Some Medical Abbreviations and Terminology

[Guest Ian Wong]

Here's a thread I've wanted to create for some time, on some of the "lingo" that you'll find in the hospital and on the wards. Here's another list of common slang words. Please add replies to this thread if there's another word(s) that you want to add.

 

Ian

 

ABC's:

Refers to the order of the ACLS protocol of assessing and treating patients. You need to assess and treat the Airway, then Breathing, then Circulation. Has a different meaning when referring to Anesthesiologists: Airway, Billing, Coffee...

 

Admissions:

An admission is the entire series of events by which a patient is entered, or "admitted" to a hospital. An admission usually includes performing a complete history and physical examination, ordering and interpretation of any pertinent bloodwork labs or imaging exams, prescribing any medications to be consumed during the hospital stay (ie. antibiotics, heart medications, painkillers, etc), and completing the paperwork in the medical record to document the encounter. Medical students routinely perform admissions during their clerkships and electives as part of the educational process. Lots of admissions unfortunately happen late at night or in the early morning hours, making the early morning admission something to be dreaded by most on call and very sleep-deprived med students...

 

Attending:

This is the same as a staff physician. Both of these terms refer to a board-certified physician who has completed residency (and potentially a fellowship as well), and is fully qualified to practice medicine independently. In the hospital hierarchy, attendings usually supervise and teach fellows and residents, who in turn teach medical students.

 

Call room:

While on In-House call, the hospital provides you with a call room, which is your sleeping quarters for the night. The typical call room includes a bed, alarm clock, and telephone for answering late night pages. Usually a haven for sleep-deprived students and residents.

 

Clerkship:

The same meaning as Rotations. Required by all medical students in a given school (this is the difference between electives and clerkship rotations; you can choose the specialties done in your electives, but if you have a clerkship rotation in a given specialty, it is mandatory). The clerkship rotations are fairly consistent across Canada, and are considered the "core" specialties that each medical student should have been exposed to before graduating with an MD degree. eg: Surgery, Internal Medicine, Pediatrics, Obstetrics and Gynecology, plus other specialties and/or elective time. Usually done in the third year for med students in a 4 year program, and in Mac and Calgary, clerkships I believe start roughly halfway through the Med 2 year.

 

Cushy:

Usually refers to specialties or clinical rotations that have lighter hours, or easier on-call schedules. Cushy specialties generally offer good lifestyles to their practitioners. Examples include: Psychiatry, Pathology, Dermatology, Ophthalmology, and Physiatry. Slightly less cushy specialties include Radiology, Emerg Medicine, and Anesthesiology, etc.

 

CTD:

Circling The Drain. Usually refers to a patient who is not doing well, and is steadily deteriorating. ie. "Our patient in the ICU is CTD..."

 

Elective:

A period of time (usually weeks-months) spent on a single specialty with clinical responsibility. During an elective, you are actively involved in patient care. You are likely the person doing and writing the actual history and physical, writing orders/prescriptions (to be co-signed by your doctor), and in the OR, you will be scrubbed in and actively helping, usually by retracting, cutting sutures, etc. Electives can either be done in your home city, or as away electives in outside cities to make connections, see the rest of Canada, get reference letters for CaRMS, etc. Usually done by senior med students who are using the elective time to round out their medical education, or to improve their residency applications. You have a choice of which specialties you'd like to do electives in; therefore electives will vary between individual medical students.

 

Fellowship:

A clinical fellowship is done by those board-certified physicians who have already completed their residency specialty, and are seeking additional training within that specialty. Most residencies have a limited number of subspecialty areas that you can train in by completing a fellowship. (ie. a fellowship of Internal Medicine is Cardiology. A fellowship of General Surgery is Vascular Surgery. However, an internist cannot do a vascular surgery fellowship, nor can a general surgeon do a cardiology fellowship).

 

Research fellowships are a different designation entirely, and may be completed by med students, residents, fellows, etc. It's a bit of an amorphous term that isn't really rigidly defined, and most people are usually referring to clinical fellowships when they talk about doing a fellowship in "xyz" specialty.

 

First call:

You are the first person in the chain of command to be paged. Therefore, EVERYTHING that requires attention is seen by you first. Only if things are above your head, or if you need authorization by a resident, do you call them. First call is taken by medical students and junior residents.

 

Gas:

Refers to the specialty of Anesthesiology. Anesthesiologists are often referred to as Gas-Passers, because of their use of inhalational anesthetics (ie. nitrous oxide, flurances, etc).

 

Gomer:

One of those derogatory terms that you never want to get caught using. Stands for: "Get Out of My Emergency Room", and usually refers to either a very irritating patient, or else an elderly and otherwise medically complicated patient (lots of co-existing, chronic diseases, which are usually very difficult and frustrating to treat effectively).

 

GORK:

Acronym for God Only Really Knows. Usually refers to a patient in a very bad condition, such as comatose. "He's gorked out after that MVA, and we really don't know why."

 

Hit:

A euphemism for an Admission, usually one occurring just 5 minutes after you've fallen asleep in your call room. ie: "I just got paged by Emerg for another direct hit... That's my fifth hit tonight. "

 

Home call:

Home call occurs when you are on-call and are responsible for ward calls and admits, but you get to wait for them at home instead of being in the hospital. This is generally done if the chance of being called in is very low, or if things can wait for the time that it takes you to get into the car and drive to the hospital. Home call is therefore more desirable than in-house call. Specialties that are more likely to take home call include Psychiatry, Ophthalmology, Dermatology, Physiatry, Radiation Oncology, etc.

 

In-House call:

This means that you stay in the hospital the entire time you are on call, and should not be off-premises. It also means going to sleep in the hospital call rooms, which are usually no better than an unfurnished room with a bed and a phone to answer pages. All UBC rotations with on call requirements are in-house call except Psychiatry.

 

Internship:

This is an outdated term that shouldn't really exist anymore. Used to refer to the first year of residency. As the most junior resident physician, invariably works the longest hours, in the past, these "interns" would actually be given housing at or around the hospital. A first year resident used to, and still is, called an intern. Not to be confused with an "internist", who is a fully-trained physician in Internal Medicine.

 

LOL in NAD:

Little Old Lady in No Acute Distress. Refers to a patient who is actually healthy, or otherwise has well-managed chronic conditions, and therefore doesn't require much if any medical intervention.

 

NPO:

Means nothing to eat or drink. Derived from the Latin words Nil/non per os, meaning nothing by mouth. Patients awaiting surgery are made NPO the midnight before in order to empty the stomach and minimize complications during surgery (ie. vomiting).

 

Observership:

Very similar to an elective, but without the clinical responsibility. You are shadowing a physician, and may see patients with him/her, go into the OR and observe surgeries (so you're not scrubbed in), etc. Generally you don't touch patients, write orders/prescriptions, or anything else. You are like a fly on the wall, observing. Observerships are usually done by junior med students who have not yet acquired the skills to make a meaningful contribution towards patient care, but would still like the experience of seeing what a typical day/week/month of that specialty is like.

 

On call:

You are carrying a pager and are responsible for both ward calls, and admits. What this means is that if a patient on the wards in the hospital needs something, you need to be there. If there is someone downstairs in Emerg who is sick enough to need to stay the night, they need to be "admitted" to the hospital. This requires getting a complete history and physical, writing down all medical orders for the nursing staff and other services (dietician, getting Physio, Social Work, Occupational Therapy, etc involved as needed). When on call, you may be either first call or second call.

 

Post-op:

Post-operative. Following surgery. A patient who is post-op day #4 CABG had a Coronary Artery Bypass Graft surgery performed 4 days ago. Also abbreviated as POD#4. In the US, the term s/p is used to refer to post-op, and stands for status/post. (ie. "Our patient, s/p CABG Day 4, is doing well.")

 

PRN:

Means as needed/if necessary. Derived from the Latin words pro re nata, meaning when necessary. Give this patient "Ibuprofen q6h PRN for pain" means give the patient Ibuprofen up to every 6 hours if necessary for pain control.

 

Q:

Means "every". Therefore, q4 means every 4, and q3 means every 3. Therefore, being on call q4 means that every fourth day you are on call. In a week, this means that if you are on call on Monday, you will also be on call on Thursday. If you are on call on Tuesday, you'd be on call on Friday, and so on. Take this "Tylenol q 6h" means take this Tylenol every 6 hours.

 

Residency:

This is the 2-5 year committment you need to make after graduating medical school in order to be trained in a specialty. During residency, you are known as a resident physician, or a "resident". A second year resident would be known as an R2 (just like a second year med student is in Med 2), or a fourth year resident is an R4. An R4 may also be referred to as a PGY4 (post graduate year 4), so the notation R4 is interchangeable with PGY4, or R2 with PGY2, and so on.

 

Rotations:

See Clerkship.

 

Second call:

Being on call at the same time as the "first call" person, but not getting paged unless the "first call" person can't handle the situation without your involvement. Second call is usually taken by senior residents.

 

Specialty:

The field of medicine which a given practitioner is involved in. ie. Obstetrics, Family Medicine, General Surgery, Ophthalmology, Emergency Medicine.

 

Stat:

No, not statutory holiday. Stat is an abbreviation used in medicine for something that needs to be performed urgently. An abbreviation of the Latin word statim, meaning immediately. ie: "I need that EKG and cardiac enzymes stat!"

 

Turf:

Slang for transferring your patient to another specialty service, so they can take care of your patient instead of you (saving you the extra work). ie: "Orthopedics is turfing an 81 year old lady with a recent hip fracture to Internal Medicine because she has a history of poorly-controlled diabetes."

 

WNL:

Within Normal Limits.

 

Ian

[Guest McMastergirl]

Here are a few that may come in handy on the wards:

 

ABG - Arterial Blood Gas - this is a test of the blood pH, oxygen content, and carbon dioxide content. Must be taken from arterial blood - usually from the radial artery in the wrist. Only MDs and RTs (see below) are allowed to do them.

 

Code Blue or Code - cardiac arrest in the hospital; you will hear this called overhead followed by the location. Everybody runs to this location with crash carts. There is mass confusion. If you are there early you might be asked to do chest compressions, take the femoral pulse or bag (provide Oxygen to) the patient

 

DNR - Do Not Resuscitate - an order written in the chart of a patient who does not want CPR performed in the case of cardiac arrest. If patient not competent, the family can make a patient DNR. Thus if patient found with no pulse, a code blue (see above) is not called; instead an MD is called to pronounce the death

 

Foley or F/C - Foley catheter: a tube inserted into the bladder via the urethra to drain urine. Used for accurate estimation of urine output in sicker patients on the ward, although nurses like them because they don't have to change diapers. However they are a lovely breeding ground for infection, so they should be used only when really necessary

 

Ins and outs - "ins" are oral and parenteral intake (IV fluids, fluids taken by mouth) and "outs" are urine, stool, vomit, drains, etc. Nurses measure or estimate these volume and record on daily patient record

 

PEG tube - percutaneous endoscopic gastrostomy tube; a tube inserted through the skin directly into the stomach; used in people who have swallowing problems such as post-stroke, CP, esophageal resection, etc

 

PICC line - peripherally inserted central catheter; has many uses but so far I have mostly seen them used for patients who need long term (weeks) IV antibiotics but are well enough to go home and be treated by a home care nurse

 

RT - respiratory therapist - very handy people who administer oxygen, monitor ventilator settings, and will come to an ABG for you (see above)

 

SLP - Speech/Language Pathology - these people often see old folks on the ward who have had a stroke and do a swallowing assessment, and recommend diet (eg do they need their food pureed, or thickened fluids, etc) to decrease choking/aspiration risk

 

VSS or AVSS - "vital signs stable" or "afebrile, vital signs stable" - a lazy way to record vitals in daily progress notes

 

 

That's all I can think of for now!

[Guest madricka]

Good posts, although I do have two comments...

 

(1) re: catheters... you said, "nurses like them because they don't have to change diapers". As a nursing student (thus I am speaking only for myself, not all nurses), I find this unnerving. First of all, we KNOW they cause infection which is why we only do it when necessary. It has nothing to do with changing diapers -- sometimes it's faster to change the briefs than to catheter a patient, which involves a sterile procedure, gathering equipment, documenting, etc. Similarly, changing diapers is a good way to do a skin assessment & check for early signs of breakdown. Secondly, a physician's order is required so it's not like we're doing it because we're "lazy". I'm sure there are some nurses out there who could care less about their patients & don't care if it gives them an infection but I think this is the exception rather than the rule.

 

(2) re: DNR... you said, " if patient found with no pulse, a code blue (see above) is not called; instead an MD is called to pronounce the death". This isn't true in every case. I work on a palliative care floor where the RN's are allowed to pronounce death. Check the chart, it will be highlighted in the front of the chart and the Kardex.

 

Sorry if that sounded snarky. I didn't mean it to. Just clarifying some points from another perspective (and yes, I am an MD candidate despite doing spectacularly well in nursing).

[Guest McMastergirl]

In response to your responses:

 

1) I wasn't implying nurses are lazy, or ignorant about foley-related infections. However, I've had plenty of nurses ask for a foley order because the patient is incontinent. It would seem like a solution to changing multiple diapers when one is very busy with several patients at once. Sometimes things are taught one way in school but done quite differently in practice. Unfortunate, but true. You'll see!

 

2) It is highly unusual in a typical hospital inpatient setting to have nurses pronounce death. It seems to me that your hospital is an exception, and it is likely because it is strictly palliative.

[Guest DrSahsi]

The nurses would not be legally pronouncing death. They can't, to my knowledge. The nurses may deem the patient deceased for internal bureaucratic purposes, but in the strict medicolegal sense the pronouncement of death would probably be conducted by a physician in due (but relative prompt) time, ie: on the next day's rounds. The paperwork can be a real pain. There's often no need to have an MD rush in to pronounce death immediately, especially in a palliative care setting where such events are anticipated.

 

Isn't splitting hairs fun?

 

- Rupinder

[Guest NurseEpi]

Hi there,

 

Not to beat a dead horse with a stick (no pun intended) but I feel the need to clarify some issues re: nurses pronouncing death.

 

In Ontario (I don't know the standards for other provinces) the College of Nurses Practice Standards clearly state, "When clients are expected to die and their care plans do not include resuscitation, nurses have the authority to pronounce death". This applies to both the community and health care facilities. If the death was unexpected, then a physician or a nurse practitioner must pronounce.

 

There is a big difference between "pronouncing" death and "certifying" death. Pronouncing death simply means declaring that death has occurred and there is no legal requirement for a physician to pronounce death. Certifying death means determining the cause of death and signing the medical certificate of death. Legally, either a physician or a nurse practitioner is required to sign a death certificate.

 

Sorry to drag this issue out, but I just wanted to add my 2 cents.

 

NurseEpi

[Guest madricka]

McMastergirl... thank you for your clarification. You are right. I have seen many nurses with less-than-perfect skills & procedures. It's sad really. I'm fortunate enough to have a preceptor that is as hard as nails & really pushes us to work very hard & do things right, even if the example set by other health care practitioners isn't the best (this includes physicians ! I've watched as a physican attempted to examine an MRSA+ pt without isolation gown or even gloves!). My preceptor has no qualms about pointing out the inadequacies of other colleagues, if only to demonstrate a point (i.e. feeding crushed meds to a pt who was lying down when sitting was not contraind.). She's also very good at teaching how, even if you are super-busy, you can still do things properly (multi-tasking at it's finest!).

 

As for RN's pronouncing death, NurseEpi is correct. We can pronounce but not certify. I'm not in a strictly palliative care facility, I'm actually at a large Toronto hospital. The patient's chart will read (in several places) that the patient is DNR & immediately below it will say that "the RN may pronounce death".

 

Not hairsplitting, just facilitating discussion.

[Guest McMastergirl]

Of course, physicians are not exempt from making mistakes and not following procedures! In fact, they are probably worse than nurses... likely because they are not trained as rigorously in such things. Most med students/junior residents are taught procedures by other residents, who in turn learned them from other residents... and who knows if they're doing it correctly, because no one ever checks on their technique... it scares me actually.

[Guest DrSahsi]

Thank you NurseEpi and Madrika for the valuable clarification.

[Guest cracked30]

LGFTD- looks good from the door

 

LOL in NYD - little old lady in no apparent distress

 

AMFYOYO - adios my friend, your on your own

[Guest druggist]

Hey everyone,

 

Being a pharmacy student before being accepted to med (2 days ago!! WOOO!!! haha), here are a few conventional abbreviations for use when writing a prescription, termed pharmaceutical sig or just sig. You will all become quite familiar with these by the time third year med rolls around.

 

I put the various prescription writing abbreviations into categories for the hell of it.

 

Methods of application:

 

A: Apply

 

T: Take

 

G: Give

 

I: Insert, inhale (metered dose inhalers), or instill (as with eye drops)

 

S: Spray

 

Frequencies:

 

OD: Once a day

 

BID: Twice a day

 

TID: Three times a day

 

QID: Four times a day

 

D: Day

 

WK: Week

 

Dosage forms:

 

Tab: Tablet

 

Cap: Capsules

 

Supp: Suppository

 

Ung: Ointment

 

Cr: Cream; this one is usually written out in full.

 

Routes of administration:

 

PR: Rectally

 

PO: By mouth, orally

 

PV: Vaginally

 

IM: Intramuscularly

 

IV: Intravenously

 

IA: Intra-arterially (rare)

 

SC: Subcutaneously

 

ID: Intradermally

 

IT: Intrathecal; this one usually written out in full.

 

Intraventricular, more...

 

Specifications:

 

PRN: As needed

 

X 6: For 6 days or with 6 refills, etc.

 

AC: Before meals

 

PC: After meals

 

So, for example, as a med student you may write:

 

I 1 supp. pv pc prn X 21 d.

6R

 

And this would mean...

 

Insert 1 suppository vaginally after meals as needed for 21 days

 

6 Refills

 

Cheers,

 

Druggy

[Guest stepstofollow]

Another resource is:

www.jdmd.com/glossary/medabbr.pdf

[Guest Ian Wong]

Floating back to the top.

 

Ian