene, removed his belt to apply tourniquet pressure to Rep. Scalise’s leg.  This implies heavy bleeding was occurring and witnesses state Scalise, after he was shot, tried to drag his body away from the shooter, leaving a trail of blood behind.

 

Sen. Rand Paul and Rep. Brad Wenstrup also administered first aid to the victims.

The victims, including Scalise, were:

 

Zachary Barth:  Shot in the leg, expected to recover. Serves as Congressional staffer for Rep. Roger Williams.

 

Matt Mika:  reportedly shot multiple times, currently having surgery and in critical condition.  Serves as a lobbyist and Tyson Foods employee.

 

David Bailey and Krystal Griner – the US Capitol Police who exchanged gunfire with the gunman and were wounded in the process.  It's been reported they are in stable condition.

 

The 66 year old gunman, James T. Hodgkinson, was shot, and taken into custody.  He has since died of his injuries.

 

Many are relieved the heroic Bailey and Griner are both in “stable condition,” but deeply concerned about those in “critical condition.”  Let’s break down what these descriptors mean:

 

“Conditions” are based on vital signs (heart rate/pulse, blood pressure, respiratory rate, oxygenation) and a current medical “picture”.  According to the American Hospital Association Guidelines these are divided into:

 

Undetermined: Patient awaiting physician and assessment.

 

Good: Vitals signs are stable and within normal limits. Patient is conscious and comfortable. Indicators are excellent.

 

Fair: Vital signs 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.

 

However this causes confusion as many ask how one could be “critical AND stable?”

 

In medical settings, we say someone is “stable” when their condition is not worsening.  It's a calming descriptor allowing families and friends to take a deep breath and know their loved one is not on the verge of death.

 

A stable patient, however could be critically injured and need intensive care.  One could be stable coming out of surgery, but become unstable if an unfortunate medical incident occurs afterwards.

 

“Critical” specifications are given to those whose injury could have been life threatening and who needs to be monitored and tended to continuously.  One may remain stable during this time.

 

This is a developing story:

 

LearnHealthSpanish.com / Medical Spanish made easy.

 

 

Daliah Wachs, MD, FAAFP is a Board Certified Family Physician. The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.