Mnemonics & Descriptors

I've worked mostly in surgery, critical care, trauma, and such.  It's been often fast paced, a bit surreal and sometimes raucous. One of the more edgy elements has been the communications, such as patient mnemonics and descriptors.

There are many, many mnemonics out there in the medical world, like FLK (Funny Looking Kid). There are vast collections of them in many locations.  I've been entertained by the inventiveness of many colleagues along the way in  conversation about their work, and the inability of regular medical terminology to capture the idea completely.  I've heard from ICU professionals about patients that were "CTD" (Circling the Drain), and the patient who was a "GiLSOB" (good looking son of a bitch) from floor nurses. One of my bosses told me he had treated a lacerated a hand from a "UBI" the night before (Unexplained Beer Injury).  Some of my faves; Usually starting with the introduction, "the patient is... or has..." :

• 185 grain Injection - 9mm gunshot wound
• ALS - Absolute Loss of Sanity
• CRS - Can’t Remember Sh*t
• BBL Sign - Belly-button Lint Sign
• BFH - Big F****ing Head
• CATS- Cut all to sh*t (after knife fights usually)
• CBT - Chronic Burger Toxicity
• Chartomegaly - large chart
• CLL - chronic Low Life
• D&D - Divorced and Desperate
• High DBI - Dirt Bag Index
• DRT - Dead Right There
• ETOH - Extremely Trashed or Hammered
• FUBAR - F***ed Up Beyond All Recognition)
• ATS - Acute Thespian Syndrome (faking it)
• GOMER - Get Out of My Emergency Room
• 4F - Fair, fat, female and forty
• GORK - God Only Really Knows
• HIBGIA - Had it before, got it again
• HMS - Hysterical Mother Syndrome
• JAFHA - Just Another Fat Hospital Administrator
• KOKO - Keep on Keeping on
• NARS - Not a rocket scientist (low IQ)
• NQR - Not Quite Right
• OBS - Obvious bullsh*t
• Osteocephaly - boneheaded
• DAFO - Drunk And Fell Over
• PFH - Parent(s) from Hell
• PPP - Piss-Poor Protoplasm
• RBS - Really Bad Shape
• SAS - Sick As Sh*t
• Smurf Sign - patient blue or going blue
• SWAG - Scientific Wild Ass Guess
• TBP - Total body pain
• TTR - Tattoo-to-Tooth Ratio
• WOMBAT - Waste Of Money, Brains And Time
• ZB or Zorro belly - someone with multiple surgeries

An ER nurse called me one night an told me a patient, beyond his amputated finger, was "NFB" (Normal for Birmingham...where we were living at the time).  The same nurse later told me that an order for "Plankton at Beside" was appropriate for a mutual patient who had a BMI of 40 something (The nurse was burned out and later married a PA friend of mine, never to work as a nurse again).  Another nurse described on of my patients as "CNS-lite" referring to his mental challenges and I'll never forget the radiology tech that described a rather large patient as "CBO" (Cheese Burger Overdosed).

I am appalled at  some of the references, but the art of mnemonics in medicine is priceless. While not always in good taste, having a sense of humor about this field can save sanity and might prevent migration to concierge medicine.