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| The area known as the Maze is not a place you'd want to be stranded. NPS photo. |
 | The Ambulance Driver's Perspective by Kelly Grayson |
By Kelly Grayson
While abbreviations and acronyms are a boon to poor spellers and slow writers, invariably one of your cases will get called to court, and some personal injury lawyer will gleefully ask you what ETOH stands for, and how it is spelled. And when you stumble, he'll try to draw nasty parallels between your subpar spelling skills and your patient care.
And for twelve people who are too naive to know how to get out of jury duty, it might even sound plausible.
So, I urge my students and younger partners to adopt the law enforcement officer's approach to documentation; abbreviate nothing, and make sure everything is spelled correctly. Everything the cop writes is, by definition, probably going to wind up in court one day. They have long experience in countering those sneaky lawyer tricks.
Besides, many of the acronyms and abbreviations we use in EMS are unique to our profession. To a cop, CID means "Criminal Investigation Division," whereas an EMT would say it means "Cervical Immobilization Device." A social worker may not understand why you called your dyspneic patient an SOB.
Heck, abbreviations aren't even universally recognized between members of the same crew. I've watched enough of my partners over the years to know what they really mean when they abbreviate something, and with that in mind, I've compiled a list of the Top Ten Most Commonly Misinterpreted EMS Abbreviations:
"NKDA." Normally, most healthcare professionals take that to mean "No Known Drug Allergies." But after comparing my patient's history to the reports I sometimes get from first responders, I think it actually means, "Not Known, Didn't Ask."
"IABP." Sure, you critical care medics who have strapped one of the these little babies to the floor of your rig may know it means "Intra-Aortic Balloon Pump," but all it takes is a look at the vital signs on some of the patients it's attached to, and you realize it means, "I Am Barely Perfusing."
"ECMO." While the ICU nurse may tell you that it means "Extra-Corporeal Membrane Oxygenation," given the long-term prognosis of some of these patients, it more likely means "Extra Cash-Making Opportunity," or perhaps, "Even Corpses May Oxygenate."
"EMS." Sure, we know that it means "Emergency Medical Services," but anyone who has ever worked an event standby knows that it means "Earn Money Sleeping."
"LOL2." No, it's not some new form of text-speak. It's LOL Squared, meaning "Little Old Lady, Lying On Linoleum."
"IDDM." Taber's Medical Dictionary defines it as "Insulin Dependent Diabetes Mellitus," but judging from some of my hypoglycemic frequent flyers, it means "I Don't Do Meals."
"BLS and ALS." Sure, they're supposed to mean "Basic Life Support" and "Advanced Life Support," but judging from the way some of my colleagues treat their EMT-B partners, they mean "Basic Lifting Service" and "Ain't Lifting Sh*t."
"DCAP-BTLS." EMT textbooks since 1994 have used that mnemonic to teach students what to look for in a secondary survey; "Deformities, Crepitus/Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations and Swelling…" But any medic who has ever served as a skill station examiner can tell you that many of the exam candidates "Didn't Comprehend Any Part of Basic Trauma Life Support."
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Course Offering:
Courses Approved for Advanced Life Support (ALS) Providers
A100 – 12 Lead EKG Interpretation
This course discusses cardiac anatomy as it relates to the cardiogram. Goals of the course include: to develop an initial understanding of “Axis,” understand how to interpret hypertrophy, recognize Bundle Branch Blocks, understand how to interpret EKGs for signs of myocardial infarction, and understand the “grouped leads” concept.
A220 – Pediatric Patient: Part 1
This is Part 1 of a two part series on the Pediatric Patient. The course will review pediatric patient traits, explore relevant anatomy and physiology, and discuss causes of pediatric injury and death.
A221 – Pediatric Patient: Part 2
This is Part 2 of a two part series on the Pediatric Patient. The course will discuss pediatric patient assessment techniques, explore principles for immobilizing pediatric patients, and explain issues in pediatric patient transport.
A255 – Airway Management
This course describes airway structures and function, identifies important differences in pediatric airway anatomy, explores basic airway management techniques, and describes delivery of ventilations and supplemental oxygen.
A268 – Diabetic Emergencies: Part 1
This is Part 1 of a two part series on Diabetic Emergencies. The course will discuss the relationship of insulin, glucagon and glucose, examine the pathophysiology of diabetes mellitus, and discuss types of diabetic emergencies.
A269 – Diabetic Emergencies: Part 2
This is Part 2 of a two part series on Diabetic Emergencies. The course will review assessment findings from Part 1 and introduce treatment options.
A281 – Pharmacology and Drug Administration
This course on pharmacology will review basic pharmacodynamics and pharmacokinetics, explore essentials of drug administration, and discuss the indications and uses of specific medications.
Courses Approved for Basic Life Support (BLS) Providers
B204 – Unusual Resuscitation
This course discusses unusual resuscitation situations in environmental emergencies. It will explain the underlying pathophysiology that complicates respiratory and cardiac resuscitation from an environmental emergency, describe treatment for respiratory and cardiac arrest resulting from an environmental emergency, and identify reasons not to begin CPR.
B239 – Emergency Childbirth
This course will review the relevant anatomy, physiology and care for an emergency childbirth. It will discuss assessment for the obstetric patient with an impending delivery, explain assessment and care of the newborn infant, and review care for the mother immediately following the delivery of a newborn.
B405 – NiPPV (Non-Invasive Positive Pressure Ventilation: Pre-hospital Use of CPAP and BiPAP)
This course discusses the pre-hospital use of CPAP and BiPAP. It will describe non-invasive positive pressure ventilations (NiPPV) and physiology, identify indications, contraindications and benefits of NiPPV, explain steps to applying NiPPV and adjusting settings, and discuss adjunctive therapies and ongoing monitoring. |
