Is Your Patient Stable?

[firedoc5]

Come to think of it, I don't think I've ever documented or reported a pt. stable or unstable, hmmm. MINIMUM at least two sets of complete vitals. I personally liked to talk with the patient, if they were coherent, at all times. That way you can do two things, 1) Notice any change in LOC or other symptoms. 2) Your patient knows someone is right next to them at all times and will not leave them. If for some reason I was not able to I made sure my partner (one I could trust) did.

In the field I can't see where it can be your call whether they are stable or unstable. You can say they "appear" either way, but it's not until a doc with all the goodies in the ER and Lab can actually make that call. (Am I going on too much? Sorry)

BAM away if called for.

[JakeEMTP]

I think many people mistakenly use the term "stable" for "within normal limits". If a patient has a constant heart rate of zero and it never changes, is this "stable"?

Good choice. However, what is normal? Some pt.'s have a low HR which is normal for them, but would be bradycardia for someone else. BP's very from pt. to pt. We can't treat numbers, only how the pt. presents.

[VentMedic]

I rarely use the word stable unless it is a patient on life support meds and technology. The word is over used and not always understood. Stable on one patient may not mean the same for another patient in terms of acuity. Too often we will hear the word "stable" from Paramedics bringing in a patient with GSWs to the chest or TBI. That patient is not stable regardless of the BP because there is a short term compensatory period and there are still too many unknowns that have yet to be assessed. Thus they either don't have an understanding of mechanism of injury, disease processes or just watch numbers on machines. We use the word "stable" in the ICU when we think we have found all the problems and covered all the bases. Even then we use the word with caution.

I also relate this to the Paramedic or nurse that will argue with a patient that he/she is not in pain because their HR and BP are not sky high and fail to notice the meds the patient is on to prevent that.

[fiznat]

I don't use the term in my run reports, but I admit I am guilty of it in my hospital patches/notifications. I mean to say "within normal limits," as others have said, and I believe it is understood this way on the other end of the line. It may be technically incorrect, but there is something to be said for the colloquialism of it as well. I'm not patching to the hospital to give them a precise overhaul of everything I've found with the patient (they'd stop listening halfway through), but rather to give them a quick summary and to let them know how long till I get there. I tell them what they need to know, and they understand.

You're right though, I probably should say "within normal limits," but comeon- that's a mouthful isnt it? :wink:

Oh, and I always take more than one set of vital signs.

[Dustdevil]

You're right though, I probably should say "within normal limits," but comeon- that's a mouthful isnt it? :wink:

LOL! Sure, but "vitals are good" or "vitals are fine" is a lot shorter and says the same thing. I don't give vitals unless there is an abnormality, or unless some pissy nurse demands them.

[AnthonyM83]

I don't think I've used the word stable in a written report (rather "- delta" for "negative change"). I've always thought of describing a patient as stable something they do in the hospital when listing patient condition for family members.

I do tend to use it when giving face-to-face reports, though. He's stable. He's critical (I need attention from charge nurse, please).

Or when letting a cop know how a victim's doing*

*PS Observation: Only time I've seen on-duty cop act timid is when on medical scenes or asking medical questions "Is he . . . umm...okay?" (I assume they just want to know is: Will he be okay? Is he F'ed up? Is he a gonner?)

[Arizonaffcep]

So tell me; if you have only taken one set of vital signs' date=' how can you have the slightest clue as to whether or not they are stable? :roll: [/quote']

No...its impossible. One set can tell you if they are within normal limits. The term "stable" implies so much more! Not only are vitals not really deviating from set to set, but your Pt's mentation is appropriate OR normal for the Pt, and a differential diagnosis that indicates everything is NOT going to change or worsen in your care...AND for a while after you transfer care to the hospital.

1 set=point of reference

2 sets=potential trend

3+ sets=trend/pattern

Do you often use this term in your patient reports? If so, what exactly does it mean? And, if asked to demonstrate from only that information you have charted, have you charted enough information to clearly show that your patient (and/or his/her vital signs) are "stable"?

[AnthonyM83]

1 set=point of reference

2 sets=potential trend

3+ sets=trend/pattern

I liked that enough to repeat it . . .

[mobey]

Do you often use this term in your patient reports? If so, what exactly does it mean?

I personally have a pet peeve with this term.

I usually say "Non-priority" or "patient comfortable at this time"

I personally believe that without enough time and data I can not determine a patients stability.

I used to use it when my transport times exceeded 2 hrs, but at my current non-remote job, there is rarely time to determine whether a patient is truly stable.

Although I am pretty quick to use the word unstable I must admit :wink:

[mailmantech82]

I find this discussion interesting! I'm personally guilty using the word "stable" in radio patches to the hospital, and working to change that after reading. I had never thought of this before, I guess thats why I keep coming back to the city!