Ambiguous Acronyms: A reader complains about 'PMS' & other medical shorthand


 
 

| Wednesday, August 26, 2009


Dear Sirenhead,

One of your recent articles referred to PMS being checked in lower extremities. I_ve been married for more than 40 years, and I know what PMS means in my house, but I_m sure that_s not what you meant. I searched online and found hundreds of meanings, none of which made sense, either. I finally found a reference to PMS in an excerpt of a Caroline Paramedic book. It referred to distal pulses, motor skills and sensory feel of the extremities. My point is that I prefer English and big words to acronyms.ƒPreferably Wordy

Dear WORDY,

THX (thanks) for the suggestion.

Obviously, we use acronyms to shorten phrases to make them easier to remember or more convenient to say or write. Your question made me wonder where it all started.

Acronyms weren_t prevalent until the 20th century, when their use exploded around WWII (World War Two). FDR_s (Franklin Delano Roosevelt_s) New Deal created a host of "alphabet agencies," and we just never quit. I_m sure the government, the DOD (Department of Defense) in particular, has entire linguistics units dedicated to developing new and tedious acronyms.

The second huge source of acronyms is technology. Researchers and engineers create names that accurately and completely describe the technology, but us common folk usually can_t understand them. That_s where acronyms came into playƒRADAR (radio detection and ranging), ECG (electrocardiogram) and SOAR (solar occultation for atmospheric research) to name a few. Every profession and organization has their own acronyms and jargon. EMS (emergency medical services) is no exception.

I did a simple WWW (World Wide Web) search for "EMS" and found 125 different meanings. You_ll be happy to know that "emergency medical services" was at the top of the list.

In the old days, I used "official" acronyms to condense the narrative portion of my PCRs (patient care report). Yes, before computers, we actually had to write on paper. Some of us even started with chalk and a slate. The reports were one page and the narrative box was pretty small, so we abbreviated lots of stuffƒAAOx3 (awake, alert, oriented times three), CA (cancer), CC (chief complaint), Hx (history), etc. Of course, there are some "unofficial" acronyms, and if you don_t know those, I_ll let you remain uncorrupted.

Well, enough history. Let_s get on to the pontification. Abbreviations and acronyms don_t belong in official reports that will be shared with people from varied organizations or professions. A patient care report is the best example. Copies go to various hospital units, insurance companies, attorneys, billing companies, your department and juries. You have to write these reports in a way that_s clear to anyone who reads them.

Although some agencies have approved lists of acronyms, even these can be confusing. Once, a subordinate called in sick, and I faxed paperwork to the administrative office indicating that she would be out for two shifts with NVD (nausea, vomiting and diarrhea). The office clerk e-mailed that my medic was required to be off for at least 30 days following an NVD (normal vaginal delivery). Oops.

This is why most hospitals don_t allow abbreviations on patient charts. We should get in line with this in EMS. Fortunately, with the move to fully electronic charting, some programs have automatic entry refusal if an acronym is entered.

Even radio communications have gone away from codes and strictly use free voice. Do you use "10 codes"? 10-4 and 10-20 are pretty universal, but everything else is up in the air. After pulling up on a 10-50 (vehicle collision), our new dispatcher notified our sheriff_s office that we were out on a 10-50. Nearly every deputy in the county and a couple of troopers showed up on the scene, running hard Code 3 (lights and sirens). They all wanted to know if we were OK. It turned out that 10-50 for the sheriff_s office is "officer in trouble needs immediate assistance." Oops again.

So, department policies should clearly state specifically what, if any, abbreviations are permitted in specific reports. Our PCRs should reflect that same level of professionalism. Write what you mean and make sure everyone understands, and I_ll be sure to do the same here.

TCOY, MGB and LBCOT (take care of yourself, may God bless, and let_s be careful out there).JEMS

Tell Someone Who Cares

Got a question or complaint? Let Sirenhead hear all about it. He_ll answer you with 124 dB of traffic-stopping noise. E-mailsirenhead@elsevier.com,and then brace yourself!




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