List of Medical Terminology
ACLS: Advanced Cardiac Life Support. A protocol developed in the 1990s that involves the use of drugs, cardiostimulators, and sequenced flowcharts to correct most cardiac dysrhythmias. A modern version of this protocol is still in use today. For the complete ACLS algorithm, see the ACLS reference elsewhere in this guide.
AED: Automated External Defibrillator, the precursor of the cardiostimulator. A device developed in the late 20th century to allow untrained laypeople to effectively treat cardiac arrest patients, using computerized analysis and treatment algorithms to provide fast, effective cardioversion without the need for a trained EMT.
Agonal: Description of a major negative change in a patient's condition, usually preceding immediate death; examples include cessation of breathing, loss of pulse(s), or a dire change in the patient's EEG or ECG.
AMA: Against Medical Advice. If a medical officer tells you to stay in Sickbay and you leave anyway, you're leaving Against Medical Advice. Usually an AMA departure involves the signing of a release form absolving the medical staff of responsibility if the patient's condition deteriorates after he/she leaves.
Ambu-bag: A handheld squeeze bag attached to a face mask, used to ventilate patients; also known as a bag-valve-mask device. See "bagging."
Amp: Abbreviation for ampoule, a single-dose sterile vial of a given medication.
Anterior: Reference to the front of something - a body surface, an organ, etc.
AOB: Alcohol on Breath. Now discouraged in favor of “alcohol-LIKE odor on breath.” (After all, it could be synthehol...)
Apnea: The absence of respiratory effort (i.e. patient not breathing). Apnea is, for obvious reasons, a life-threatening condition.
Appy: Abbreviation of appendectomy, an emergency procedure done on many species of humanoids to remove an inflamed and/or infected appendix.
Arrhythmia: Any one of a number of ways the heart can beat abnormally. Arrhythmias are usually classified by where they originate (sinus, supraventricular, atrioventricular, bundle branch) or what they cause (block, tachycardia, bradycardia, fibrillation).
Attending physician: A fully licensed and boarded physician who has staff privileges at a given hospital. Depending on their field of specialty, attendings either work full-time in shipboard Sickbays or take emergency call for their specialty services (cardiology, OB/GYN, surgery, etc.) Attendings supervise and direct the education of residents.
Babinski's reflex: Also known as the plantar reflex, stimulated by stroking a pointed object (back of a knife, tongue depressor, etc.) up along the medial aspect of the sole of the foot. If the toes (especially the great toe) curl down, this is a negative Babinski, and indicates normal motor cortex function. In a positive Babinski, the toes splay outward; this is a sign of severe, diffuse brain damage, and carries an extremely poor prognosis.
BAC: Blood alcohol content, the measure of ethanol in the bloodstream. BAC can be expressed two ways, as a direct measurement in milligrams per deciliter (mg/dL), or as a percentage. By calculating backwards, you can sometimes correlate BAC and the number of alcoholic drinks the patient consumed. 100 mg/dL (.10) is considered legally intoxicated; 350 mg/dL (.35) or above is considered alcohol overdose, and requires urgent medical care.
Bag 'em; bagging: To use a bag-valve mask to ventilate a patient. See "Ambu-bag."
Bag of worms: Synonym for ventricular fibrillation or "V-fib"; so named because the heart's action looks like a bag full of wriggling worms. (No, we're not making this up.)
Blade: Derogatory term for a surgeon; used by everyone, but has a special meaning for anesthesiologists and nurses (who have to put up with surgeons' bluster all day long and hence particularly enjoy getting their own back). Blades take no advice from anyone, are never wrong, never admit to being wrong even if proven so, know everything there ever is, was, and will be about medicine, can do any surgical procedure while comatose with both hands tied behind their backs, are completely invulnerable to such human needs as sleep, nutrition and elimination, and generally conceive of themselves as seated at the right hand of the Almighty.
Blow a vein: To make a vein unsuitable for IV placement, due to repeated previous IV attempts or placements in the same location.
BLS: Basic Life Support. The basic care given to any unconscious patient, consisting of airway maintenance, artificial respiration and chest compressions. BLS is sometimes referred to as "professional rescuer CPR."
Bolus dose: A high dose of a given drug, usually administered through an IV line, to achieve a rapid therapeutic effect.
Bones: Orthopedic surgeons, doctors who specialize in the surgical treatment of bone problems. Most medical professionals look down on orthopedics due to its perceived preponderance of mentally challenged ex-jocks. (Many medical schools have a persistent rumor that states that the bottom 10% of any given class of students will be lobotomized; those who can crawl away afterwards are destined for orthopedics.)
Bounce-back: Someone who is seen again with the same complaint shortly after being discharged. You'll hear this as a "bounce-back [complaint]."
BP: Blood pressure. BP is written as two numbers; the first represents the pressure inside the arteries during contraction of the heart (systole), and the second during relaxation (diastole) of the heart. There are two ways to take a blood pressure, one involving the use of a machine and the other involving the use of a stethoscope and a compression cuff. If it's done the second way, the pressure will be in even numbers only. Normal blood pressure in a human is around 120/80 mmHg; hypertension is defined as systolic blood pressure of higher than 150 mmHg.
Bradying down: Bradycardia is a slow (less than 40 beats/min) heart beat. Bradying down is the slowing of the heart rate. See "tachycardia" for the opposite effect.
Buff: To give a patient the basic treatments, i.e. IV fluids and oxygen, to make their conditions look as good as possible. Buffing is typically done as preparation for a "turf," or right before an intern has to present the day's cases to his or her attending.
Bug juice: IV antibiotics; usually refers to high-powered drugs used to eradicate particularly nasty infections.
Caesarean section (C-section): Surgical delivery of a baby through the abdominal wall. C-section is indicated in certain situations (i.e. breech presentation, in which the baby does not turn around in utero) where a normal labor and delivery would endanger either the mother or the baby.
Call: Duty in Sickbay. A physician "takes call" for a certain shift; that physician is then "on call" and will be "called" for any and all problems related to his or her specialty. Call typically rotates among a number of doctors in a given specialty, according to a pre-determined call schedule.
Cardioversion: Conversion of a cardiac arrhythmia to normal sinus rhythm, usually accomplished by means of electrical shock and drugs. See "defibrillation" for a specific, well-known form of cardioversion.
CBC: Complete Blood Count (not Canadian Broadcast Corporation, at least not here.) It's the first test most ED doctors order for the vast majority of their patients, due to its extreme usefulness in determining a patient's condition. A CBC includes red cell and white cell counts (which may be further differentiated into the types and amounts of white blood cells; this is known as a "WBC diff"), hematocrit, hemoglobin, and some determinations calculated from those values. Those determinations are the mean corpuscular volume (MCV), the mean corpuscular hemoglobin (MCH), and the mean corpuscular hemoglobin concentration (MCHC).
Cervical spine (C-spine): The first seven vertebrae in the spine, going from the base of the skull downward. A "C-spine collar" is a stiff collar used to immobilize the C-spine in patients with suspected spinal trauma. A "cross-table C-spine" is a kind of scan taken laterally across the body to check for fractures of these vertebrae, a common occurrence in traumatically injured patients.
Champagne tap: A successful lumbar puncture with no red blood cells found, which means it is as clean as possible. By custom, if a medical student or intern makes a champagne tap, the resident or attending must buy him or her a bottle of champagne.
Chem 7, Chem 20: Blood chemistry series used to measure blood urea nitrogen (BUN), serum chloride (Cl), CO2, creatinine, glucose, serum potassium (K), and serum sodium (Na). A Chem 20 is far more extensive, and measures (in alphabetical order): albumin, alkaline phosphatase, ALT, AST, BUN, serum calcium, serum chloride, CO2, creatinine, two bilirubin determinations, gamma-GT, glucose, LDH, serum phosphate, serum potassium, serum sodium, cholesterol, protein, and uric acid.
Coag panel: A blood test used to determine the efficacy of the clotting factors in a patient's blood.
Code Blue: Medical emergency code, called to indicate that a patient is not breathing, does not have a pulse, or any combination thereof. When announced over a hospital PA system or a ship's all-call, the format is "Code Blue, [location]"; all available medical personnel are then required to respond to the code. A patient on whom a Code Blue is called is said to have "coded;" the process of resuscitating a coded patient is called "running a code." DNR patients, for this reason, are sometimes referred to as "no codes."
Code Brown: Derogatory "code," indicating that a patient with gastrointestinal upset didn't make it to the facilities in time.
Code Pink: Emergency code indicating an emergency in the nursery or NICU. Code Pinks are usually called when an infant's ID bracelet does not match up, when an infant is threatened or abused, or when an infant goes missing.
CPR: Cardiopulmonary Resuscitation, or the technique of systematically squashing someone’s chest to simulate cardiac function. We cannot recommend strongly enough that you take a course in it. A six hour investment might help you save somebody's life someday. If it's been more than a year since you've done the course, your certification has expired. To stay certified, you need to take it every year.
Crack the chest: To perform an emergency thoracotomy on a patient.
Crash: To have one's condition take a sudden and severe turn for the worse. Usually refers to trauma patients whose "Golden Hour" has run out, i.e. "The GSW in Room 4 is crashing!"
Crasher: Irreverent slang term for a family member or loved one of an ED patient who passes out in shock at learning of the patient’s condition.
Crispy critter: Irreverent ED slang for a severely burned patient.
Crit: Hematocrit, or the height of red blood cells over the plasma in a centrifuged tube, expressed as a percentage. Since red blood cells carry oxygen to the tissues of the body, this is a useful measurement of how well the blood is doing its job.
Cross-clamp(ing): The aorta, the main oxygenated artery leading from the heart, has two parts, one going up and one going down, called the ascending and descending aorta respectively. During a thoracotomy, the descending aorta can be clamped off to control hemorrhage below the diaphragm. This process conserves blood while preserving perfusion to the heart and brain, but obviously compromises circulation to the lower body.
CTD: Circling The Drain. Derogatory term for a patient who is extremely sick and not likely to recover.
CxR: Chest x-ray.
D5W: A commonly used intravenous solution (not motor oil - that would be 10W30.) D5W and its ilk are various amounts of dextrose (a simple sugar, also known as glucose) in water. D5W is 5% dextrose; D10W is 10% dextrose, and so on.
Debridement: Cleaning an open wound by removing foreign material and dead tissue. In some cases, it can be painful enough to require sedation.
Decerebration: The progressive loss of cerebral function; advanced decerebration (and the resultant deep unconsciousness) occurs with severe damage to the cerebrum, the largest part of the brain. A totally decerebrated patient is said to be brain dead.
Deep: That which is located deeper within the body than a given reference point, i.e. "the heart is deep to the ribs."
Defibrillation: The cessation of fibrillation (chaotic, ineffective “wriggling” beat) of the cardiac muscle and restoration of a normal rhythm, usually accomplished by means of electrical shock and drugs. (Incidentally, medical personnel yell "Clear!" for a very good reason when shocking a patient. Remember that the human body is mostly water with some salt, and that saline solution is a very good conductor of electricity... hence whatever or whoever touches the body will get shocked as well.)
Differential diagnosis: A list of every disease that may possibly cause your patient’s symptoms. Typically when making a diagnosis, you will start out with as large a differential as possible and narrow it down to the one disease most likely to cause the observed symptoms.
Disaster protocol color
coding: The use of color codes to rapidly triage
mass-casualty patients for examination or treatment:
Green = walking wounded; last to be seen
Yellow = urgent; can wait a few hours for treatment
Red = critical; treat immediately
Black = DOA
DKA: Diabetic ketoacidosis, a life-threatening complication of hyperglycemia.
DOA: Dead on Arrival. Enough said.
Doc: A physician, short for "Doctor." When used by a student or resident in reference to an attending, it indicates that said attending is well liked and highly respected, i.e. "Dr. Kirtschner is a good doc; she's on the ball, she doesn't pimp too badly, and she's pretty decent for a blade."
Dorsal: Reference to the back of a person (as opposed to "posterior," which refers to any rear surface).
DPL: Diagnostic peritoneal lavage. Saline is infused into the peritoneum (abdominal cavity), then suctioned out. The presence of blood in the resultant fluid is an indication for surgical exploration of the abdomen. It's not a pleasant procedure, but it can save a great deal of time and avert a good many surgical complications.
DNR: Do Not Resuscitate. A legal advance directive filed by some patients, especially those with terminal illnesses, ordering that no heroic measures be undertaken by medical personnel to save their lives in an emergency.
DVT: Deep vein thrombosis - a blood clot in a deep vein. A dangerous condition because the clot can travel up to the heart or lungs and block a vessel feeding those organs, causing cardiac or pulmonary ischemia, cardiac arrest and death.
ECG: Electrocardiogram - a graphic representation of electrical activity in the heart. A proper ECG uses twelve leads to produce twelve tracings, and is called exactly that - a 12-lead ECG. ECG can diagnose conductive problems in the heart, localize ischemic damage in MI patients, and indicate the presence of some traumatic and pathological conditions (i.e. torsades de pointes, a fatal arrhythmia, often occurs in drug OD).
ED: Emergency Department. (Other variations on this abbreviation include "ER", "EW", "EU", "EC", which stand for emergency room, ward, unit, center, etc.) Often derogatorily referred to as "The Pit" by those who work there.
Edema: Fluid accumulation in tissues. Crackling sounds in the chest are a characteristic finding of pulmonary edema, or “wet lungs.”
EEG: Electroencephalogram. Graphic representation of brain activity. See ECG for its cardiac equivalent.
EMT: Emergency Medical Technician, commonly referred to as a medtech. EMTs come in two varieties, classified by the kind of care they can provide: basic (BLS, first response, evaluation and transport) and advanced (ACLS, some drugs, evaluation and transport).
Endoscopy: Use of a flexible, fiber-optic scope to see inside the body, usually via the gastrointestinal and respiratory tracts. Endoscopy has been available since the 20th century as a diagnostic and therapeutic procedure; with the advent of modern, non-invasive scanning techniques, it is typically only used when biopsy of deep tissues is required to make a diagnosis, i.e. ruling out cancer in a patient with colon polyps.
Endotracheal intubation: The placement of a plastic tube through the mouth and into the trachea (windpipe) to establish an airway into the lungs and provide a means of ventilating patients who cannot breathe on their own. An instrument called a laryngoscope is used to see inside the throat and ensure that the tube goes into the trachea correctly. The tube is known as an ET tube or airway; the procedure is called either RSI or "tubing."
EtOH: Ethanol (ethyl alcohol), the active ingredient in alcoholic beverages. When written as a chief complaint, it indicates that the patient has had too much to drink.
4F: A patient in whom you strongly suspect gallbladder disease. The abbreviation (which is slightly irreverent) refers to the four major risk factors for cholecystitis: Female, Forty-ish, Fat, and Fertile.
400 Club: The subset of alcoholic patients who have presented to Sickbay with a blood alcohol level above 400 mg/dL. 400 Club members are usually spoken of with a kind of grudging respect, as for most individuals, that much alcohol is sufficient to induce unconsciousness.
Flatliner: A patient in asystole; one whose ECG shows only a flat line, indicating a dead patient.
Flail chest: Traumatic condition in which multiple rib fractures create a "floating" section of chest wall that impedes breathing. Flail chest is a life-threatening emergency.
FLK: Funny-Looking Kid. Derogatory term, in pediatrics, used to refer to a child who appears to have some congenital or developmental abnormality.
Flog: A code gone horribly wrong due to massive medical error, or one in which the patient never had a hope in the first place. Unusually bad flogs are also called "horror shows."
Foley cath: A type of indwelling urinary catheter, placed through the urethra and into the bladder, used to drain the bladder in patients who cannot get themselves to the facilities. (Foleys are not pleasant for the patient... you can probably figure out why.)
Frequent flier: Derogatory term for a patient who reports to Sickbay far more often than is good for him/her.
Gas passer: Derogatory term used by surgeons to refer to anesthesiologists, who (according to surgeons) do nothing but collect outrageous fees for playing with mind-altering gases. (The reference to flatulence is intentional.) For the retort from Anesthesia, see "blade."
Gomer: Get Out Of My Emergency Room. Derogatory term for a patient you really don't want to deal with. The "definitive" gomer is usually elderly; suffers from a boatload of terminal illnesses, any one of which may be acting up at the moment; is usually senile; and is practically indestructible. More generally, gomers are patients with minor, irritating complaints for which you're paged out of bed. ("...And what exactly made your ingrown toenail require urgent medical care at in the morning?")
Goop: Conductive gel - that stuff that gets dumped on the paddles of the cardiostimulator before shocking the patient. Used so the patient on the receiving end doesn't get the skin burned off his or her chest, which is obviously Not a Good Thing.
Gork: God Only Really Knows. A patient who is extremely sick and usually moribund, usually for reason or reasons unknown. Such a patient is often said to be "gorked out." Derogatory when used in reference to a patient.
GSW: Gunshot wound. (You’ll also see PW, phaser wound, though less often.) A hazard of modern life.
Haldol: Trade name for haloperidol, a commonly used neuroleptic sedative. Quite possibly the most useful drug in emergency medicine, it's also known as Vitamin H.
Hyperglycemia: Abnormally high levels of glucose in the blood, a key sign of diabetes. If the blood sugar goes too high, diabetic coma and DKA can result; either can be fatal.
Hyperlipidemia: Excessive fat in the blood. Usually used to refer to high blood levels of cholesterol and other triglycerides, which is a risk factor for atherosclerosis and MI.
Hypertension: Abnormally high blood pressure. Hypertension is a risk factor for all kinds of diseases, including but not limited to heart disease, MI, CVA and aneurysm.
Hypoglycemia: Abnormally low levels of glucose in the blood. Usually the patient presents with “weak and dizzies” from skipping meals.
Hypotension: Abnormally low blood pressure. Too low and the patient faints. (You can induce low blood pressure in yourself by the following neat trick: Lie down on a flat surface and remain still for about ten minutes. Now stand up quickly, and try not to fall down. The lightheadedness you feel is a kind of low blood pressure called orthostatic hypotension.) Other causes of hypotension include trauma (i.e. hypovolemia), drug overdose and shock.
Hypothermia: Body temperature significantly below normal.
Hypovolemia: A decrease in the volume of circulating blood, almost always as the result of trauma; also referred to as being in shock. Hypovolemia is a life-threatening condition, and is treated with IV fluids and hemolog transfusion.
Hypoxia: A severe deficiency of oxygen in the blood and tissues. Hypoxia leads to ischemia; ischemia leads to tissue death. If a patient has a PaO2 of less than 90% on normal air, hypoxia is likely; give oxygen by mask or nasal cannula, or intubate if the condition warrants.
ICP: Intracranial Pressure. The humanoid brain floats in a fluid-filled space, enclosed by bone; when the pressure goes up, the fluid cannot be compressed, so the brain gets squeezed (this is not a good thing). Increased ICP is one of the results of blunt trauma to the head, among other things.
IM: Intramuscular. An injection given into a muscle as opposed to into a vein (IV). IM injections do not take effect as quickly as IV, as the drug takes longer to reach systemic circulation, but they tend to last longer than IV injections for the same reason.
Inferior: That which is below a given reference point, i.e. "the stomach is inferior to the esophagus." The term does not indicate that something is bad or substandard, just physically below the reference.
Intern: A first-year resident. An internship lasts one year and is the minimum amount of post-MD training required to obtain a license to practice medicine. Many residencies do not count the intern year as part of the residency, and some (ophthalmology being one example) require the intern to reapply for his or her residency at the end of the year. Interns typically supervise medical students and co-sign their charts.
IOP: Intraocular Pressure. The humanoid eye contains a certain volume of fluid, known as aqueous humor, which circulates in the front of the eye (the anterior chamber) and nourishes the tissues therein. Too much aqueous results in high IOP, most commonly seen in the context of glaucoma; low IOP usually results from a leak of aqueous, as in an open globe injury. Both are sight-threatening conditions and need immediate treatment.
Ischemia: Condition in which the tissues are starving for oxygen due to inadequate blood circulation. Ischemia is more serious in some tissues than in others; in the brain, ischemia lasting more than four minutes indicates certain brain damage, and the heart can only sustain 90 minutes of ischemia before dying.
IV: Intravenous. Can be used to refer to a line for injection of fluids and medications, or the injection itself. IV injections tend to take effect very rapidly.
IV push: A bolus dose of a medication as quickly as possible through an IV port. IV push is used when a medication must take effect very rapidly, as in ACLS.
Lac: Laceration. A cut in any tissue, usually as a result of sharp object trauma.
Lasix: Trade name for furosemide, a diuretic (i.e. causes patient to urinate). The name derives from the fact that the drug's effect lasts six hours. (Not to be confused with LASIK, which is an acronym for Laser In-situ Keratomileusis - a kind of eye surgery.)
Lateral: That which is further from the midline than a given reference point, e.g. "the arm is lateral to the chest."
Lavage: Washing out. See "DPL" for a specific example. Other cases include gastric lavage in cases of poisoning or upper GI bleeding.
LGFD: Looks Good From Doorway - derogatory term for a patient who, despite complaints to the contrary, does not appear to be acutely ill or injured. Usually used to refer to a malingering patient or a hypochondriac.
Liver rounds: A tradition in nearly all hospitals and Sickbays, wherein the doctors and nurses go hang out in the local bar of their choice at the end of the day on Friday. (The term derives from the fact that alcohol is metabolized by the liver.)
LOC: Level of Consciousness, or Loss of Consciousness.
LOL in NAD: Little Old Lady in No Acute Distress - an elderly woman who has nothing acutely wrong with her, but has come "just to get checked out." You won't see this too often in a shipboard Sickbay, but it's extremely common in civilian hospitals.
Mass-cas: Mass casualty; a situation in which a disaster occurs and creates a large number of injured patients who then must be seen and treated as rapidly as possible. Aboard ship, a mass-cas is almost synonymous with a battle, as any attack that damages the ship is guaranteed to injure at least one crewperson, and probably more.
Medial: That which is closer to the midline of the body than a given reference point, e.g. "the nose is medial to the eyes."
Medical student: A person in the process of obtaining his or her MD. Technically, only third- and fourth-year students who have passed Phase I of the licensure exam may work with patients; however, many programs now also allow the more junior students to spend supervised time on the wards as well. Interns supervise medical students and co-sign their charts, along with an attending.
MI: Myocardial infarction, sometimes called an AMI (the "A" standing for "acute"). Blockage of a coronary artery as a result of plaque formation cuts off the oxygen supply to the heart muscle, and causes severe chest pain as the muscle becomes ischemic and begins to die. If enough of the heart muscle dies, the patient dies too. MI is commonly known as "heart attack." See also “TPA.”
M&M: abbreviation for Morbidity and Mortality, a conference held by many departments on interesting cases that ended either with some unforeseen complication (morbidity), or death (mortality). Most M&M conferences are held as teaching lectures, to determine what went wrong with a patient and how to avoid the same thing happening again. More malignant programs use it to embarrass physicians and their mistakes. If refreshments are served, often the nickname is Death and Donuts (D&D).
MRI: Magnetic Resonance Imaging - a form of imaging study that produces detailed pictures of internal organs. MRIs are extremely useful in trauma cases for assessing the amount and nature of internal injury.
MVA: Motor Vehicle Accident. Can refer to two vehicles crashing, or a vehicle hitting something else, i.e. ground car vs. pedestrian.
NAT: Not A Trooper. Derogatory term used for a trauma patient who is screaming, uncooperative and generally not bearing with his or her injuries like the model Starfleet serviceperson.
NG tube: Nasogastric tube; a tube placed through the nose, down the throat and into the stomach. It's about as much fun as it sounds. (Derogatorily, it’s “up your nose with a rubber hose.”) In the ED, it's used for gastric lavage and emptying of the stomach in cases of accidental ingestion.
NMB: Neuromuscular blockade - a drug-induced dissociation between the nervous impulses and the body's reactions to them. NMB is typically induced in cases where a patient must be completely immobile to avoid doing himself inadvertent injury, as in surgery, or when reflex muscular actions make a time-critical procedure difficult or dangerous, as in endotracheal intubation. See “RSI” for more information.
Normal sinus rhythm: A normal heart rate and rhythm, which is between 60 and 80 beats per minute in an adult human.
Nosocomial infection: Opportunistic infections contracted while in the hospital, e.g. a urinary tract infection a patient develops from his Foley catheter.
NPO: Nothing by mouth (from the Latin Nil per os). Typically written as a pre-operative order, where eating before surgery can have serious complications.
NSAID: Non-steroidal anti-inflammatory drugs, an extremely useful class of medications. NSAIDs are typically non-prescription drugs, and can be used to treat just about any combination of pain (including headache), swelling and fever. The old medical joke "Take two of these and call me in the morning" was probably said in reference to aspirin, one of the first NSAIDs.
O neg: Type O-negative blood, called “universal donor” because it contains no amounts of the common A or B antigen. In humans and many other species, four blood types exist: A, B, AB and O. For each blood type, the immune system makes antibodies to the antigen the blood doesn't have; A-type patients have antibodies against B-type, B against A, O against both, and AB against neither. Giving A-type blood to a B-type patient, for example, will cause an agglutination reaction, a fatal condition in which the blood clumps (agglutinates) and clots throughout the body. The negative relates to the Rhesus factor, a second antigen that must also be matched to avoid this outcome. Patients who are Rh+ can take either type of blood; Rh- patients have antibodies against Rh and can only take Rh- blood. You can use O+ blood in place of O- in any Rh+ patient. Note that most shipboard Sickbays carry hemolog, a synthetic blood replacement, instead of actual blood; only a few rare conditions require actual blood transfusions.
O sign: Derogatory term, indicating that an unconscious or moribund patient's mouth is hanging open. See also "Q sign."
OD: Overdose; usually on medications, alcohol or recreational drugs.
OTC: Over the counter; any medication that can be obtained without a prescription. NSAID pain relievers and respiratory decongestants are two examples of OTC medications.
Papilledema: Swelling of the optic disk in the back of the eye, a good indicator of increased ICP.
PE: Pulmonary embolus - a thrombus (blood clot) that lodges itself in one of the pulmonary arteries, the vessels that carry blood to the lungs to pick up oxygen. If the clot blocks the artery sufficiently, the blood can no longer make it to the lungs, and hypoxia results. Treatment consists of TPA, respiratory therapy with drugs and ventilation, and (rarely) surgical clot removal with nanites.
PET: Positron Emission Tomography. An imaging technique even better than MRI for observing the dynamics of and blood flow to the tissues under study. Great for patients in whom you're trying to assess ischemic damage, but also incredibly power-hungry (and hence incredibly costly).
Pimp: Acronym for Put In My Place (not a purveyor of the services of prostitutes). Pimping is a belittling "teaching" practice, perpetrated by attendings or residents on students or interns, consisting of asking increasingly difficult questions of the student in an attempt to make him or her look stupid.
Pit: Irreverent ED slang for the Emergency Department itself.
PRN: As needed (from the Latin pro re nata). Typically written in prescriptions to indicate that the patient may take the drug whenever the patient's symptoms require it.
Q sign: Similar to the O sign, but with the addition of the patient's tongue hanging out of the mouth (hence forming a "Q" shape). An ominous sign, particularly in gorks and gomers. Like "O sign," this is a derogatory usage.
Rays: Radiologists, a category of physicians universally ridiculed by their peers because they make pretty pictures of the body that may or may not have any bearing at all on a patient's condition.
Resident: A physician in the process of completing his or her training in a given specialty. Residents are ranked by seniority; most residencies run three to five years. Residents supervise interns and medical students, and sometimes each other.
ROS: Review of Systems. The basic physical exam, covering every bodily system and usually including some degree of blood work.
Round up the usual suspects: To order a "shotgun" panel of lab tests on a patient whose condition cannot be immediately diagnosed. A "roundup" usually consists of a CBC with WBC diff, a Chem 20, an LFT (liver function) panel, blood cultures, cardiac enzymes, urinalysis, and chest scans.
RSI: Rapid Sequence Intubation. The preferred way of intubating a patient in the emergency department, involving the use of paralytic drugs to induce apnea (absence of respiration) and to suppress the gag reflex. The induced neuromuscular blockade lasts only a few minutes, and the patient suffers no ill effects.
SC: Subcutaneous (the spoken abbreviation is "sub-Q"). An injection given just under the skin, where it can reach the systemic circulation very quickly and yet have a long duration of action. SC epinephrine is often used to treat allergic reaction.
Scut: Mundane daily tasks such as blood draws, vital-sign checks and chart notes; usually done by (and often heaped upon) the lowest person on the totem pole in Sickbay. Sometimes taken as an acronym for "slightly clinically useful training."
Shock: A circulatory disturbance caused by a number of factors; when induced by bleeding, it’s hypovolemic shock or traumatic shock. Shock is marked by a severe drop in blood pressure, rapid pulse, clammy skin, pallor, and a rapid heart rate.
Stat: Immediately (from the Latin statinum). Most medical personnel hate this term with a passion.
Studying for the final exam: Derogatory term used to refer to a patient, usually terminally ill, who has taken a sudden interest in religion.
Superficial: That which is closer to the surface of the body than a given reference point, i.e. "the skin is superficial to the bone." A superficial injury is one that does little damage beyond the skin and subcutaneous tissue.
Superior: That which is above a given reference point, i.e. "the head is superior to the neck." The term does not indicate that something is good or better than average, just physically above the reference.
Tachycardia: Rapid heart beat. Sinus tachycardia (normal rhythm, just an accelerated beat) is more than 120 beats/minute; ventricular tachycardia is a life-threatening arrhythmia that requires immediate correction (and is, along with ventricular fibrillation, a leading cause of death in arrest patients).
TCAB: Torpedo Casing At Bedside. Derogatory code indicating that a patient is expected to die soon. See also "CTD."
Thoracotomy: Emergency surgery that involves opening the chest cavity to get at the organs inside. There are two ways to do a thoracotomy: the first involves making an incision between the fourth and fifth ribs on the left side and cranking the ribs apart with a rib spreader, and the second (and more common) requires a midline incision down the sternum (breastbone) and the use of a saw to split the sternum down the midline, whereupon the rib spreader is used to open the chest. The procedure is designed to directly expose the heart, lungs and great vessels for immediate surgical repair. It’s extremely gory, is only used as a last resort for traumatic chest injury, and carries a rotten prognosis (although the rotten prognosis comes more from the trauma than the procedure).
Tox screen: Analysis of blood toxins. A tox screen will tell you what your patient took and how much of it, a useful thing to know when treating an OD.
TPA: Properly tPA, it stands for Tissue Plasminogen Activator, part of a class of drugs known as thrombolytics (from the Latin thrombus, clot, and lysis, to break). TPA and its ilk dissolve blood clots in the bloodstream. It's similar to drain opener for your blood vessels. Historically, thrombolytics have been given to heart attack patients, patients with thrombotic emboli, and stroke victims, usually within six hours of the actual ischemic event.
Trach: Slang for “tracheostomy,” a surgical procedure used to establish an airway in a patient who cannot be intubated.
Train wreck: A patient who has so many diseases and/or injuries that any hope for a cure is to be found somewhere out in miracle territory.
Turf: To transfer a patient to the care of some other physician, usually one on another service. A great way of making your day easier (unless, of course, you’re a shipboard CMO, in which case it’s your patient anyway.)
Type and cross-match: Blood typing prior to transfusion.
Ventral: Reference to the front (thorax, abdomen and pelvis) of a patient (as opposed to "anterior," which only refers to a frontal surface).
V-fib: Ventricular fibrillation, a condition in which the pulse is absent and the heart is in a chaotic, uncoordinated rhythm (commonly called "bag of worms" because a heart in V-fib looks like a bag full of small, squirming creatures). V-fib is fatal unless treated immediately (see "ACLS" and "defibrillation").
V-tach: Ventricular tachycardia, a condition in which the heartbeat originates in the ventricles (as opposed to the sinoatrial node, where it should) and is abnormally fast (150-200 beats/minute). V-tach is also life-threatening and is treated with drugs (see "ACLS").
Zebra: A rare medical condition, almost never seen outside of textbooks. The term refers to an old medical dictum, "When you hear hoofbeats, think of horses, not zebras"; the implication is that the patient's symptoms are more likely due to some common ailment rather than an exotic one.