Emergency! (25 page)

ETA: Estimated time of arrival.

F
AMILY
P
LAN
: One of the kids has a cold so the parents pack the whole family into the station wagon and bring them along to the ER “to be checked.” Often used in association with the
MAGIC KINGDOM CARD
.

F
EATHER
C
OUNT
: A measure of flakiness.

F
ELLOW
: A doctor in subspecialty training beyond residency.

F
EMORAL
A
RTERIES
: The big arteries of the upper leg.

F
LAIL
: A resuscitation that goes badly.

F
LATLINE
: When the heart-monitor tracing no longer shows heart blips but only a flatline tracing reflecting the absence of heartbeat.
See also
ASYSTOLIC; CARDIAC ARREST
.

F
LEA
: An internist, particularly one who orders multiple test results to establish a list of multiple possible diseases so that multiple further tests can be done, thereby sucking a lot of blood from the patient with no discernable benefit.

F
LOG
: A resuscitation on a patient who is essentially dead upon arrival to the emergency room.

F
LUORESCENT
L
IGHT
T
HERAPY
: This treatment is reserved for those patients whose unpleasant manner has offended the triage nurse, who makes the patient sit forever in the waiting room, basking in the harsh fluorescent light.

F
OLEY
C
ATHETER
: A rubber tube put into the bladder through the urethra to assure the flow of urine.

FOS: Full Of Shit—a severely constipated patient with abdominal pain.

F
REQUENT
F
LYER
: A regular ER visitor who comes in for drugs, minor problems, or social contact.

FTD: Fixin' To Die.

F
ULL
A
RREST
:
See
CARDIAC ARREST
.

GI: Gastrointestinal, or pertaining to the gut.

GOK: God Only Knows. Used to refer to a puzzling set of symptoms.

G
OMER
: Originally proposed by Dr. Samuel Shem to be a mnemonic meaning Get Out of My Emergency Room, but more generally used to refer to any debilitated, senile, elderly person. Also
GOMED-OUT; GOMERTOSE
.

G
OMERGRAM
: Since the gomer by definition can't describe her symptoms due to senility, a shotgun approach is used and every screening lab is ordered: EKG, CXR, CBC, Chem 7, UA, ABG, PT/PTT, LFT. This ordering of all possible tests is called a
GOMERGRAM
.

G
OOMBAH
: A worrisome mass or tumor found on exam or X ray. For example, one might say after reviewing a patient's head CAT scan: “He has a mean-looking
GOOMBAH
in the brain.”

G
ORK
: A patient who has sustained a brain injury resulting in severe mental impairment. One might say: “The patient is now a
GORK
(or
GORKED OUT
).”

H
EMATOMA
: A blood-filled lump that forms after trauma; a “goose egg.”

H
OUSE
S
TAFF
:
INTERNS
and
RESIDENTS
at a teaching hospital.

H
YPOTENSION
: Abnormally low blood pressure.

H
YPOTHERMIA
: Abnormally low temperature.

ICU: Intensive care unit. Also known as the “expensive care unit.” (Often the last stop on the way to the “eternal care unit.”)

I
NTERN
: A young doctor in the first year of training after medical school (100-hour work weeks).

I
NTUBATE
: To insert a plastic tube through the mouth (sometimes the nose) and into the trachea (windpipe) to help ventilate a patient.

IV: Used to administer solutions intravenously (in the vein).

L
ABS
: Tests commonly used in evaluating a patient:

CBC: Complete blood count of red and white blood cells.

L
YTES
: Electrolyte levels.

UA: Urine analysis.

ABG: Arterial blood gas; checks the oxygen in the blood.

C
HEM
7: More blood chemistry.

EKG: Electrocardiogram; measures the heart's electrical activity.

CXR: Chest X ray.

PT/PTT: Blood coagulation measurements.

LFT: Liver function test.

L
ARYNGOSCOPE
: A metal blade used to push the tongue aside and lift up the throat so that the windpipe can be seen.

L
INE
: An IV line for access to circulating blood.

L
INE
'E
M
U
P
: To insert multiple lines in order to resuscitate and monitor a critically ill patient.

LMP: Last menstrual period.

LOL NAD: Little Old Lady, No Acute Distress. May or may not be a
GOMER
.

LP (L
UMBAR
P
UNCTURE
):
See
SPINAL TAP
.

M
AGIC
K
INGDOM
C
ARD
: A Medicaid card with monthly stickers. When an amusement park admission is free, the customer tends to come more often. Also known as “McStickers.”

MI: Myocardial infarction—aka heart attack or “the big one,” as in, “Oh shit, he's having the big one.”

M
ICRODECKIA
: “Micro” meaning small, “deck” as in a deck of cards—hence, playing with less than a full deck: “The patient is suffering from
MICRODECKIA
.”

M
ONITOR
: A cardiac monitor that displays the patient's heart rhythm.

N
EGATIVE
W
ALLET
B
IOPSY
: Cash patient without funds. Also known as a no-cash patient.

N
EONATE
: An infant less than a month old.

N
EURO
: Relating to the neurological system (the brain and nerves).

N
O
C
ODE
: A classification of a patient (with the patient's and family's approval) that if the patient should go into cardiac arrest, no effort should be made to resuscitate him.

NSR: Normal sinus rhythm—the normal pacemaker beating of the heart.

OB/GYN: Obstetrics and gynecology.

OR: Operating room.

O
RTHO
: Orthopedic surgery—practiced by bone doctors. In medical school the folklore reported that the bottom 10 percent of the class would be pithed (have their little brains destroyed by a sharp instrument).
Those that could crawl away went into
OB/GYN
. Those that couldn't went into
ORTHO
. Hence the phrase “An orthopedic surgeon must be as strong as an ox, and twice as smart.”

OTDMF: Out The Door, Mother Fucker.

O
XIMETRY
: A monitor of the effectiveness of a patient's breathing.

P
ATH
: Pathology—that specialty of medicine that examines tissues and dead people to determine the nature of the disease or the cause of death.

P
ATHOLOGIST
: A doctor who prefers the company of dead people and enjoys the smell of formaldehyde.

PBAB: Pine Box At Bedside—a suggestion for patients who aren't doing very well and are
SICK
.

P
ERSEVERATION
: Persistent repetition of an action or words.

P
HYSICIAN'S
A
SSISTANT
: A licensed health care provider who does medical care under the supervision of a physician. Usually called a P.A.

PID: Pelvic inflammatory disease—a venereal gynocological infection.

P
IT
: Frequently used to refer to the emergency room by the people who work in it.

P
LAYER
: A patient.

P
OP
D
ROP
: When a family drops their elderly, disabled, burdensome dad off at the emergency room so they can take a vacation.
See also
POSITIVE TAILLIGHT SIGN
.

P
ORCELAIN
L
EVEL
: A term that stems from porcelain crockery, or a “crock,” as in “a crock of shit.” This is a fictitious blood test ordered at the bedside to communicate to a coworker that you think the patient is malingering and hence a
DSB
or
TERRASPHERE
.

POS: Pre-Orgasmic Syndrome—the male equivalent of PMS. Also known as “Irritable Male Syndrome.”

P
OSITIVE
S
UITCASE
S
IGN
: Noted about a patient who arrives in the Emergency Department with a packed suitcase. Generally denotes a diagnosis of “Needs a place to stay.”

P
OSITIVE
T
AILLIGHT
S
IGN
: Noted when a patient is dropped off at the emergency room by the family and all we see are rapidly fading tail-lights
as the family sedan speeds off into the night. Generally denotes a diagnosis of “Find him a place to stay.”
See also
POP DROP
.

P
OST
: A postmortem, or autopsy.

P
REEMIE
: A prematurely born infant.

P
RETERMINAL
: Almost terminal, or nearly dead.
See also
CTD; STBD
.

P
ULMONARY
E
DEMA
: Fluid in the lungs, most often occurring with
CHF
.

P
ULMONARY
E
MBOLUS
: A blood clot that forms in the body, breaks off, and travels to a lung, where it lodges, causing pain, shortness of breath, and, if it is big enough, death. Also referred to as a PE.

PVC: Premature ventricular contraction—an abnormal heartbeat that may warn of impending
VFIB
or
VTACH
.

Q S
IGN
: Usually found in debilitated patients (e.g., a
GOMER
) who are
GORKED OUT
. The mouth has slacked open into an
O
and the tongue hangs out to one side, forming a
Q
.

R
AY
: A radiologist—i.e., a person who likes to work in the dark but not make any decisions. Radiologist's national flower: the Hedge.

R
ESIDENT
: A
HOUSE STAFF
doctor; still in training, but beyond
INTERN
.

R
INGERS
: An IV fluid used in resuscitation.

R
OCK
G
ARDEN
: When the emergency room fills up with
ROCKS
.

R
OCKS
: Patients who can't be moved out of the emergency room. Often a
GOMER
, the patient is not sick enough to put in the hospital, but the family refuses to take him home. Sometimes, however, it can be a patient with a
NEGATIVE WALLET BIOPSY
, and no staff physician will admit him and no other hospital will take him in transfer. The worst possible rock is known as a “diamond.”

R
OUNDING
U
P THE
U
SUAL
S
USPECTS
: Ordering all the tests and studies that routinely get ordered on a given type of patient. May often coincide with a
GOMERGRAM
.

R
OUNDS
: Usually occur at shift changes; the departing doctors and the newly arriving doctors go from patient to patient giving an update on each patient's condition.

S
ACRAL
: Relating to the sacrum, which is the back wall of the pelvis (the tailbone).

S
CUT
: The lowest form of
HOUSE STAFF
work—drawing blood, labeling tubes, carrying labs, pushing patients to X ray, etc.

S
CUT
M
ONKEY
: A medical student; one who performs scut.

S
HOCK
:
See
DEFIBRILLATION
.

S
ICK
: Sick. Real sick. May be
CTD
. Expect a
CODE BLUE
.

SIDS: Sudden infant death syndrome. Babies in the first few months of life suddenly die while napping. The reason is unknown but sometimes is associated with sleeping on the stomach.

S
NOW
: To give a patient high doses of morphine or Demerol when he is in a lot of pain.

S
PINAL
T
AP
: Insertion of a needle between the lumbar vertebrae into the spinal canal to withdraw spinal fluid in order to check for infection or bleeding. Also
LP
(
LUMBAR PUNCTURE
).

S
POTAS
: People who come to the ER in hopes of obtaining a written excuse for not doing whatever it was that they were “spota” be doing: “I spota be in court right now, but every time the train goes by, my feet get numb.”

S
TAT
: At once; immediately.

STBD: Soon To Be Dead.
See also
CTD, FTD, PBAB
.

S
TERNOTOMY
: A procedure in which the chest is cut open through the sternum.
See
CRACK THE CHEST
.

S
TOOL
M
AGNET
: An unlucky medical student who gets dumped on with the worst scut and the nastiest patients.

T
ATTOO-TO
-T
OOTH
R
ATIO
: A prognostic indicator of a patient's self-destructive potiential.

T
OURON
: A term derived from “tourist” and “Klingon” used to denote a rude and irresponsible tourist.

T
ERRASPHERE
: From the Latin
terra
, meaning earth, and
sphere
, meaning ball; i.e., a “dirtball.” Useful when discussing the patient's condition with someone else while in front of the patient.