A moribund patient who is not expected to survive without an operation is put under which category as per the ASA Physical status classification system?
The ASA system is used to assess a patient's preoperative health. The classifications range from I to VI. Class I is a normal healthy patient, II has mild systemic disease, III has severe systemic disease, IV is a patient with severe systemic disease that's a constant threat to life, V is a moribund patient who's not expected to survive without the operation, and VI is a declared brain-dead patient for organ donation.
The key here is the term "moribund," which means the patient is at the point of death and the surgery is their only chance. So that points to class V. The options might be A to D, but the correct answer is V. The other options like IV or III would be for severe disease but not imminent death. Class VI is for brain dead, which isn't the case here. So the answer must be V.
**Core Concept**
The ASA (American Society of Anesthesiologists) Physical Status Classification system evaluates a patient's preoperative health to predict surgical risk. Class V is defined as a moribund patient who is not expected to survive without the operation, indicating life-threatening systemic disease requiring urgent intervention.
**Why the Correct Answer is Right**
ASA Class V applies to patients with severe systemic disease so profound that their survival depends on the surgical procedure. These patients are in a terminal state without immediate intervention, and their mortality risk is extremely high even with optimal care. The classification emphasizes the urgency and high-risk nature of the surgery.
**Why Each Wrong Option is Incorrect**
**Option A:** ASA Class I (normal healthy patient) is incorrect because the patient is clearly not healthy.
**Option B:** ASA Class II (mild systemic disease) is incorrect as the patient’s condition is life-threatening, not mild.
**Option C:** ASA Class III (severe systemic disease not immediately life-threatening) is incorrect because the patient is moribund, not merely severely ill.
**Option D:** ASA Class IV (severe systemic disease constant threat to life) is incorrect as Class V specifically denotes a moribund state requiring surgery for survival.
**Clinical Pearl / High-Yield Fact**
Remember: ASA Class V = "Moribund without surgery." Class VI is a special category for brain-dead patients. Confusing Class IV and V is a common exam trap—Class IV patients are critically ill but not yet moribund. Always pair "moribund" with Class V in your mind.
**Correct Answer: D. ASA Class V**