A patient in status epilepticus is considered which AS grade?

• A. II or 2
• B. III or 3
• C. IV or 4
• D. V or 5

Answer: (C)

ASA physical status classification is used to gauge perioperative risk by describing the patient’s systemic health. A patient in status epilepticus has ongoing seizures that can cause significant systemic derangements—hypoxia, acidosis, electrolyte disturbances, blood pressure fluctuations, and metabolic stress—creating a life-threatening situation. This level of disruption aligns with the category for severe systemic disease that is a constant threat to life. Hence the correct choice places the patient in ASA grade IV. If the patient were moribund and not expected to survive without immediate intervention, ASA V would apply; weaker grades would understate the immediate life threat present in status epilepticus.