Adjective/phrase for a situation that requires fast and accurate decisions

My sentence is At the individual level, it seeks to provide an objective risk estimate for medical decision making in the highly charged and emotional environment of intensive care

I want to rephrase the bolded parts so as to give an effect of the intensive care being a place where decisions needs to be made fast and accurately because there is so much to lose if something went wrong. I thought of high stakes but I find it a little informal

Both the word and phrase that come to mind (coincidentally or not) have a medical connotation.

Critical:

[Merriam-Webster]

2 a : of, relating to, or being a turning point or specially important juncture · a critical phase : such as (1) : relating to or being the stage of a disease at which an abrupt change for better or worse may be expected; also : being or relating to an illness or condition involving danger of death · critical care · a patient listed in critical condition (2) : relating to or being a state in which or a measurement or point at which some quality, property, or phenomenon suffers a definite change · critical temperature
b : indispensable, vital · a critical waterfowl habitat · a component critical to the operation of a machine
c : being in or approaching a state of crisis ·a critical shortage · a critical situation
d : crucial, decisive · a critical test

Life-and-death:

[Merriam-Webster]

: involving or culminating in life or death : vitally important as if involving life or death