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ENW's Emergi-Lexicon
A Compendium of those pithy phrases of Emergency Jargon
and regional variations of terminology!
Send
contributions to:
ENW Lexicon You will be listed
as the contributor.
While ENW
does relish those slang terms that aptly
characterize patients or situations not otherwise easily described, we are
wary of pejorative or denigrating terms.
We are
especially interested in providing terms that clarify a clinical
presentation, or in national or regional differences in nomenclature.
Authorship
or authority will be cited where known. Those indicated"©
Tom Trimble, RN" are authored and copyright by Tom Trimble, RN.
Otherwise, words are in public domain and the definitions are by Tom Trimble, RN.
"Adios Yo-Yo": (phrase) "Goodbye,
you're on your own!" Term contributed by E. Needham RN, CEN
"Amp
of "Holy Water'": (phrase) An irreverent but not meanly intended indication
that in the failing resuscitation effort still underway past any prospect of actual
survival as a sentient person, the next or last drug to give would be an ampoule of Holy
Water as either a miraculous cure or as benediction for afterlife, and as a gentle
suggestion that resuscitation efforts be terminated. © Tom Trimble, RN
"Binky™-Test":
(phrase) The ability of an infant to evidence basic stability and an interest in "the
important things in life" by placidly sucking on a pacifier. [From an
account by M. Borgeson, MD, of an infant whose over-hasty intubation for mere tachypnea
without respiratory distress was averted by a nurse who placed a pacifier in the child's
mouth, thus demonstrating the "positive Binky™--Test," and blocking an
unnecessary procedure. ] The term is a salutary reminder to check the whole patient and
not focus too narrowly upon a single finding.
"Blue
Bloater / Pink Puffer": (noun) Stereotypical descriptions of bodily appearance of
COPD patients with (respectively) Chronic Bronchitis and Emphysema.
"Bounce-Back":
The patient returns with exacerbation of the problem for which he was diagnosed and
treated, or because of treatment failure, within twenty-four hours to a few days duration.
Box:
(verb) "He's going to . . . " "He boxed" ---to die (from
coffin)
"Brutane":
(noun) The putative name of a fictitious anesthetic agent used as an euphemism for the
careful and scientific application of brute force to manually restrain the patient for a
procedure, e.g., a wiggling child for repair of a laceration.
Bus
Unloaded", "The: (phrase) A cluster or "bolus" of patients has
arrived in the ED, near-simultaneously or within a short period of time, causing a rapid
increase or perhaps overstretching of the workload to the available resources.
"~
Care Unit": (noun - euphemism) "Celestial ~ ", "Eternal ~ ",
"Expensive ~ ", references to Death or to a moribund stay in Intensive Care.
cart
= cot = gurney = stretcher = trolley: (noun, & regional equivalents) The narrow
movable bed typically used for transporting patients or caring for them in emergency or
critical care settings.
"Cellular
Samaritans": (noun) The individual, perhaps hundreds of them, who call 911 to
report a public safety occurrence without physically contributing any useful aid or
information to the resolution of the problem who thereby assuage their consciences to
"do something" without effort or involvement or direct assistance.
Term contributed by V. Rooker, EMT-P
"Chandelier
Sign": (noun) The intense amount of physical response including near-levitation
from the bed to the chandelier on the ceiling induced by examining for cervical motion
tenderness in cases of Pelvic Inflammatory Disease.
"Chicken
Spray": (noun) Nickname, as used by "oncology kids", for Ethyl Chloride
Spray, the chilling evaporant liquid used for transiently numbing injection sites.
"Circling
the Drain": (phrase) The patient's future prospects of life are dim . . .
(synonym for rapid deterioration or near-extremis) Other variations include "F.T.D.
-- Fixing to die. Pre-code patient" (submitted by Jack Sheehan), "Trying To
Die", etc.
"Code
Blue-->Code Purple-->Code Yellow-->Code Brown-->Code Rock": (phrase)
Description of the pathophysiologic sequence often encountered in the process of death or
responding to a person in some phase of the same. e.g., cyanosis, intense
cyanosis or post-mortem lividity, loss of urine from the bladder from sphincter
relaxation, loss of stool from the rectum due to sphincter relaxation, rigor mortis. © Tom Trimble, RN
Crock:
(noun) The patient whose physical complaints are without organic or discernible basis, or
frankly bogus. Often resented for the "wasteful" amount of work necessary to
prove non-validity. If one might be overheard, reference might be made less plain by the
pseudo-scientific "high Serum Porcelain Level" or to putatively send such a test
to measure the degree of falsity.
Demerol®
Sponge: (noun) The great capacity and tolerance to, and desire for high doses of
narcotics by patients with chronic pain management problems, often further compared to
"if you or I had that much we'd be comatose or dead!"
"Didivoid":
(phrase) Question of apparently high importance regarding the patient's history
almost invariably asked by ward nurses taking report: colloquial translation of
"Did he void? (empty the urinary bladder).
"Diffusely
Positive 'Review of Systems'": A patient who reports findings or complaints
broadly through each system of the body during the history interview of formal
examination; may be an unfortunate who has truly had many ailments, may be vague
unorganized or psychosomatic complaints; may represent suggestibility on the partient's
part who tries to give some information on everything to please the doctor.
"Diplomat
Nurse": (noun) The Clinical Nurse Specialist attached to a hospital service or to
a private practice group of physicians who operates not only as the problem-solver and
preventor but also as the "polisher and smoother" and intermediary for the
practice in many matters.
"DFO"
or "Done Fell Out!": (verb) A dialectical expression of syncope.
"Duck":
(noun) Obsolete slang for a male urinal from its (former) typical white enamelware
construction and its similar silhouette to the bird.
DRT
-"Dead Right There'': (phrase) [field usage} "The patient has been deceased
long enough to greatly decrease the probability of resuscitation." Submitted by MTNCOM@aol.com {Editor's
Note: Implies meeting of criteria for field reporting of Death or to Withhold
Resuscitation Efforts, includes non-transport of dead body by an EMS}
Dwindles,
the: (noun): the slow vague "failure to thrive" of senile physical
deterioration.
"Epi-Sick":
(noun): The pale, "green", nauseous, chest-pounding, tachycardiac, appearance of
the patient who has received aggressive subcutaneous epinephrine (Adrenaline) therapy in
anaphylaxis or status asthmaticus as distress resolves and the patient awaits the
resolution of his circulating exogenous catecholamines. © Tom Trimble, RN
"FOOSH": (noun/verb) "Fall Onto
Outstretched Hand" as mechanism of injury.
"Frequent Flyer": (noun) A well-known patient
who is seen often in the Emergency Department.
"Green
Poultice": (noun) The object of eventual desire for a patient who is "improving his case" ,viz., the
soothing warm application of a substantial sum of money (American currency is
green) to be derived from a financial settlement of a lawsuit. Suggested
by Charles S. Krin, DO FAAFP who
states that "the originator of that particular term, . . . as far as I know, (is)
lost in the mists of antiquity...or at least the last 30 years."
H.O.D.: (noun) Heroin Overdose.
"Improving His Case":
Self-alleged victim of a minor motor vehicle accident or workman's compensation injury who
wishes and requires no or little other care than documentation of aches and pains for the
purpose of a legal claim or lawsuit. May state that he is here now because his lawyer or a
friend advised that he should be seen by the doctor. May request a copy of "my
medical record" or to be given a cervical collar or sling. If one wishes to obscure
one's meaning if there is a chance of being overheard the pseudo-diagnosis of "subluxation
of the ligamentum litigationii" might be used, particularly if spoken
softly and rapidly but might not fool the well-educated. © Tom
Trimble, RN
"JIC" tube: Submitted by Andrea Novak: "When
drawing blood for lab studies, a "JIC" tube is drawn for "just in
case" the doc adds more to the lab order later on."
"La
Malade du Petit Papier": The patient who brings in a list of his purported
ailments, excessively extensive documentation of each bowel movement or sip of water, and
persistently recounts them from point to point. This is in contradistinction to the
non-neurotic patient with lengthy and complicated history, well elders who may need an aide-memoire,
or bring in the requested self-monitoring notes of their diabetes or peak-flows.
"Landmark-Walking":
(phrase) The practice of the ataxic, infirm, sea-sick, drunk, and others of un-confident
stability and gait, of walking (and looking to find) from one object to another to steady
oneself or rest before moving on to the next; intervals without a steadying object or hand
may resemble a lurching, festinating, or semi-controlled fall. ©Tom
Trimble, RN
"Lipstick
Sign": As a patient rouses from earlier misery, the first application of lipstick
or hairbrush indicates a sense of future, self-perception, self-image and esteem, and a
willingness to leave behind the sense of illness.
"LOC":
At a paramedic tape-review session, discussion to clarify communicated meanings revolved
around "LOC". I was asked what it means. For some reason, hilarity ensued when I
explained that "where I work, "LOC" can mean Level of
Consciousness, Loss of Consciousness, or "Laxative of Choice!"
"
LWBS": (acronym) Left Without Being Seen, abbreviation placed upon charts to
account for patients who no longer can be accounted for, i.e., patient
discouraged by wait- changed his mind - departed without examination or treatment. Term contributed by Scott G.
Shelp, RN AAN CEN AASc AA
"Main
d'Accoucheur, La": (noun), from French, literally "the hand of the man
who assists women with childbirth". The "obstetric hand" describes the
cramped and "coned" posture of the hand and fingers that occurs with carpal
tetany as found in Acute Hyperventilation Syndrome with Tetany.
"Meet'em,
Greet'em, Treat'em, & Street'em": (phrase [and philosophy]) The aphoristic
admonition to rapidly evaluate the patient in problem-oriented fashion with expeditious
discharge avoiding the trap of a "Million-Dollar Work-Up"
(q.v.). Implied is the goal of providing care only for those current complaints
that actually require treatment now, rather than addressing all comprehensive health
maintenance issues, and urging patient self-responsibility for follow-up, as arranged, and
obtaining a primary health care provider. ENW has received
reminders to include this prevalent phrase from: Angel
Bumpers, Tracy E. Ward, Terri Kushner
"M.T.F.":
"Metabolize To Freedom" Worked-up sufficiently to exclude other diagnoses than
alcohol intoxication, disposition/discharge planned when achieves safe functional level. Source
= Highland General Hospital, Oakland, CA
"Million-Dollar
Work-Up": (noun) The lengthy, extensive, expensive, labor-intensive, sometimes
painful, process to seek a diagnosis or to rule out more ominous differential diagnoses.
This may have initiated due to patient complaint [e.g., "worst headache of
my life"], patient request [e.g., comes unannounced with x-rays in hand from
another hospital and wants a "second opinion"], physician fear of lawsuit, or
attempt to achieve a definitive diagnosis of a fascinoma, q.v.
"Nose-Hose":
(noun) Nasogastric tube.
"O
- Sign": The open-mouthed slack-jawed appearance of the narcotized, unconscious,
stuporose, and dead-drunk. c.f. Q - Sign q.v.
OTD:
(phrase) Out the door. {as in, "Don't erase Room 5 until he's really
OTD."}
Term contributed by E. Needham RN, CEN
"Perineal
Towel Sign": (noun) refers to the panty liner, sanitary napkin, tissues,
incontinence diapers, washcloths, or towels worn in the underwear of elderly women with
urinary incontinence which, in the context of otherwise unexplained illness or early
urosepsis, has positive predictive value for diagnosis in view of the high potential for
seeding of the urinary tract with e. coli bacteria.
"PID
Shuffle": (noun) clinical slang for the characteristic mindful and uncomfortable
shuffling gait and flexed posture of the woman with significant Pelvic Inflammatory
Disease. Term contributed by Scott G. Shelp, RN AAN CEN AASc AA
Pimp:
(verb) To interrogate another mercilessly regarding knowledge of a subject so as to derive
personal benefit from another's study without doing so oneself, or for the purpose of
embarrassing that person and to display one's own superiority.
(c.f, also http://www.neonatology.org/pearls/pimping.html
"The Art of Pimping "by Frederick L. Brancati, MD,
Department of Medicine, University of Pittsburgh. From JAMA 262(1):89, July 7, 1989
reproduced on "Neonatology on the Web")
"Pothole
Sign": (noun) Ask someone who may be having an acute appendicitis attack how the
drive was to the hospital. If every little bump was felt, they displayed a "positive
pothole sign". From: Yvonne
Harris
"The
Progressive Purple Mask of Death": (phrase) Deep anoxic cyanosis of the face
extending to the earlobes, the entire ear, the neck, and proceeding to include the chest
associated with progressively diminishing possibility of resuscitation from
cardiopulmonary arrest. In my experience, the patient may sometimes be resuscitated from
cyanosis of the pinna or even the upper neck more rarely, but have not encountered any who
have been resuscitated from thoracic cyanosis. © Tom Trimble, RN
"Prolixin™
Shuffle: (noun) Characteristic shuffling gait and bradykinesia of patients on
high doses of this potent anti-psychotic drug.
"Q
- Sign": (noun) The more advanced and severe form of O - Sign, q.v.,
wherein the tongue lolls protruding from the mouth like the tail of the Q.
"Dotted-Q Sign": One or more flies resting
on the tongue. From: Geoff
Pangrac RN
"Road-Test":
(noun) The attempt to establish discharge suitability criteria by testing arousal
(compelling the patient to waken and bestir himself to some level of self-sufficiency),
neurological cerebellar testing of station, gait, ataxia, ambulation, etc., give
discharge instructions, and promise or threaten whatever incentive is necessary for the
patient to depart and stay gone without falling down in front of a bus or other
misadventure.
"The
'S'-Word"/"The 'Q'-Word"/ "The 'B'- Word": (noun) The most
prevalent and accepted folk-custom in the ED culture, ---nay, even pandemic, perhaps
second only to the belief in the malevolent effect of the full moon upon workload and
weirdness, is the practice of avoiding (and castigating any usage thereof) the words
"S**w" (antonym of "fast"), "Q***t" (antonym of loud or
peaceful), or "B**y" (antonym of inactive), in reference to the workload or
activity level. For surely, as the night must follow day, there is a direct causal
relationship to the adverse changes and bad karma which follow.
Scut:
(noun) The clinical chores and tasks involved in examining and treating patients.
Shoot
and Boot: (phrase) Medicate and discharge. Term contributed by E. Needham RN, CEN
"Shooter":
(noun) A user of injected illicit drugs, e.g., "shooter with fever",
needs "million-dollar work-up". q.v., and admission for presumptive
endocarditis.
"Spooge":
(noun) describes ANY fluid once it has escaped from the body......usually onto the
patient's freshly changed bed. Term contributed by Tracy Emery RN
"STAT":
(abbreviation of Latin "statim" = now, or immediately) jocularly, "Some
Time After Tomorrow" is offered as the "real" probable likelihood of having
the event occur within the desired timeframe. Suggested by Geoff Pangrac
"Suitcase
Sign": (noun) The patient arrives with a packed suitcase with clear
and evident intent or expectation of being admitted, perhaps regardless of any merit to
their complaint. Moy95@aol.com
reports that '''suitcase sign' is commonly called a 'positive samsonite sign' in my
area."
"Sundowner"
or "Sundown Syndrome": The well-known tendency for senile or demented
patients to have a nocturnal worsening of their mental status and confusion; may also be
caused in such patients by even relatively small doses of sedatives, analgesics, and
hypnotics, or to have nocturnal paradoxical effect of such agents.
"Tachy-Aye":(noun) (pronounced tackyeye) refers to a patient whose response to
pain is to repeatedly yell "aye-aye-aye". Term contributed by
Tracy Emery RN
"Tape
Boogers": (noun) Remnants upon the skin of old adhesive residue from tape or
monitoring electrodes. May sometimes be of nearly archeological age. {I wish I had
thought of this one!}
"Three
Hots & A Cot": (phrase) The food and shelter actually sought by homeless and
socially dysfunctional persons who seek to use a hospital as an almshouse by either
direct/indirect request or by simulation of illness.
TBF:
Total Body Failure: (noun) Used in describing a patient, usually the elderly, who are
suffering from "failure to thrive". From: Cessford
"TNTC":
(abbreviation) From laboratory usage reporting "Too Numerous To Count". Can be
applied to the patient's list of complaints.
"Toxic
Socks Syndrome": (noun) The pervasive malodor emanating from the unwashed
and unkempt when foot coverings are exposed or removed. Other regional variants
exist, e.g., "Mission Foot" as in Mission Emergency Hospital, San
Francisco.
"Train-Wreck":
(noun) A patient with too many problems, perhaps in dire and desperate condition,
as if he had "been hit by a . . . "
"Trumpet":
(noun) Nasopharyngeal Airway, said to be so due to the flared end that keeps the tube from
slipping backwards.
" Vapors,
the": (noun) The vague somatization and physical, perhaps hypochondriacal,
complaints, often flutteringly or histrionically displayed by the patient.
"Velcro":
(noun) The family or friends who brought the patient to the ED and are usually stuck to
the patient's side when the patient needs to be brought to the patient care areas. As
in." (I wish they would) leave the Velcro in the lobby." Term
contributed by Tracy Emery
RN
(A)
Wall: (noun) "Be a Wall, Man! This injunction by or to other
house staff physicians is the imploring of protection from admission of patients, i.e.,
(I'm exhausted, or do not wish to be bothered, therefore protect me from admitting more
patients; stonewall them; be an impregnable barrier.
"Wastebasket
Diagnosis": (noun) A diagnosis which is deemed to be faddish, not well proven to
exist, or yet physiologically explained, or not described with great specificity, broad
inclusiveness to the point of being scientifically useless. Notwithstanding, such
diagnoses may be commonly spoken of, claimed by patients, or have many articles in the
last three years in the journals and tabloids at the supermarket checkstand.
" WNL":
(abbreviation of "Within Normal Limits") jocularly, a false definition of
"We Never Looked" is offered to cast doubt on the validity of the process by
which the said datum was obtained. Suggested by Geoff Pangrac
"Worst
Headache Of My Life": (phrase) Chief Complaint of a patient that may result in a
million-dollar work-up, q.v., of exam, labs, IV, CT Scan, Lumbar Puncture,
Neurology Consult. Often referred to in staff conversation of things oneself does not wish
to have happen, as in "I never want to be an ED patient and say that
it's the "worst headache of my life"; too much can happen to you!"
Zebras:
(noun) Rare diagnoses, as in the classic aphorism to consider consider common diseases
most probable: "If you hear thundering hoofbeats behind you, it's more likely to be
horses than zebras!"
"ENW's Emergi-Lexicon"
[http://ENW.org/Lexicon.htm]
is a webarticle presented by:
Emergency Nursing World !
[http://ENW.org]
©Tom Trimble, RN [Tom@ENW.org]
Internet Resources for Medical Language and Abbreviations
The TLA Web Page
- A Guide To Medical Abbreviations
from National
Center for Emergency Medical Informatics
Acronyms
and Abbreviations
from World Wide Web of Emergency Services
at Rochester Institute of Technology
Humorous Run Report
Acronyms
from National Collegiate
Emergency Medical Services Foundation
Multilingual Glossary of Medical Words
from Heymans Institute of Pharmacology,
University of Gent, Belgium
at the direction of The Commission of European Communities
The WorldWideWeb Acronym and Abbreviation Server (a general source)
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