Crash
Formal Definition
Acute, rapid clinical deterioration requiring immediate intervention to prevent death. A "crashing patient" is one in whom vital sign derangements and physiologic instability are progressing despite initial measures.
How It's Used on the Ward
"The patient is crashing" — more acute and alarming than "going south." Implies immediate action is required.
Example
""Intern to senior at 2am: 'Room 7 is crashing — BP 60 systolic, no response to 2L, RR 34, now less arousable.' Senior: 'Code cart, call the attending, get anesthesia here now.'""
Clinical Context
"Crashing" implies a trajectory that will end in cardiac arrest without intervention. The response is not watchful waiting — it's immediate action: airway, access, resuscitation, escalation. Knowing how to communicate urgency clearly ("this patient is crashing") is a critical clinical skill. Vague language delays response.