A moribund patient is scheduled for surgery and is not expected to survive without the operation. Which ASA class applies?

• A. ASA V
• B. ASA IV
• C. ASA III
• D. ASA II

Answer: (A)

Understanding ASA physical status is key. A moribund patient who is not expected to survive without the operation falls into ASA V. This designation marks a life-threatening condition where the surgery offers the only chance of survival. In contrast, ASA IV describes severe systemic disease that is a constant threat to life but not necessarily a patient who is dying without immediate operation. ASA III is severe systemic disease that limits activity but isn’t imminently life-threatening, and ASA II is mild systemic disease. ASA I is a normal healthy patient. If the case were urgent rather than elective, an emergency designation (E) might be added, but the underlying level for a moribund patient is ASA V.