The Devil’s Dictionary of the Emergency Department
ALC: Alternate Level of Care. Described in Dante’s Inferno as a living hell, just above the Second Circle, where patients are sent by the Ontario Ministry of Health because they too frail to go home.
BENZOS: Benzodiazapines. A class of commonly used sedatives, often prescribed for anxiety or sleep. Routine agent of drug overdoses. The nurse’s BFF.
C. DIFF.: That hospital smell.
CIRCLING THE DRAIN: About to die. Usually shortened in speech to “circling” as in “She’s been circling all night.”
CNO: College of Nurses of Ontario. The organization that regulates nurses in Ontario. Situated on the ugly end of an unfashionable street in downtown Toronto (or is it the other way round?) Bane of all nurses.
CODE BLACK: Bomb threat, during which management observes the charge nurse making a careful search of the department for suspicious packages, boxes, etc. This is because all charge nurses have been trained in advanced bomb-disposal techniques.
CODE BLUE: a group activity where 20 or more health care professionals gather to watch 3 or 4 work, and also to give advice and/or commentary.
CODE BROWN: Hint: it involves poo
CODE WHITE: The same as CODE BLUE (which see), except the patient is usually spitting.
CTAS: Canadian Triage Acuity Scale. All patients coming ito the ER in Ontario, and probably most of the country are classified according to a 5-level scale ranging from CTAS 1 (dead, or nearly so) to CTAS 5 (go away and don’t bother us). Treatment priorities are based on a patient’s CTAS level, which explains why the stubbed toe (CTAS 5) gets a little less priority than the V TACH (which see) (CTAS 1).
ECU: Eternal Care Unit. Where the stablest patients are sent, i.e. the morgue.
DYING SWAN: a patient, who dramatically, gracefully and carefully lowers himself to the waiting room floor, claiming he is “too sick to wait in a chair.”
HBD: Has Been Drinking.
MELENA: That other hospital smell. See C. DIFF.
MID: Muffin In Distress. An entirely sexist and often correct term for a young adult female who for reasons best known to herself will overdramatize the most trivial complaints into a cataclysm of cosmic proportions. +ve STUFFED ANIMAL SIGN (which see) sometimes accompanies and represents the most extreme variation. Usually cured by childbirth, after which any pain is borne without complaint. A Male Muffin in Distress is the male equivalent, often accompanied by a fawning girlfriend and/or mother. (See DRAMA QUEEN and DYING SWAN.)
NonSTEMI: Non-ST Elevation Myocardial Infaction. The “good” sort of heart attack. See STEMI.
NYD: Not Yet Diagnosed. Common abbreviation used in diagnoses, appended to a symptom, i.e. Chest Pain NYD. Physicianese for “Damned if I Know”.
ONA: Ontario Nurses Association. Our beloved Union. The less said the better.
NOSOCOMIAL: A word of Greek origin, meaning “we fucked up.”
PRN: See BENZOS.
STEMI: ST Elevation Myocardial Infarction. The “bad” sort of heart attack. In the Emergency Department, provokes ten minutes of frenzied activity to administer the thrombolysis, followed an hour of tedium to see if the drug worked, which is only relieved by the occasional thrilling reperfusion arrhythmia.
STUFFED ANIMAL SIGN, POSITIVE: Bringing a small stuffed animal into the ED for comfort when above voting age.
SUITCASE SIGN, POSITIVE: Patients, or more commonly, patient’s families who bring to Triage fully packed luggage in expectation of admission. Usually seen just prior to major holidays, vacations, etc.
TRAPPED FART: i.e., gas pain
URTI: Upper Respiratory Tract Infection. Not to be confused with UTI, which in most people is somewhat lower.
UTI: Urinary Tract Infection. Bane of Triage Nurses, because it requires the collection of foul urine samples.
VRE: Vancomycin Resistent Enterococcus.
VSA: Vital Signs Absent, i.e. Dead. To be avoided both personally and in patients.
V TACH: Ventricular tachycardia. Bad, bad heart thingy when you heart goes thumpity thumpity thumpity really, really fast. Fixed by electricity.