The EMS Provider’s Guide to Southern Medical Terminology Bryan E. Bledsoe, DO, FACEP Midlothian,...

The EMS The EMS Provider’s Provider’s Guide to Guide to Southern Southern Medical Medical

TerminologyTerminology

Bryan E. Bledsoe, DO, FACEPBryan E. Bledsoe, DO, FACEPMidlothian, TexasMidlothian, Texas

Southern Medical TerminologySouthern Medical Terminology


““You can be a little You can be a little ungrammatical if ungrammatical if you come from the you come from the right part of the right part of the country.”country.”

- - Robert FrostRobert Frost


““The educated The educated Southerner has Southerner has no use for an ‘r,’ no use for an ‘r,’ except at the except at the beginning of a beginning of a word.”word.”

- Mark Twain- Mark Twain


Some things Some things happen in the happen in the South that just South that just don’t happen in don’t happen in other parts of the other parts of the country.country.


It is really hard to It is really hard to determine where determine where errant Southern errant Southern Medical Medical Terminology Terminology developed.developed.


Factors include:Factors include:High illiteracy rates.High illiteracy rates.Southern language trends.Southern language trends.Influence of folk medicine and other belief Influence of folk medicine and other belief systems.systems.Religion.Religion.Influence of freed slaves and other ethnic Influence of freed slaves and other ethnic groupsgroups..


Abbominable pain = abdominal painAbbominable pain = abdominal painAcid in the blood = a summer rash due Acid in the blood = a summer rash due to eating too many tomatoes.to eating too many tomatoes.Actin’ drunk = vertigoActin’ drunk = vertigoArthuritis = meanest of those “itis” Arthuritis = meanest of those “itis” brothers.brothers.Athletic seizure = epileptic seizureAthletic seizure = epileptic seizureAugres = violent, shaking chillsAugres = violent, shaking chills


Bad = tendency. (“I’m bad to eat Bad = tendency. (“I’m bad to eat sweets.”)sweets.”)

Bad blood = positive syphilis serology.Bad blood = positive syphilis serology.

Bate = abate. “The pain bates down.”Bate = abate. “The pain bates down.”

Bealed = gather matter, come to a head Bealed = gather matter, come to a head (often in reference to ear infections)(often in reference to ear infections)

Bottom = perineum Bottom = perineum

Southern Medical TerminologySouthern Medical TerminologyCadillacs = cataractsCadillacs = cataractsCascade = vomit; also referred to as:Cascade = vomit; also referred to as:

Technicolor yawnTechnicolor yawnYelling at the concreteYelling at the concreteHollerin’ for RalphHollerin’ for RalphWantin’ a BuickWantin’ a BuickDrivin’ the porcelain busDrivin’ the porcelain bus

Chicken breath = “she can’t breathe”Chicken Pops = chicken poxChicken Pops = chicken pox

Southern Medical TerminologySouthern Medical TerminologyClabber = What happens to milk in the Clabber = What happens to milk in the stomach. Felt to be significant when seen stomach. Felt to be significant when seen in vomitus.in vomitus.Clogs = clots (“Dem blood clogs is comin’ Clogs = clots (“Dem blood clogs is comin’ down”)down”)Clutter Headache = cluster headacheClutter Headache = cluster headacheCold = any unexplained inflammation Cold = any unexplained inflammation above the waist (“I got a cold in my above the waist (“I got a cold in my shoulder”)shoulder”)


Courage = potency (also see “nature”)Courage = potency (also see “nature”)Deathly sick = nauseatedDeathly sick = nauseatedDown there = delicate reference to the Down there = delicate reference to the genitalsgenitalsDrawin’ Spell = hyperventilation with Drawin’ Spell = hyperventilation with carpopedal spasm.carpopedal spasm.Dropsy = heart failureDropsy = heart failureEvicted = addictedEvicted = addicted


Fester = to become infectedFester = to become infected

Fireballs of the Eucharist = fibroids of the Fireballs of the Eucharist = fibroids of the uterusuterus

Flustrated = Flustered and frustrated all in Flustrated = Flustered and frustrated all in one.one.

Gape = Gasp (“He had to gape for his Gape = Gasp (“He had to gape for his breath”)breath”)


Gaulded = Scalded appearance (usually Gaulded = Scalded appearance (usually refers to a groin rash)refers to a groin rash)

Give out = completely exhaustedGive out = completely exhausted

Goober = penis (often used with prefix Goober = penis (often used with prefix “little”)“little”)

Goozle = throatGoozle = throat

Goin’ Down = Getting weakerGoin’ Down = Getting weaker


Hard attack = heart attack (“He had a Hard attack = heart attack (“He had a couple of hard attacks, but he’ll be OK”)couple of hard attacks, but he’ll be OK”)

Hark = cough or clear throatHark = cough or clear throat

Hawk = cough or clear throat, often used Hawk = cough or clear throat, often used with the terms:with the terms:

LoogieLoogie

Lung OystersLung Oysters


High blood = hypertensionHigh blood = hypertensionHigh hernia = hiatal herniaHigh hernia = hiatal herniaHope = help (“That medicine didn’t Hope = help (“That medicine didn’t hope me”)hope me”)Hunker = squatHunker = squatHurt = steady discomfortHurt = steady discomfortIll = angry, not sickIll = angry, not sickInfantigo = impetigoInfantigo = impetigo


Itch = scabies Itch = scabies

Intestinal flu = gastroenteritisIntestinal flu = gastroenteritis

Kernals = lymph nodesKernals = lymph nodes

Leaders = tendonsLeaders = tendons

Light heart attack = anginaLight heart attack = angina

Light stroke = transient ischemic attackLight stroke = transient ischemic attack

Locked bowels = constipationLocked bowels = constipation


Low blood = anemia (“I got high blood Low blood = anemia (“I got high blood and low blood too!”)and low blood too!”)Matter = accumulated thick secretionsMatter = accumulated thick secretionsMess = a lotMess = a lotMighty Internal Fart = myocardial Mighty Internal Fart = myocardial infarctioninfarctionMonthly = menses (“Damn that man, Monthly = menses (“Damn that man, my monthly is late again.”)my monthly is late again.”)


Nature = potencyNature = potency

Nerves = any psychiatric disorderNerves = any psychiatric disorder

Nervous bust-up = nervous breakdownNervous bust-up = nervous breakdown

Node = was aware ofNode = was aware of

Null = diminish (“My pain nulled down”)Null = diminish (“My pain nulled down”)

Numbin’ medicine = local anestheticNumbin’ medicine = local anesthetic

Octagen = oxygenOctagen = oxygen


Old Timers Disease = Alzheimer’s diseaseOld Timers Disease = Alzheimer’s disease

Old timey flu = true influenzaOld timey flu = true influenza

Pain = sharp pain (“There ain’t no pain, just a Pain = sharp pain (“There ain’t no pain, just a dead hurt”)dead hurt”)

Pass wind = flatulencePass wind = flatulence

Perireptile risin’ = perirectal abscessPerireptile risin’ = perirectal abscess

Peanut butter balls = phenobarbital Peanut butter balls = phenobarbital

Prostrate = prostate Prostrate = prostate


Persh to death = waste awayPersh to death = waste awayPiles = hemorrhoidsPiles = hemorrhoidsPity party = feeling bad for selfPity party = feeling bad for selfPlumb = completely or trulyPlumb = completely or trulyPoke = sack containing medication Poke = sack containing medication (also intercourse)(also intercourse)Pone = Smooth, rounded subcutaneous Pone = Smooth, rounded subcutaneous nodulenodule

Southern Medical TerminologySouthern Medical TerminologyPrivacies = genitaliaPrivacies = genitaliaProud = glad (“I’m proud I don’t have Proud = glad (“I’m proud I don’t have cancer”)cancer”)Regulate my bowels = give something Regulate my bowels = give something for constipation or diarrheafor constipation or diarrheaRift = belchRift = belchRight = very (“I am right tired”)Right = very (“I am right tired”)Risin’ = small, inflammatory noduleRisin’ = small, inflammatory nodule


Roaches on my liver = cirrhosis of the Roaches on my liver = cirrhosis of the liver liver Root Drop = impotenceRoot Drop = impotenceSeeds = testiclesSeeds = testiclesShy kidneys = can’t urinate while Shy kidneys = can’t urinate while watchedwatchedSick as hell anemia = sickle cell anemiaSick as hell anemia = sickle cell anemiaSick rag = wet cloth to foreheadSick rag = wet cloth to forehead

Southern Medical TerminologySouthern Medical TerminologySkim = haziness (“There is a skim over Skim = haziness (“There is a skim over my eyes”)my eyes”)

Smilin’ Mighty Jesus = spinal Smilin’ Mighty Jesus = spinal meningitismeningitis

Sprangles = paresthesiasSprangles = paresthesias

Straddle = crotchStraddle = crotch

Stubborn = constipatedStubborn = constipated

Swimmin’ = vertigoSwimmin’ = vertigo

Southern Medical TerminologySouthern Medical TerminologyTechnical shot = tetanus shotTechnical shot = tetanus shotTerrify = annoy greatlyTerrify = annoy greatlyThick blood = imaginary condition Thick blood = imaginary condition whereby the doctor gives blood whereby the doctor gives blood thinnersthinnersThrowing up his toenails = impressive Throwing up his toenails = impressive vomitingvomitingTrots = diarrheaTrots = diarrheaTylon = TylenolTylon = Tylenol


Vomick = vomitVomick = vomitWeak kidneys = incontinentWeak kidneys = incontinentWeasles = measlesWeasles = measlesWen = sebaceous cyst (usually on Wen = sebaceous cyst (usually on head)head)Whelps = hivesWhelps = hivesWorkin’ medicine = laxativeWorkin’ medicine = laxativeWorry = to bother Worry = to bother

REDNECK TRAUMA SCORE

Redneck Trauma ScoreRedneck Trauma Score

Chances of Survival:Chances of Survival:

0-5 points…………………….30%0-5 points…………………….30%

5-12 points…………………..60%5-12 points…………………..60%

Greater than 12 points……..95%Greater than 12 points……..95%

Redneck Trauma ScoreRedneck Trauma ScoreETOH level:ETOH level:

100-299………..………………….2 pts100-299………..………………….2 pts

300 – more…..……………………4 pts300 – more…..……………………4 pts

Injured while riding motorcycle:Injured while riding motorcycle:

with helmet……………………….1 ptwith helmet……………………….1 pt

without helmet……………………2 ptswithout helmet……………………2 pts

Arrives wearing biker shirt…………..1 pt Arrives wearing biker shirt…………..1 pt

Redneck Trauma ScoreRedneck Trauma ScorePatient coming from or going to jail...4 Patient coming from or going to jail...4

ptspts

Spouse in jail…………………………. 1 ptSpouse in jail…………………………. 1 pt

Arrives via helicopter between 1:00-5:00 Arrives via helicopter between 1:00-5:00 AM…………………………………… 1 ptAM…………………………………… 1 pt

Known by at least 5 persons in ER… 1 ptKnown by at least 5 persons in ER… 1 pt

Tattoo….…1 point each (maximum 5 pts)Tattoo….…1 point each (maximum 5 pts)

If homemade…………….……1 extra ptIf homemade…………….……1 extra pt


Last bath more than 2 weeks ago…..1 ptLast bath more than 2 weeks ago…..1 pt

Forty pounds or more overweight……1 ptForty pounds or more overweight……1 pt

““Bad Back” and must be lifted by staff Bad Back” and must be lifted by staff for all x-rays…………………………….1 for all x-rays…………………………….1 ptpt

Beard longer than 2 inches………….1 ptBeard longer than 2 inches………….1 pt


Known seizure disorder secondary to Known seizure disorder secondary to previous closed head trauma, but previous closed head trauma, but doesn’t know the name of medications doesn’t know the name of medications that he is not taking……………….. 2 ptsthat he is not taking……………….. 2 pts

Routinely “vomicks” two or more times a Routinely “vomicks” two or more times a week………………………………… 1 ptweek………………………………… 1 pt

Has two children with the same first Has two children with the same first name………………………………… 1 ptname………………………………… 1 pt


Number of abortions – 1 point each Number of abortions – 1 point each (maximum of 3 points)(maximum of 3 points)

Number of previous episodes of PID or Number of previous episodes of PID or VD -1 point each (maximum of 3 points)VD -1 point each (maximum of 3 points)

Previous suicide attempts…………..1 ptPrevious suicide attempts…………..1 ptPreviously shot or stabbed………….2 ptsPreviously shot or stabbed………….2 ptsAllergic to Tylenol, Aspirin, Motrin, or Allergic to Tylenol, Aspirin, Motrin, or

Darvon…………………………….…1 ptDarvon…………………………….…1 pt

Redneck Trauma ScoreRedneck Trauma ScoreAllergic to Kwell……………………… 1 ptAllergic to Kwell……………………… 1 pt

Drinks more than 2 cases of beer per Drinks more than 2 cases of beer per week………………………………… 1 ptweek………………………………… 1 pt

Smokes more than 2 cartons of Smokes more than 2 cartons of cigarettes per cigarettes per week……………………………. 1 ptweek……………………………. 1 pt

Education less than 10Education less than 10thth grade…….. 1 pt grade…….. 1 pt

Sells blood every other month……… 1 ptSells blood every other month……… 1 pt


On disability…………………………. 1 ptOn disability…………………………. 1 pt

Seeking disability…………………… 1 ptSeeking disability…………………… 1 pt

Found at scene without shoes or socks Found at scene without shoes or socks and ambient temperature < 30 and ambient temperature < 30 degrees…………………………….. 1 ptdegrees…………………………….. 1 pt

Calls EMS personnel “ambulance Calls EMS personnel “ambulance drivers”……………………………… 2 ptsdrivers”……………………………… 2 pts


Found at scene with stool or urine in Found at scene with stool or urine in shoes………………………………. 1 ptshoes………………………………. 1 pt

Found at scene with holes or excretions Found at scene with holes or excretions in underwear…………………………. 1 ptin underwear…………………………. 1 pt

Calls a male paramedic “a good looking Calls a male paramedic “a good looking bitch”………………………………... 1 ptbitch”………………………………... 1 pt

Patient or next of kin is named Patient or next of kin is named “Bubba”……………………………… 1 pt“Bubba”……………………………… 1 pt

END OF PART 1END OF PART 1

Medical HumorMedical Humor““Laughter without Laughter without a tinge of a tinge of philosophy is but philosophy is but a sneeze of a sneeze of humor. Genuine humor. Genuine humor is repeat humor is repeat with wisdom.”with wisdom.”


Medical HumorMedical Humor

““Humor is Humor is mankind’s mankind’s greatest greatest blessing.”blessing.”


Medical JargonMedical Jargon

““That’s about as clear as the ostomy club That’s about as clear as the ostomy club swimming pool.”swimming pool.”““That ain’t right”That ain’t right”Testicles: they do dress a fellow up.Testicles: they do dress a fellow up.““Never let knowledge or reason substitute Never let knowledge or reason substitute for dogma.”for dogma.”““Never examine a child who is wearing Never examine a child who is wearing cowboy boots.”cowboy boots.”““Never trust a naked baby.”Never trust a naked baby.”

Medical JargonMedical Jargon““All bleeding stops.”All bleeding stops.”““Don’t let the skin stand between you and Don’t let the skin stand between you and the diagnosis.”the diagnosis.”““The hurtin’ stops when the pain goes The hurtin’ stops when the pain goes away.”away.”““When everything is going right, you’ve done When everything is going right, you’ve done something wrong.” something wrong.” ““The three most over rated things in the The three most over rated things in the world: Mayo Clinic, the US Postal Service, world: Mayo Clinic, the US Postal Service, and the Seattle Fire Department.”and the Seattle Fire Department.”


““Crimson Tide” = menstrual periodCrimson Tide” = menstrual period““Dropping the roses” = menstrual periodDropping the roses” = menstrual period““Two Beers” = always the answer to, “How Two Beers” = always the answer to, “How much did you have to drink?”much did you have to drink?”““Some Dude” = always the answer to “Who Some Dude” = always the answer to “Who stabbed you?”stabbed you?”““He looks like a Baptist to me” = He looks like a Baptist to me” = unconscious Jehovah’s Witness who needs unconscious Jehovah’s Witness who needs an emergent transfusion an emergent transfusion

Medical JargonMedical Jargon““A hospital visitor in a three-piece suit A hospital visitor in a three-piece suit carrying a brief case is a lawyer until proven carrying a brief case is a lawyer until proven otherwise.”otherwise.”““A patient’s ability to survive illness or major A patient’s ability to survive illness or major trauma is inversely proportional to his value trauma is inversely proportional to his value to society.”to society.”““Why are we all here and what does this all Why are we all here and what does this all mean?” mean?” ““It’s better to have a positive VDRL than to It’s better to have a positive VDRL than to never have loved at all.”never have loved at all.”


““Do not ridicule large people carrying Do not ridicule large people carrying weapons.”weapons.”““Car Bite” = automobile accidentCar Bite” = automobile accident““Crispy Critter” = burn patientCrispy Critter” = burn patient““Crunch” = automobile accidentCrunch” = automobile accident““Pus Butt” = perirectal abscessPus Butt” = perirectal abscess““Triage tragedy” = what happens when a Triage tragedy” = what happens when a ruptured AAA is triaged to OB as a term ruptured AAA is triaged to OB as a term pregnancy. pregnancy.


““Tachylordia” = lordy, lordy, lordyTachylordia” = lordy, lordy, lordy

““Tachylordia with a Junctional Jesus” = Tachylordia with a Junctional Jesus” = lordy, lordy, lordy, Jesus, lordy, lordy, lordylordy, lordy, lordy, Jesus, lordy, lordy, lordy

““Trols ‘R Us” = emergency departmentTrols ‘R Us” = emergency department

““Pit” = emergency departmentPit” = emergency department

Phi Lacka Tacka = fraternity of ED trollsPhi Lacka Tacka = fraternity of ED trolls

““Tar Baby Cases” = the more you try to get Tar Baby Cases” = the more you try to get free, the more you get stuck.free, the more you get stuck.

Medical JargonMedical Jargon““Gomers are like yogurt, you can’t tell when Gomers are like yogurt, you can’t tell when they go bad”they go bad”““The amount of screaming and hollering is The amount of screaming and hollering is inversely proportional to the severity of the inversely proportional to the severity of the injury.”injury.”““Gome” = diminutive of GOMERGome” = diminutive of GOMER““Gome from a home” = nursing home Gome from a home” = nursing home patient.patient.““Gome from a home in a come” = Gome from a home in a come” = unconscious nursing home patientunconscious nursing home patient

Medical JargonMedical Jargon““GOMER Toter” = non-emergency ambulanceGOMER Toter” = non-emergency ambulance

Signs of a dead GOMER: Signs of a dead GOMER: more than 2 days worth of juice glasses still full at more than 2 days worth of juice glasses still full at bedsidebedside

Temperature less than 90 degreesTemperature less than 90 degrees

Stool velocity = test ordered by interns when Stool velocity = test ordered by interns when working up GOMERs with diarrheaworking up GOMERs with diarrhea

““No mother is ever satisfied with the amount No mother is ever satisfied with the amount or quality of food her child eats.”or quality of food her child eats.”


““In the “pit” (ED), if you don’t know what is In the “pit” (ED), if you don’t know what is wrong, keep putting in tubes until someone wrong, keep putting in tubes until someone who does arrives.”who does arrives.”

““Pone Belly” = acute surgical abdomenPone Belly” = acute surgical abdomen

““Aye Sign” = found in Latin OB patients Aye Sign” = found in Latin OB patients where “oh, oh, oh” changes to “aye, aye, where “oh, oh, oh” changes to “aye, aye, aye” when cervical dilation is complete.aye” when cervical dilation is complete.

Status hispanicusStatus hispanicus = aye, aye, aye = aye, aye, aye


““Shake and Bake” = MVC with trauma and Shake and Bake” = MVC with trauma and burnsburns““Death is not always the enemy”Death is not always the enemy”““Bug Juice” = antibioticsBug Juice” = antibiotics““Gorrilacillin” = potent antibioticsGorrilacillin” = potent antibiotics““Incision of the Blue Cross” = unnecessary Incision of the Blue Cross” = unnecessary surgical proceduresurgical procedure““If I had a uterus in me, I’d want them to take If I had a uterus in me, I’d want them to take it out.”it out.”


““If she doesn’t have appendicitis, then she If she doesn’t have appendicitis, then she should take down the sign.”should take down the sign.”

““If it takes more than 3 people to hold down a If it takes more than 3 people to hold down a child for a spinal tap, he probably doesn’t child for a spinal tap, he probably doesn’t need to have it done.”need to have it done.”

““When in doubt, order the drug on your pen.”When in doubt, order the drug on your pen.”

““Idiopathic” = the doctor is an idiot, the Idiopathic” = the doctor is an idiot, the patient is pathetic.patient is pathetic.

Medical JargonMedical Jargon““You don’t need to run a Chi Square test on You don’t need to run a Chi Square test on common sense.”common sense.”““Anything not worth doing, is worth not Anything not worth doing, is worth not doing well.”doing well.”““If two things can go wrong, the worst one If two things can go wrong, the worst one will happen.”will happen.”““If good intentions are combined with If good intentions are combined with stupidity, it is impossible to out think them.”stupidity, it is impossible to out think them.”““Beware of the paramedic who is great at Beware of the paramedic who is great at getting out of trouble.”getting out of trouble.”


““Ohms Law of Hospital Telephones” = the Ohms Law of Hospital Telephones” = the person who answers the phone can never help person who answers the phone can never help you.you.““Smoking the White Owl” = intubatedSmoking the White Owl” = intubatedVagina = most powerful organ in the human Vagina = most powerful organ in the human bodybody““You’re not the one who is sick, they are; and You’re not the one who is sick, they are; and it’s not your fault.”it’s not your fault.”““In aphasia, swear words go last.”In aphasia, swear words go last.”

Medical Jargon:Medical Jargon:““20% of the patients have 80% of the 20% of the patients have 80% of the diseases”diseases”

““Hemophiliacs are accident-prone.”Hemophiliacs are accident-prone.”

““Positive lipstick sign” = female patient’s Positive lipstick sign” = female patient’s condition improvement marked by condition improvement marked by sudden interest in appearancesudden interest in appearance

““Doc in a Box” = urgent care centerDoc in a Box” = urgent care center

““Air Conditioned” = multiple GSWsAir Conditioned” = multiple GSWs


““Age/Weight Ratio” = when the age Age/Weight Ratio” = when the age exceeds the weight, it’s going to get badexceeds the weight, it’s going to get bad

““Urban outdoorsman” = homeless personUrban outdoorsman” = homeless person

1 tattoo = 1 drunken party1 tattoo = 1 drunken party

2 tattoos = 2 drunken parties2 tattoos = 2 drunken parties

3 tattoos = 1 sociopath3 tattoos = 1 sociopath


Motorcycles / Motorcycle Riders:Motorcycles / Motorcycle Riders:““ORTA” = orthopedic resident training apparatusORTA” = orthopedic resident training apparatus““Murder cycle jockey”Murder cycle jockey”““Honda hero”Honda hero”““Dead head”Dead head”““Kawasaki Kamikaze”Kawasaki Kamikaze”““Crotch rockets”Crotch rockets”““Give your son a motorcycle for his last birthday.”Give your son a motorcycle for his last birthday.”““Any motorcycle rider in an accident without a helmet Any motorcycle rider in an accident without a helmet is an organ donor until proven otherwise.”is an organ donor until proven otherwise.”


Psychiatric Patients:Psychiatric Patients:““Walnut Storage Disease” = nutty patient Walnut Storage Disease” = nutty patient

““Serum Porcelain Level” = blood test for crocksSerum Porcelain Level” = blood test for crocks

““Spook” = a sick crockSpook” = a sick crock

““Ring Sign” = When a patient has more rings on a Ring Sign” = When a patient has more rings on a hand than fingers (usually requires a serum porcelain hand than fingers (usually requires a serum porcelain level)level)

Elevated serum succotashElevated serum succotash

Skewed bean/pea ratioSkewed bean/pea ratio


Psychiatric Patients:Psychiatric Patients:Terminal microdeckia = not playing with a full deckTerminal microdeckia = not playing with a full deck

““Elevator doesn’t go to the top floor”Elevator doesn’t go to the top floor”

““Toys in the attic.”Toys in the attic.”

Serum peanut butter levelSerum peanut butter level

““That patient has only three neurons. One’s infected, That patient has only three neurons. One’s infected, one’s infarcted, and the other one is inhibitory.”one’s infarcted, and the other one is inhibitory.”

““Granola Ward”: psych ward; fruits, nuts, & flakesGranola Ward”: psych ward; fruits, nuts, & flakes


Obesity:Obesity:Chronic biscuit abuseChronic biscuit abuse

Cornbread poisoningCornbread poisoning

Land whaleLand whale

Dunlops DiseaseDunlops Disease

Sea World consult Sea World consult

““Scrub dorsal fin TID, routine blow hole care.”Scrub dorsal fin TID, routine blow hole care.”


Hysterical Patient Scoring System (10 pts Hysterical Patient Scoring System (10 pts is diagnostic)is diagnostic)

Golden slippersGolden slippers 3 pts3 pts

Calls Dr. by first nameCalls Dr. by first name 3 pts3 pts

Seductive behaviorSeductive behavior 4 pts4 pts

Satin pillow from homeSatin pillow from home 2 pts2 pts

Multiple drug allergies (1 point per drug)Multiple drug allergies (1 point per drug)

La belle indifferenceLa belle indifference 5 pts5 pts

Medical JargonMedical JargonSick patients:Sick patients:

““He may not have bought the farm, but he made a big He may not have bought the farm, but he made a big down payment.”down payment.”

““Don’t put anything on layaway.”Don’t put anything on layaway.”

““He’ll have to get better to die.”He’ll have to get better to die.”

““Looks like death eating a cracker.”Looks like death eating a cracker.”

““O Sign” = obtunded, mouth openO Sign” = obtunded, mouth open

““Q Sign” = obtunded, mouth open, tongue sticking outQ Sign” = obtunded, mouth open, tongue sticking out

““Dotted Q Sign” = obtunded, mouth open, tongue Dotted Q Sign” = obtunded, mouth open, tongue sticking out, fly on tonguesticking out, fly on tongue


Dying patients:Dying patients:““Hang the black crepe.”Hang the black crepe.”

““He’s got buzzards sitting on his shoulder.”He’s got buzzards sitting on his shoulder.”

““Give them a bottle of whiskey and a short book to Give them a bottle of whiskey and a short book to read.”read.”

““He is about to receive a celestial discharge.”He is about to receive a celestial discharge.”

““Subacute dead”Subacute dead”

““Swarming Sisters Sign” = seen at Catholic hospitalsSwarming Sisters Sign” = seen at Catholic hospitals


Dying patients:Dying patients:““Pillow Rounds Needed”Pillow Rounds Needed”

Stat Pathology ConsultStat Pathology Consult

““Circling the drain”Circling the drain”

““A-line to wall suction”A-line to wall suction”

““Got his skates on.”Got his skates on.”

““His porch lights are getting dim.”His porch lights are getting dim.”

AbbreviationsAbbreviationsADR = ain’t doing rightADR = ain’t doing rightADS due to TMB = acute dying spells due to too ADS due to TMB = acute dying spells due to too many birthdaysmany birthdaysAGA = acute gravity attackAGA = acute gravity attackAGMI = ain’t gonna’ make itAGMI = ain’t gonna’ make itALS = advanced lizard slingingALS = advanced lizard slingingAQR = ain’t quite rightAQR = ain’t quite rightART = assuming room temperatureART = assuming room temperatureAVD = acute Vistaril deficiencyAVD = acute Vistaril deficiency

AbbreviationsAbbreviationsBLS = basic lifting serviceBLS = basic lifting serviceBOHICA = bend over, here it comes againBOHICA = bend over, here it comes againBSS = bilateral Samsonite syndromeBSS = bilateral Samsonite syndromeCC = cancel ChristmasCC = cancel ChristmasCCFCP = “coo coo for Cocoa Puffs”CCFCP = “coo coo for Cocoa Puffs”CNS-QNS = central nervous system - CNS-QNS = central nervous system - quantity not sufficientquantity not sufficientCPR = can’t possibly recoverCPR = can’t possibly recoverCTS = crazier than sh**CTS = crazier than sh**

AbbreviationsAbbreviationsD&C = dusting and cleaningD&C = dusting and cleaning

DFO = done fell outDFO = done fell out

DIB = dead in bedDIB = dead in bed

DRT = dead right thereDRT = dead right there

DVR = Darth Vader respirationsDVR = Darth Vader respirations

DWO = death warmed overDWO = death warmed over

DWO = driving while orientalDWO = driving while oriental

EMD = early morning discovery (woke up dead)EMD = early morning discovery (woke up dead)

AbbreviationsAbbreviationsFDGB = fall down, go boomFDGB = fall down, go boomFIBD = found in bed deadFIBD = found in bed deadFLB = funny looking beatFLB = funny looking beatFLK = funny looking kidFLK = funny looking kidFLK-GLM = funny looking kid, great looking FLK-GLM = funny looking kid, great looking

mommomFOF = found on floorFOF = found on floorFOIC = fell out in churchFOIC = fell out in churchFTD = fixin’ to die (call the florist)FTD = fixin’ to die (call the florist)FUAB = found under a bridgeFUAB = found under a bridge

AbbreviationsAbbreviations

FUAR = found under a rockFUAR = found under a rockFUBAR = fu**ed up beyond all recognitionFUBAR = fu**ed up beyond all recognitionGOA = gone on arrivalGOA = gone on arrivalGPH = God damns per hourGPH = God damns per hourHGD X 3 = he’s gonna die, he’s gonna’ die, he’s HGD X 3 = he’s gonna die, he’s gonna’ die, he’s gonna’ diegonna’ dieHMO = heave mom outHMO = heave mom outHVLT = high-velocity lead therapyHVLT = high-velocity lead therapy

AbbreviationsAbbreviationsLMC = low marble countLMC = low marble countLOL = little old ladyLOL = little old ladyLOL-NAD = little old lady, no apparent LOL-NAD = little old lady, no apparent distressdistressOLFDGB = old lady fall down, go boomOLFDGB = old lady fall down, go boomOTD = out the doorOTD = out the doorPBAB = pine box at bedsidePBAB = pine box at bedsidePGS = positive grits signPGS = positive grits signPID = pus in dere.PID = pus in dere.

AbbreviationsAbbreviationsPID = pus** in distressPID = pus** in distressPPP = piss poor protoplasmPPP = piss poor protoplasmQID = queen in distress QID = queen in distress SAS = sick as sh**SAS = sick as sh**SSDD = same sh**, different daySSDD = same sh**, different daySWAG = scientific wild-assed guess SWAG = scientific wild-assed guess SWI-GOK = something’s wrong inside, God SWI-GOK = something’s wrong inside, God only knowsonly knowsSWW = sick, wet and whineySWW = sick, wet and whiney

AbbreviationsAbbreviationsTBC = total body crunchTBC = total body crunchTDS = terminal deceleration syndromeTDS = terminal deceleration syndromeTID = transient in distressTID = transient in distressTMB = too many birthdaysTMB = too many birthdaysTOBASH = take out back and shoot in TOBASH = take out back and shoot in headheadTOBASH-GHF = take out back and TOBASH-GHF = take out back and shoot in head-give heparin firstshoot in head-give heparin first

AbbreviationsAbbreviationsTPW = therapeutic pistol whippingTPW = therapeutic pistol whipping

TRO = time ran outTRO = time ran out

TSS = toxic socks syndromeTSS = toxic socks syndrome

WADAO = weak and dizzy all overWADAO = weak and dizzy all over

WNL = we never lookedWNL = we never looked

WWI = walking while intoxicatedWWI = walking while intoxicated

YOYO = you’re on you’re ownYOYO = you’re on you’re own

Medical SpecialtiesMedical SpecialtiesSurgeons (AKA “blades”)Surgeons (AKA “blades”)

If a surgeon was asked to name the three If a surgeon was asked to name the three greatest surgeons, he would be hard greatest surgeons, he would be hard pressed to name the other two.pressed to name the other two.““Knife rhymes with life.”Knife rhymes with life.”““A chance to cut is a chance to cure.”A chance to cut is a chance to cure.”““Nothing heals like stainless steel.”Nothing heals like stainless steel.”““A surgeon is an internist who can A surgeon is an internist who can operate.”operate.”

Medical SpecialtiesMedical SpecialtiesSurgeons (AKA “blades”)Surgeons (AKA “blades”)

““Internists can only shake the Christmas Internists can only shake the Christmas present, surgeons get to open it.” present, surgeons get to open it.”

““Cold steel is the best deal.”Cold steel is the best deal.”

Medical SpecialtiesMedical Specialties

Emergency PhysiciansEmergency Physicians““Are you an intern or a real doctor?”Are you an intern or a real doctor?”

““Is you the doctor what’s waitin’ on me?”Is you the doctor what’s waitin’ on me?”

““We just lost the last patient. Who is We just lost the last patient. Who is next?”next?”

Medical SpecialtiesMedical SpecialtiesInternists (AKA “fleas”, “swamis”)Internists (AKA “fleas”, “swamis”)

““Herb doctors”Herb doctors”

““The primary function of the internist is to The primary function of the internist is to find cases for the surgeon.”find cases for the surgeon.”

““He may have died—but at least his He may have died—but at least his electrolytes were in balance.”electrolytes were in balance.”

Medical SpecialtiesMedical SpecialtiesOrthopedists (AKA “Orthopods”)Orthopedists (AKA “Orthopods”)

Orthopedic surgeon: twice as strong as an ox, Orthopedic surgeon: twice as strong as an ox, half as smart.half as smart.

Orthopedic surgeon: smarter than a rock, dumber Orthopedic surgeon: smarter than a rock, dumber than a plantthan a plant

Double blind study = 2 orthopedists looking at an Double blind study = 2 orthopedists looking at an ECGECG

Orthopedists point = area near the xiphoid where Orthopedists point = area near the xiphoid where placing a stethoscope will allow you to hear placing a stethoscope will allow you to hear breath, heart, and bowel sounds.breath, heart, and bowel sounds.

Medical SpecialtiesMedical SpecialtiesOrthopedists (AKA “orthopods”)Orthopedists (AKA “orthopods”)

Orthopedic Law of the Heart = The Orthopedic Law of the Heart = The purpose of the heart is to pump Ancef to purpose of the heart is to pump Ancef to the bones.the bones.BBMF = standard orthopedic consent BBMF = standard orthopedic consent form, “bone broke, me fix”form, “bone broke, me fix”Orthopedic ooze = when the blood Orthopedic ooze = when the blood pulsates through the plaster after the pulsates through the plaster after the tourniquet is removed.tourniquet is removed.

Medical SpecialtiesMedical Specialties

Radiologists (AKA “electrons” or Radiologists (AKA “electrons” or “rads”)“rads”)

““Shadow merchants”Shadow merchants”

““Throckmorton’s Sign” = On x-rays, the Throckmorton’s Sign” = On x-rays, the penis points to the pathology.penis points to the pathology.

””Positive Radiology Sign” = arrows and Positive Radiology Sign” = arrows and circles drawn on x-rayscircles drawn on x-rays

Medical SpecialtiesMedical SpecialtiesObstetrician/GynecologistsObstetrician/Gynecologists

VaginicologistsVaginicologists

Spreader of old wives talesSpreader of old wives tales

Tuna boat captainsTuna boat captains

Rule of the OB Clinic = love is blind; and it Rule of the OB Clinic = love is blind; and it has no sense of smellhas no sense of smell

22ndnd Rule of the OB Clinic = everybody loves Rule of the OB Clinic = everybody loves somebodysomebody

Medical SpecialtiesMedical SpecialtiesPediatricians (AKA “pediapods”)Pediatricians (AKA “pediapods”)

Midget medicineMidget medicine

““Give me a pediatrician with testicles, and Give me a pediatrician with testicles, and I’ll kiss his feet.”I’ll kiss his feet.”

Medical SpecialistsMedical SpecialistsDermatologistsDermatologists

““The monkeys that pick things off of the The monkeys that pick things off of the other monkeys.”other monkeys.”

““A doctor who tells you in Latin what you A doctor who tells you in Latin what you told him in English.”told him in English.”

Axiom of Dermatology in the ED = if it is Axiom of Dermatology in the ED = if it is dry, wet it; if it is wet, dry it; if you don’t dry, wet it; if it is wet, dry it; if you don’t know, use steroids.know, use steroids.

Medical SpecialistsMedical SpecialistsUrologists (AKA “plumbers” or Urologists (AKA “plumbers” or “prostatologists”)“prostatologists”)

The worst shriek you have ever heard = The worst shriek you have ever heard = there is a urologist in the EDthere is a urologist in the ED

““Priapism is better than no ‘ism’ at all”Priapism is better than no ‘ism’ at all”

Medical SpecialistsMedical SpecialistsProctologists (AKA Rear Admirals)Proctologists (AKA Rear Admirals)

Super duper pooper snoopersSuper duper pooper snoopers

““Ride the silver rocket” = proctoscope Ride the silver rocket” = proctoscope exam.exam.

““Dance with the black stallion” = Dance with the black stallion” = colonoscope examcolonoscope exam

Snake pit = endoscopy suiteSnake pit = endoscopy suite

Medical SpecialistsMedical SpecialistsNeurosurgeons (AKA brain bone Neurosurgeons (AKA brain bone cutters)cutters)

““There are only two types of neurosurgical There are only two types of neurosurgical patients—those that live and those that patients—those that live and those that die. die.

The Dressing = the only difference The Dressing = the only difference between the preop and postop between the preop and postop neurosurgical patient.neurosurgical patient.

Neuro ICU = vegetable gardenNeuro ICU = vegetable garden

The EndThe End

The EMS Provider’s Guide to Southern Medical Terminology Bryan E. Bledsoe, DO, FACEP Midlothian,...

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