DOCTORS' SLANG, MEDICAL SLANG AND MEDICAL ACRONYMS

AND VETERINARY ACRONYMS & VET SLANG

These have been mostly collected from around the UK and USA, with a few non-English contributions (many thanks to all contributors from around the globe), so you'll only find a few of them used in any single establishment. Some of the acronyms are region-specific and have differing meanings in US and UK. It is noticeable that the US has numerous acronyms and slang terms relating to gun-shot injuries. The slang/acronyms are directed variously at patients, other medical staff or mystifying medical conditions. I haven't included the slang terms for all of the various medical equipment. The veterinary appendix - due to popular demand - is at the foot of the page.

3H enema - Enema that is "high, hot, and a hell of a lot." Reputedly given to patients who give staff a hard time.

3P’s - Pill, Permissiveness and Promiscuity (relates to female patients with sexually transmitted disease)

4F - Fair, fat, female and forty OR fat, forty-ish, flatulent female (both mean abdominal pain patient who is candidate for gall bladder disease)

4H - (US) Haemophiliac, Hispanic, Homosexual, Heroin addict

404 moment – On card rounds - when a patient’s medical records cannot be located (from internet error message: 404 Page Not Found)

5-H-1-T - polite medical term for shit

10th Floor Transfer - dying (floor number is always the next number on from the highest floor in the hospital).

45C - patient is one chromosome short of a full set (thick)

AAA (or Triple A): Ay Ay Ay. Precursor to Status Hispanicus. Wound-up Hispanic female unable to tolerate even the small discomfort of removing an adhesive plaster, but not yet full-blown histrionics.

AALFD - Another A**hole Looking For Drugs

Acades vulgaris - medical students.

Acronymophilia - excessive reliance on TLAs /TLMs & XTLMs (extended 3 letter acronyms)

Acute Lead Poisoning - Gunshot wound

(Acute Lead Poisoning) 185 grain Injection - 9mm gunshot wound

(Acute Lead Poisoning) 240 grain Injection 44 calibre magnum wound

(Acute Lead Poisoning) Air-conditioned - Multiple gun shot wounds

Acute Hyponicotaemia - desperate for nicotine fix (cigarette)

Acute Pneumoencephalopathy - airhead

Adminisphere - where hospital managers work, reckoned to be "another planet"

Administrivia - pointless emails and notices that clog up real medical work

ADR - Ain’t Doing Right

AFU & BR - all f***ed up & beyond repair

AGA - Acute Gravity Attack (fell over)

Aggressive Euthanasia - A procedure that obnoxious patients would benefit from.

ALFI(e) - (Australia) Adelaide's Largest F*cking Idiot

AGMI - Ain't Gonna Make It (won't survive)

Agnostication - Substitute for prognostication; describes the usually vain attempt to answer the question: "How long have I got, doctor?”

AHF - Acute Hissy Fit

Airwolf - air-ambulance (after a popular US TV series)

Albatross - chronically ill patient who will remain with a doctor until one or other of them expire

ALC - a la casa (send the patient home)

ALS - Absolute Loss of Sanity (nutcase)

Amphoterrible - Amphotericin B, an antifungal medication with toxic side-effects

Amyoyo syndrome - Alright motherf*****, you're on your own (seen in head injury patients in Intensive Care); there will be no miracle recovery

Angel lust - a male corpse with an erection (not uncommon). Is also sometimes used to mean death that occurred during intercourse.

AOB - Alcohol On Board

APD - Acute Prozac Deficiency (depression)

Appy - person with suspected appendicitis

APRS - (US) Acute Puerto Rican syndrome (bouts of screaming and yelling)

APTFRAN - Apply Pillow To Face, Repeat As Necessary (for annoying patient)

AQP - Assuming the Q Position: deteriorating or dying with tongue hanging out

AQR - Ain't Quite Right

Arsenic in antifreeze - Melarsoprol (IV sleeping sickness drug) is exactly this!

ART - Assuming/Approaching Room Temperature (dead)

Ash Cash - money for signing a cremation form

Ash Point - where you collect the Ash Cash

Ass Grapes - badly thrombosed or strangulated haemorrhoids

Assmosis - promotion by "kissing ass"

AST - Assuming Seasonal Temperature (dead)

ATD - (US) Acute Tylenol Deficiency (simple fever or head cold)

ATFO - Asked To F*** Off

ATS - Acute Thespian Syndrome: faking illness; known in US as MGM syndrome

Aunt Minnie Lesion - once seen, never forgotten, much like certain aunts at the family wedding

AWTB/AWTF - Away With The Birds/Away With The Fairies; a patient who is totally confused

Ax(e) - surgeon

B-52 - combined 5mg of Haldol IV + 2mg of Ativan IV

Baby catcher - obstetrician

Babygram -x-raying (radiographing) a newborn

Bagged and Tagged (B&T) - Body ready for dispatch to morgue

Bagrinhos - (Brazil) interns ("bullheads" - type of fish that gets in the way of real fishing)

Banana - patient with jaundice

Basement admission - will end up in hospital morgue (located in the hospital basement)

Bash Cash: the money paid for completing accident (insurance) claim forms in A&E

BBCS - Bumps, Bruises, Cuts and Scrapes (i.e. no serious injuries)

BBL Sign (Belly-button Lint Sign) - male, middle-aged, overweight and hairy (an umbilicus that looks like the lint [fluff] trap in a tumble dryer is most common in overweight, hairy, older men). Known as Belly-button Fluff in Britain.

Beached whale - obese patient unable to do much for him/herself except lie there with flailing arms and legs

Beating off Angels - doing CPR in vain on a patient who won't make it

Benny - patient on benefit (welfare payments)

Betty - a patient with diabetes

BFH - Brat From Hell (usually accompanied by PFH - Parent(s) from Hell)

BFH - Big F****ing Head; hydrocephalus as in a "FLK with a BFH" (can be metaphorical for arrogant consultant)

BIT - burp in transit (gas seen in the stomach on an abdominal film)

Black cloud - a doctor who attracts difficult or prolonged cases or an unusually high number of code blues calls

Blade - Surgeon: dashing, bold, arrogant and often wrong, but never in doubt

Blamestorming - apportioning of blame for mistakes, usually to any locum or lowliest medic in sight

Blinky the Fish - radiologist (The 3-eyed, mutant goldfish from The Simpsons is the mascot of many radiology depts).

Blood-Brain Barrier - surgical drapes

Blood Suckers - those who take blood samples, e.g. lab techs

Blown Mind - gunshot wound to the head.

Blue Bloater - obese person in respiratory arrest

Blue Blower - patient with severe lung disease

Blue Pipe - vein (as opposed to 'red pipe' or artery)

BMT - Bowel-Movement Taco (faecal matter trapped in female genitalia)

BMW - Bitch Moan & Whine

Bobbing for apples - unblocking a badly constipated patient with one's finger

BOHICA - Bend Over, Here It Comes Again

Bone Break Need Fix - derogatory term for Orthopaedics

Boneheads - orthopaedics

Bones and Groans - non-specialist general hospital

BoneHo - an off-service resident working in Orthopedics

Boogie or Goober - tumour. A Roasted Goober is a tumour after intensive cobalt treatment; a Healthy Goober is a dead tumour patient.

Bordeaux - bloodstained urine

Bottle return - removing a bottle lodged in the anal canal

Bounce - returning a turfed patient back to original dept (see also turf and buff)

Bounceback - a (usually turfed) patient who keeps returning to the hospital with same condition

Box - to die

Brain Fry - Electroconvulsive Therapy (ECT) for depression

Bronze John's Law - (paediatrics) if the weight of the records exceeds the weight of the child, the prognosis is grim

Brothelizer test - microbiology test (on swab or sample) requested by the Genito-Urinary Clinic or STD clinic to check for sexually transmitted diseases. A positive test result means the patient has "failed the brothelizer test".

Brothel Sprouts - Genital warts

Brown trout - a stool that won't float (as opposed to an air biscuit, which does)

BSS - Bilateral Samsonite Syndrome: patient admitted with both their bags packed in preparation

BTSOOM - Beats The Sh*t Out Of Me

Buff - re-hash the patient's story to make it sound more appropriate for the patient to be referred to another dept (see also turfing and bouncing)

Buff Up - to ready a patient for release

Bug Juice - antibiotics

Bugs in the rug - pubic lice

Bull in the ring - blockage in the large intestine

Bumps and Lumps - junior doctor (intern) cases

BUNDY - But Unfortunately Not Dead Yet

Bungee jumper - a patient who pulls on his catheter tube

Bunnies - Sanitary Towels (sanitary napkins)

Bunny Boiler - (Psych) dangerously obsessive or unbalance woman (based on film "Fatal Attraction")

Burger - sunburned patient with ruptured blisters

Bury the Hatchet - accidently leave a surgical instrument inside a patient.

Butchers - Obstetrics & Gynaecology (also general derogatory term for surgeons)

BVA - Breathing Valuable Air

BWCO - Baby Won't Come Out (needs Caesarian)

C/C- "Cancel Christmas" (dead)

C2 - a "can't c**t"; lazy physician who passes off work to colleagues and often whine

C&T Ward - Coma ward - "cabbages and turnips"

Cabbage - heart bypass i.e. CABG (Coronary Artery Bypass Graft)

Cabbage and tomato ward - Ward for comatose patients

Calcified Penisitis Morbidium - male patient whose ailment is due to excessive or unprotected sex

Callbellectomy - minor operation, sadly not permitted, to remove over-used call bell from patient's hand/reach!

Call Button Jockey/Buzzer Junkie - patient that uses call button all night long for no good reason.

Calling Doctor Blue [to location] - public address system code for "baffling case needing more doctors to take a look in the hope that one of them will know what to do"

Captain Kangaroo - chairman of a paediatrics department.

Category 6 Patient - Triage is Cat 1 (major) to Cat 5 (minor) so Cat 6 means a timewaster

Cath Jockey - cardiologist that catheterizes every patient they see (or one that does cardiac catherizations)

CATS- Cut all to sh*t

Caveman - Derogatory term for Orthopaedic surgeons “so easy a caveman could do it”. Derived from an advert

CBT - Chronic Burger/Biscuit Toxicity (obesity)

cc - Complaint Corner, a patient that complains about everything; BCC is one that behaves nicely to medical staff and complains behind their backs (from business acronyms for carbon copy and blind carbon copy)

CCFCCP - Coo-coo for Co-Co Puffs (dementia or similar)

Ceiling Sign - near-levitation from the bed to the ceiling induced by examining for abdominal tenderness

Celestial discharge - died

Celestial transfer - died (transferred to the Eternal Care Unit)

Cephosplat - Domestos Antibiotic; Kills all known germs

CFT - Chronic Food Toxicity i.e. obesity

CFU - Complete(ly) F*ck(ed) Up

Champagne tap - bloodless lumbar tap

Chandelier's Sign - The result of any test or probing after which the patient must be removed from the chandelier

CHAOS - Chronic Hurts All Over Syndrome (PTSD/Fibromyalgia, etc.)

Chart Biopsy - check chart for other depts' plans on the patient

Chart Dehiscence - drop patient chart and everything falls out.

Chartomegaly - patient is so frequent s/he has a large (and growing) chart

Cheerioma - a patient with a highly aggressive, malignant tumour

CHIBLOC - Closed Head Injury, Brief Loss of Consciousness

Chocolate Hostage - constipated

Choly / Chole - patient with cholecystitis (inflammation of the gallbladder) or cholecystectomy patient.

Chrome Induced Ischaemia - patient that develops inexplicable chest pains when arrested and handcuffed

Chronic Slapping Deficiency - annoying/unruly family members hitting nurse's call button every 5 minutes with minor requests/inane questions or for fun

CIBS - Cast Iron Bum/Butt Syndrome: when the needle goes into the buttocks straight, but comes out curved

CKS - cute kid syndrome

Clip and Strip - remove staples and adhesive sutures

CLL - chronic Low Life

CLOMI - Cat Like Observation and Masterful Inactivity (patient under observation)

Clupea fallacius rufus - red herring

Cock Doc- urologist

Cockroach Factor - a patient's ability to survive trauma or serious treatment is inversely proportional to his contribution to society (see TTI).

Code 0 - (Ambulance) Time-waster/tax-waster (genuine codes are Code 1 [non-serious] to Code 4 [emergency])

Code Azure - message to other medics to do nothing extraordinary to save a very ill patient who will die shortly no matter what is done

Code Brown - faecal incontinence emergency (e.g. of bedlinen)

Code Pink (Triangle) - a likely homosexual (used back when HIV/Aids tests took a while to come back)

Code Pink (Paediatric) - baby taken without permission from maternity/nursery by family or staff

Code Surfer - medic straddling the patient on trolly (gurney) performing chest compressions while patient is being transported

Code Yellow - urinary incontinence emergency

Coffee and a Newspaper - Patient is Constipated (i.e. long time sitting on toilet with drink and reading matter)

Coffin Dodger - survived against expectations, or a very old person

Cold-tea Sign/Cold Tea Syndrome - refers to the several cups of cold tea on the bedside cabinet beside a dead geriatric (i.e. no-one noticed the patient had died)

COPD - Chronic Old Persons Disease (unwell, no specific cause)

COSMONAUT - Cat Owner, Smells, Made Of Nuts And Used Tampons ("mad cat lady" with poor hygiene and body odour)

Crackerjack referral - (UK) It's Friday, it's five to five, it's... (Crackerjack was a popular TV show) i.e. Friday afternoon job

CRAFT - Can’t Remember A F*cking Thing

Cranial rectosis - US: butthead (US term for idiot); UK: head-up-ass (arrogant/arrogant fool)

Cranio-faecal Syndrome - s**thead or s**t for brains

CRAP Score - Cynical Real Alternative Pain Score - an alternative method of scoring pain (see foot of page)

Creepers - geriatrics using walkers and wheelchairs

CRI - Cranial-Rectal Insertion or Cranial-Rectal Inversion (head-up-ass syndrome)

Crinkly - geriatric

Crispy critter - severe burns case

CROACC - Cannot Rule Out Anything, Correlate Clinically

Crock - Hypochondriac.

Crook-U - Prison Ward in a hospital (slang to match ICU - Intensive Care Unit etc)

Crop Rotation - Ambulance shuttle service from nursing home to surgery and back again

CRS - Can’t Remember Sh*t

CRT - Can't Really Treat

Crumble (crumbly) - elderly patient

Crump - (UK) RTA [Road Traffic Accident], (US) crash; trying to die

Crump, Gork or Vedgy - Intensive care patient incapable of movement and apparently unaware of his surroundings.

CTD - Circling the Drain (Close To Death)

CTF - Cletus the Fetus (US). A 23 week, or earlier, births that parents expect to survive against all odds

CTS - Crazier than sh*t

Cuckoo - alternative term for CCU

C*nts and Runts - Maternity and Paediatrics

Cut and Paste - To open a patient, discover that there is no hope, and immediately sew him up (or almost immediately - sometimes young surgeons practice surgical techniques for a while).

CYA - Cover Your Ass; unnecessary procedure/prescription done to avoid being sued

D&D - Divorced and Desperate (middle aged female who visits doctor weekly just for male attention)

D&D - Death and Donuts (night shift)

Dagenham - (psychiatry) or "Three Stops Beyond Barking": severely disturbed/mad (based on British train station names)

DACB - (US) Drunk As Cooter Brown (UK equivalent is PAAF/PIAF)

Dance (or Gown Dance) - the process of tying a surgical gown behind the surgeon's back (requires a 180-degree spin by the surgeon: Shall we dance?)

Dandruff on wheels - scabies or other transmissible flaky skin condition

DBI - Dirt Bag Index: number of tattoos x number of missing teeth = days since the patient last bathed

Death Camp - terminal nursing home

Death Star - that ward in every hospital where patients go to die

De-coke and Re-bore - Dilatation and curettage (gynae) op

Deep fry - cobalt therapy (radiation therapy)

Dement - Alzheimer patient

DENTIST - Doesn't Even Need Treatment - It's Sorted, Truly

Departure lounge - geriatric ward

Dermaholiday - nickname for dermatology dept used by staff in busier depts

DFO - (1) (US) Done Fell Out (anything from fainting to cardiac arrest)

DFO - (2) Drunk and Fell Over

DFO-SFJ - Done Fell Out - Screaming For Jesus

DIFFC - Dropped In For Friendly Chat (i.e. no medical problem)

Digging for Worms - varicose vein surgery

DIIK - Darned if I know

DILF - Doctor I'd Like to F*** (Fornicate with): Nursing slang for good-looking doctor

DILLIGAF - Do I Look Like I Give A F*ck

Dirtball - patient who enters the emergency room filthy and smelling badly

Discharged downstairs - transferred to the morgue

Disco Biscuit – Quaaludes (1980s), Estasy (2000s)

Dishwasher - sterilization machine

DKA - Don't/Doesn't Know Anything (but is explained to relatives as Diabetic Ketoacidosis if challenged)

DMFNFL - Dumb mother f*cker, not fit to live

Doc In A Box - a small clinic/health centre, with ever-changing staff.

Doing the Twirly - circling the drain (about to die)

Donorcycle - motorbike: the biggest cause of donated organs! (hence reckless motorcyclists are known as Organ Donors and rainy days are Donation Days)

Donut of Death - CT scanner

Doorknob Rounds - the entire presentation takes place in 5 seconds while the consultant's hand never leaves the doorknob to the entrance of the patient's room (US hospitals have small single occupancy rooms)

Dose of I Don't Care - pain-killing meds that make patient light-headed

Dose of I Don't Remember - pain-killing meds that leave patient without memory of painful procedure

Dose Sponge - Radiology Worker

DOTS- dead on the spot (of an accident), also FDOTS (F*cking Dead On The Spot)

Double bind trial - Two orthopods looking at an electrocardiogram

Double Whopper with Cheese - Obese female with genital thrush

Double Whopper with Mayo - obese female with vaginal discharge

Double Whopper with Ketchup - obese female with blood-stained vaginal discharge (often post-natal)

Doughnut - CT scanner

DPP - (Brazil) leave patient for the next shift to deal with ("Deixa para o Próximo Plantão")

DPS - Dumb Parent Syndrome

DPS - (General Practice) Droopy Penis Syndrome: a patient wanting Viagra prescription

DPS - (Hospital) Disappearing Penis Syndrome: the usual reaction of the male organ in response to insertion of catheter or endoscope

DQ - Drama Queen

Dr Feelgood - a doctor who is indiscriminate about prescribing drugs

Drinkectomy - separating a drunk from his can of lager (performed in A&E dept)

Drooler - catatonic patient.

Drop a Lung - when medical treatment causes a pneumothorax

DRT - Dead Right There (patient dead at scene of accident)

DRTTTT - Dead Right There, There, There and There (patient dead and in multiple parts at scene of accident)

DSB - Drug-Seeking Behaviour (faking illness to fuel narcotic addiction)

DSP - Dumb Sh*t Profile

DTMA - Don't Transfer to Me Again.

DTS - Danger To Shipping (in a particularly large patient's records)

DWPA - Death/Dying With Paramedic Assistance

DUB - Damn Ugly Baby

Duck - portable urinal for bedridden male hospital patients

Dude Factor - Survival scoring factor based on social worth. A high dude factor = an individual of questionable social worth who survives near-fatal injuries. A low dude factor = professional person who slips in the bathroom sustaining a fatal injury

Dump - patient that nobody seems to want (or to transfer a patient to another hospital); also a verb - arranging for patient to be off-loaded elsewhere

Dunlap Syndrome - belly done lapped over the waistband; obese (spare tyre, Dunlop being a brand of tyre)

DWPA - Death/Dying With Paramedic Assistance

Dys-Synaptogenic - stupid

Eating In - Intravenous feeding

Eating the Bill - (USA) providing care for indigent patients lacking insurance i.e. "We ate the bill on that guy."

ECU - Eternal Care Unit: heaven ("gone to the ECU = dead)

EDDU – eating drinking defecating urinating (but not much else)

EDGATWTTTF - Elevator Doesn't Go All The Way To The Top Floor (thick)

Eiffel Syndrome - (From I-fell on it) patient with a foreign object in the rectum

ELFs - Evil Little F*ckers (irritating children)

Embromed - (Brazil) imaginary health plan: postponement of solution through hoax.

Ego Boost Units - med students/junior doctors that follow a doctor

EMS - Earn Money Sleeping (joke at expense of Emergency Medical Service)

EMT - Extraordinary Masochistic Tendencies (joke at expense of Emergency Medical Technicians)

Engessar - (Brazil) to orient treatment so that the patient can't complain (literally "to place in a cast").

ERCP - Emergency Retrograde Clerking of Patient, an emergency procedure before the consultant rounds

ERNOBW - Engine Running, No One Behind the Wheel (thick)

ESBAM - Eat s**t and Bark At the Moon (or "not ruddy likely" in British English)

Estropício - (Brazil) poor, unkempt obstetric patient ("jeopardy").

Eternal Care - Intensive Care (for a patient who won't come out again)

ETOH - Extremely Trashed or Hammered (2 derivations given: corruption of "Etho" [ethanol addict] or from "EtOH" [chemistry abbreviation for ethanol])

Expensive care - intensive care

Expensive Scare - intensive care

FABIANS - Felt Awful But I'm Allright Now Syndrome

FAC - F*cking Awkward Client

Faecal Encephalopathy - Sh*t for brains

Fallaciopisces rufus - red herring

Family Care Plan - One child gets the sniffles, whole family gets a trip to A&E

Fanger - oral surgeon

Fascinectomy - long, but fascinating procedure

Fascinoma - Interesting pathology, but not as interesting as the ensuing politics over who gets first authorship when the case is written up

Father Jack - (the drunken old priest in Father Ted), confused and elderly patient who constantly shouts and tries to get out of bed

FCBP - Fellow of the College of Bystander Physicians i.e. doctor having a look-see

FD - F*cking drunk

FDGM - Fall Down, Go Boom (see LOLFDGB)

FDSTW - Found Dead Stayed That Way

Feather Count - measure of flakiness (e.g. high feather count)

Feed and Seed - care for vegetative patients in "the garden"

Feet-up General - a quiet district hospital

FFDID - Found Face Down In Ditch

FFDIG - Found Face Down In Gutter

FFF - see 4F (Fat, Fair, Female, Forty = gall bladder disease)

FHHS - (US) Female Hispanic Hysterical Syndrome (screaming and crying)

FIDO - F*ck It, Drive On (a waste of time/hoax ambulance all)

Fighting Darwin - patients refusing essential treatment through stubborness or stupidity

File 13 - The Trashcan

FINE - F*cked up , insecure, neurotic & emotional

Finger Wave - rectal exam

Fireballs of the Uticas - fibroids of the uterus

FIRT - Failed impact resistance test (crash victim)

Fish Filet - vaginal infection with discharge and odour

Fish Filet with Catsup/Ketchup - vaginal infection with discharge, odour and bleeding (e.g. post-natal)

FIT - fart in transit (gas seen in the intestines on an abdominal film)

FITH - F***ed in the head

Fluttering Eye Syndrome - Patient faking unconsciousness

FLBs - those "Funky Looking Beats" found on an EKG that no one can figure out

FLB - Funny Little Bumps (unexplained skin bumps)

Flea - (US) internists, (UK) ethnic nurses (used in 1970s during an influx of imported healthcare staff) i.e. "they get everywhere"

FLK - Funny Looking Kid (sometimes suggests rural inbreeding)

FLK w/ GLM - Funny Looking Kid with a Good Looking Mother

FLKBCOTP - Funny Looking Kid But Check Out The Parents

FLKOFS - Funny Looking Kid, Okay For Sunderland (one of many regional variants of NFN [Normal For Norfolk])

Floating - how ghosts (i.e. med students) get from "here" to "there."

Flower Sign - flowers at a bedside, denotes patient has a supportive family and might be candidate for early discharge

FLP - Funny Looking Parents (hereditary cause suspected for FLK)

FLUF - Funny Little Ugly F*cker

Fluttering Eye Syndrome - Patient faking unconsciousness

FMPS - Fluff My Pillow Syndrome (attention/sympathy seeker), like Call Button Jockey

FOALS NEIGH - F*ck Off And Let Someone Not Extremely Incompetent Get Here

FOB - Found on Bench

FODE - Falling On Deaf Ears

FOL, GOL, FOS - Fat Old Lady, Gone off Legs, Full Of S**t. Confused elderly female, unable to exercise at home, now unable to move unaided and badly constipated as a result (see also Toxic Confusional State).

Fonzie - Unflappable medic (Fonzie was the unltra-cool character in TV series Happy Days)

FOOBA - Found On Ortho Barely Alive (a play on FUBAR - F***ed Up Beyond All Recognition)

FOOSH - Fall Onto Outstretched Hand (as cause of broken wrist/arm)

FOOT - Flat Out On Tarmac (e.g. biker gone down in full flight)

FORD - Found On Road Dead

Foreverectomy - A surgical procedure that lasts a very long time

FOS - Full Of Sh*t (either severely constipated or metaphorically)

FOS - Found On Street: unidentified dead homeless person

FPO - For practice only (FTD)

FPT - (Brazil) beyond help, do not resuscitate ("Fora de Possibilidade Terapêutica").

Frequent Flyer - Someone who is transported to and from hospital on a routine basis (also someone who spends more time at the local hospital then most employees and is known by all staff members including Environmental Services)

Freud Squad - psychiatrists

Friday construction - Anatomical equivalent of the cars made on Fridays, when the workers mind was more on the weekend than the job in hand

Fruit Salad - group of stroke patients, all unable to take care of themselves

FTD - Fixing To Die

FTF - Failed to Fly (botched suicide)

FUBAR - Fucked up beyond all repair/recognition

FUBIL - F**k You Buddy, I'm Leaving. The act of a doctor at a small hospital dumping a critically ill patient on larger hospital on Friday afternoon before he leaves for the weekend

Full Moon - full or overcrowded waiting room/A&E/ER

FUPA - Fat Upper Pussy Area

FURB - Funny, Unusual, Rectal Blockage (people who use inappropriate objects as butt-plugs)

Galloping amputations - gangrene spreading up a limb so more and more has to be removed in consecutive surgeries

Garden - neurosurgical intensive care ward, so called because of the "vegetables" found there.

Gardening - attending to patients in neurological intensive care.

Gassers OR Gas Passers - anaesthetists

Gatekeeper - General practice doctor whose role is to keep costs low by only allowing a certain number of patients to go to specialists

GDA - Gonna die anyway

Genital hurties - genital herpes

Geosphere - Dirt Ball (Geo = dirt + sphere = ball)

Gerifix - that collection of broad spectrum antibiotics, diuretics and bronchodilators prescribed to elderly patients admitted to hospitals in wintertime

Ghost - Derogatory term for med students; they are largely invisible, are absent during difficult situations, silent when asked for volunteers and stealthily evade hard work

GI Rounds - a meal (GI = gastrointestinal)

GLF - Ground Level Fall (tripped over)

GLM - Good Looking Mum

GMG - Gurnicht Mit Gurnicht; Yiddish for "nothing with nothing" (Israel; nonsense jargon used to pacify nervous patients)

GOA - Gone On Arrival (police turn up, ambulance turns up, fire brigade turns up, patient doesn't)

Goat Rodeo/Goat Rope - Emergency scene which goes badly (resembles a bunch of people riding or wrestling goats)

God's Waiting Room - intensive care unit and/or geriatric unit

GOK - God Only Knows

Goldbrick - patient who demands more attention than their (minor) condition warrants.

Golden ass - affluent mother who treats the obstetrics nurses like servants

Golden Child - jaundiced youngster

GOLP - Generalised Old Lady Pains

GOMER - Get Out of My Emergency Room; extended to mean elderly patient who is unable to communicate their symptoms and passed from one department to another

Gomergram - Ordering all available tests because the person is unable to explain what is wrong with them

Gone Camping - patient in oxygen tent

Goober - nutter

Gorillacillin - very powerful antibiotic

GORK - God Only Really Knows

Gork - comatose or brain dead

Gorked - unresponsive and nonverbal, either due to sedation or medical condition

Gorked Out - mental impairment through disease or substance abuse

Go to Ground - fall out of bed or chair

Go to Meet Joe Black/Consult Joe Black - die

Gown's Sign, positive - a patient who leaves (self-discharge ) without official discharge orders

GPH - Goddamns Per Hour

GPO - Good for Parts Only (won't survive)

GRAFOB - Grim Reaper At Foot Of Bed

GRAHOB - Grim Reaper At Head Of Bed

Granny Dumping - dumping elderly relative in A&E; often happens just before Christmas or family holiday aka the hospital granny-sitting service

Granny Farm - old persons' residential home, run by a Granny Farmer

Grape Sign - grapes at a bedside, denotes patient has a supportive family and might be candidate for early discharge

Grapes - haemorrhoids

Gravity Assisted Concrete Poisoning - jumped/fell from height

Gridiron Belly - scarred from multiple ops

GROLIES - (UK) Guardian Reader Of Low Intellect In Ethnic Skirt

GTMJACB - Gone To Meet Jesus, Ain't Coming Back (dead)

GTO - Gomer tip over (elderly person with injury from trip or fall)

GTTL - Gone to the light (died)

GUCCI - Genito-Urinary Clinc, Chlamydial Infection (posh female with sexually transmitted chlamydial infection)

Guessing tubes - stethoscope

Gun and Rifle Club - Trauma ward full of gunshot and stabbing victims

Gutectomy - major gastro-intestinal surgery; also abdominal fat removal (such as liposuction)

Guts and Butts - general surgery

HAIRY PSALMS - Haven't Any Idea Regarding Your Patient, Send A Lot More Serum

Hallucinoma - a mass seen on a scan or x-ray that wasn't really there

HALS - Hit And Left Standing (apparently uninjured but in shock after RTA/MVA)

Hamburger (Helper) - Train or juggernaut vs pedestrian

Hammer - local anesthetic

Hammered - to get numerous admissions while on call

Handbag positive - confused patient (usually elderly lady) lying on hospital bed clutching handbag

Happy feet - (US) patient having a grand mal epileptic seizure (in UK, Happy feet means smelly feet (feet which "hum" [stink])

Happy Little Campers - children in oxygen tents

Hasselhoff – emergency patient with bizarre explanation for their injury (David Hasselhoff's had a bizarre shaving accident in which he hit his head on a chandelier; the broken glass severed 4 tendons and an artery in his right arm)

Hat Trick - trauma patient with 3 tubes into him

HBD - Has Been Drinking or He Be Dead

Head - a brain-injury patient. Usage - "I’ve got a head I’ve got to deal with."

Head Bonk - an otherwise uninjured patient who was struck on the head and presented at A&E just to be sure

Head whack - head injury

Healthy Goober - dead tumour patient.

Hearts and Farts - unit specialising in geriatrics and cardiology

Heel Elevation Ataxia - a woman who appears staggering drunk, but is sober (or slightly tipsy) and can't walk on seriously high stiletto heels

Hepatology Conference - doctors meeting at a pub or bar (no late appointments, I'm going to a hepatology conference)

Hey Docs (or Haydock) - alcoholics handcuffed to wheelchairs in big-city medical wards who chorus "Hey, Doc! when they see a white coat" (sometimes disguised as "Haydock" which is a UK placename)

Hepatology Conference - doctors meeting at a pub or bar (no late appointments, I'm going to a hepatology conference)

Hi 5 - HIV positive ("V" being Roman for 5)

HIBGIA - Had it before, got it again

High Serum Porcelain Level - Patient is a crock of sh*t

High Slug Titre - lazy patient (slug) that won't get out of bed

High Speed Lead Injection - gunshot

Hippo - Hypochondriac or depressive

Hit and Run - the act of operating quickly so as not to be late for another engagement (often a non-medical appointment).

HIVI - Husband Is Village Idiot

HMF - Hysterical Mother Figure

HMO - From phrase, "Hey, Moe!", a concept pioneered by Dr Moe Howard, who discovered that a patient could be made to forget about the pain in his foot if he was poked hard enough elsewhere. Modern "pokes" with same outcome include estimates for private treatment.

HMS: Hysterical Mexican Syndrome

HOPEFUL - Hard-up Old Person Expecting Full Useful Life (i.e. OAPs are not priority for most hospitals)

Hole-in-One - A gunshot wound through the mouth or rectum.

Hollywood code - see Slow Code

HONDA - Hypertensive, Obese, Non-compliant, Diabetic African-American

HOP - house of pain (nursing home)

Hope'n'Scope - exploratory laparoscopy where you hope to find no disease (unless you're the student, in which case you hope to see something interesting)

Horrendoectomy - a long and painful procedures

Horrendoma- an awful unknown disease

Horrendoplasty - A god-awful surgery with a probable poor outcome e.g. difficult operation for 12 hours on a patient with a BMI of 45

Hospital Hobo Syndrome - person who visits multiple hospitals seeking attention or accommodation

Hospitalismo - (Brazil) Revolving-door patient (in-and-out-and-in ....).

Hospital pilantrópico (Brazilo) - (sarcasm) dubiously charitable hospital where profits outweigh philanthropy.

House red - blood

HP - Hispanic Panic (see tachylordia)

HTD - Higher Than a Duck

HTK - Higher Than a Kite

HTT(A) - Hot Tots and Twats (Area): Paediatrics & Ob/Gyn wing of hospital

Humpty-dumpty doctor - a physiotherapist or rehabilitation doctor (from the nursery rhyme verse "all the king's horses and all the king's men could not put humpty together again")

HVLT - High Velocity Lead Poisoning: gunshot wound

Hypoxanaxemia - patient with anxiety symptoms (Xanax deficiency)



Icing on the Cake - lethal tumor discovered in the X-rays of a heart attack victim.

I fell on it - (also Eiffel Syndrome) universal explanation given by a patient with a foreign object in the rectum

Imaginascope - what you use during radiology rounds to see the lesion the clinician is showing you but you don't see

Improving His Claim - Victim of minor accident, needs no treatment but wants something to support his insurance/legal claim.

Inbreds - doctors whose parents are also doctors

Incarcaphobia - patient is hypochondriac prisoner who prefers hospital to jail cell

Incarceritis - becoming dubiously ill when arrested or in court

Incidentaloma - a usually benign mass (needing removal) found on a scan while looking for something else entirely

Infernal Medicine - Internal Medicine department

Insurance Pain - Neck pain secondary to a minor car bump

Insurance Whiplash - Neck pain secondary to a minor car bump

Interesting Case - A patient transferred from a non-specialist hospital who is an unmitigated disaster with no accompanying chart or documentation

International House of Pancakes - neurology ward full of patients (usually stroke victims) all babbling in a different language.

Intubate Junior/Intubate Willy - catheterise a man (often results in DPS - Disappearing Penis Syndrome)

ISQ - In Status Quo ("no change"): often used during the weekend surgical round

ITBNTL - In The Box, Nail The Lid (dead or dying)

IWB - Intercourse With Biscuits (F**king Crackers)

Jack Bauer - a doctor still up and working after 24 hours (after character in "24")

JAFFA - Just Another Fat, F***ing Administrator

Jailitis - becoming dubiously ill while in custody or in a jail cell

Janitor's fracture - a fracture so obvious that a janitor (cleaner) could diagnose it

JAR or JAR Syndrome – Just Ain’t Right (often used when a patient has multiple issues)

JDFR - Just Doesn't Feel Right - most common complaint of LOL's (Little Old Ladies) and SOG's (Sick Old Guys)

JDLR - Just Doesn't Look Right (something is wrong, but no diagnosis has been made yet)

JIC - Jesus is calling

JLD - Just Like Dad (often used to explain an FLK)

JNR- Just Not Right (something is wrong, but no diagnosis has been made yet)

John Thomas sign (UK), Johnson's Sign (US) - according to tradition, the side that the penis (John Thomas, Johnson) points to (if visible on x-ray) will have an abnormality (see also Throckmorton sign).

Journal of Anecdotal Medicine - favourite, but unwritten, source of medical wisdom

J P FROG - Just Plain F***ing Ran Out Of Gas (old age etc)

JPS - Just Plain Stupid (self induced injury involving lack of common sense)

Kaiser Soze - Registrar with an uncanny ability to disappear (not answer phone or pager) when there is work to be done (from movie 'The Usual Suspects')

KFO - Knock the F*cker Out (patient either obnoxious or screaming in pain)

Kidney Stone Squirm - a spot diagnosis in A&E

Killing Fields - that ward in every hospital where patients go to die

Knife-happy - an overly enthusiastic surgeon

Knife and Gun Club - (US) local street gangs or criminal organizations that keep ER in business OR the emergency departments that care for patients with the results of street gang violence

Knuckledragger - Orthopedic Doctor/Surgeon

KOKO - Keep on Keeping on.

Lancelot - a medic who drains abscesses (called Pokemon in the USA)

Lantern Test - shine a torch in the subject's mouth and the eyes light up (no brain)

Larry - Locum, as in "doing a Larry"

Last Flea To Jump Off A Dead Dog - Oncologists (sometimes other disciplines) who seem unable to let people die with diginity

Laying Crepe - dismal prognosis (i.e. prepare the coffin)

LDF - Lying Down Fit

Leave 'Em Dead - Levofed (aka norepinephrine) , the drug given to cardiac patients to prop up their blood pressure until they die in the ambulance

Leeches - those who take blood samples, e.g. lab techs

Lerner/Bernstein Fracture - the injury suffered by a patient who is intent on suing someone over his trip or fall (Lerner/Bernstein are ambulance-chasing lawyers in one region).

LFTWM - Looking for 3 Wise Men (applied to young pregnant females who deny having had intercourse)

LGFD - looks good from door (but not closely examined, possibly an obnoxious patient)

LGFTC - looks good from the corridor (but not closely examined)

Lignocephalic - wooden-headed (i.e. dense [thick] or stubborn)

Lipstick Sign - if a female patient is well enough to put on, she is well enough to be discharged

Liver rounds - staff party, so called because of liver-damaging alcohol

LLS - Looks Like Sh*t

LMC - Low marble count (low IQ)

Load the Boat - call in senior medical staff as ass-covering exercise

LOBNH - Lights On But Nobody Home

Lobster - sunburned patient

LOFD - Looks Okay From Door

LOL - Little Old Lady

LOLFDGB - Little Old Lady, Fall Down, Go Boom

LOLINAD - Little Old Lady In No Acute Distress

LOLITS - US: Little Old Lady In Tennis Shoes (60+ year old); UK: Little Old Lady In Twin-Set (50-60 yera old)

Loop-the-loop - flamboyant surgical rearrangement of the intestines.

Loose Change - dangling limb in need of amputation.

LPT - Low pain threshold

LRO - Luck Ran Out (cheated death before, but not this time)

LWS - (US) Low Wallet Syndrome (No medical insurance or money)

M & Ms - mortality and morbidity conferences where medics discuss epidemics, mistakes and patient deaths

M sign - Patient just goes "Mmmm"

MacTilt - how a Macmillan nurse (cancer care nurse) tilts his or her head to convey sympathy

MAFAT (May-fat) - Mandatory Anasthaesia F**k Around Time, precedes any incision

Map of Antarctica - (NZ) appearance of fatal spontaneous brain haemorrhage on CT scan

MARPs - Mind Altering Recreational Pharmaceuticals

Marriageable Monster - young female patient who has successfully undergone major plastic surgery.

Masochist - Trauma surgeon; Sadomasochist - Neurosurgeon

Matern-a-taxi - when a pregnant woman calls an ambulance because the contractions are every 2 minutes, but she doesn't have a single contraction during a 30 minute journey to hospital

MCBP - Member of the College of Bystander Physicians i.e. doctor having a look-see

Meat hooks - surgical instruments.

Metabolic clinic - the tea room

Metal Poisoning - what a patient allegedly dies of when he's held together with staples (also gunshot wound)

Meth Mouth – common symptom in methamphetamine addicted patients

MFB - Measure for box

MFC - Measure For Coffin

MFD, CFD - Measure For Box, Call For Dirt (severely ill [or dead or nearly so])

MFI - very large myocardial infarction

MGM syndrome - Faker putting on a real good show

Michelin's Disease/Disorder - multiple spare tyres (obese)

MICO - Masterly Inactivity and Catlike Observation

MICOS - Masterly inactivity, cat-like observation and steroids

Microdeckia - Micro = small, deck = deck of cards; patient playing with less that a full deck (low IQ)

MIDI - myocardial infarction during intercourse (heart attack during sex)

MILF - Mother I'd Like to F**k. US version of GLM who is also PHAT

Milk of Amnesia - Propofol

Mini me - Trainee or medical student who copies their senior colleague too much but doesn’t say a lot (from Austin Powers films)

Mobile Drip Stands - Fire Dept (often found at emergencies alongside paramedics)

MOFAT (Moh-fat) - Mandatory Orthopaedic F**k Around Time, precedes any incision (alternative to MAFAT)

Molar masher - dentist

Mononeuronis Asynapsis - thick (one neuron, not connected!)

MooMoo-Mover - the big blue sheet used for moving obese patients

Mow The Lawn/Trim the Hedge - remove a long line of sutures

MTF - Metabolize to Freedom (i.e., let the person sober up, and then they can leave)

MUH - Messed up heart

Mulambo - (Brazil) poor patients in public outpatient clinics (literally rag + beggar)

MU Pain - Made Up pain (especially for sick notes and insurance claims)

Mushroom syndrome - suffered by lowly medics who are kept in the dark and have crap piled on them

MVA Special - CT scan of head, neck, chest, abdomen and pelvis (on car crash patient)

MVA Special With Gravy (aka MVA Full Meal Deal) - MVA Special plus face

n=1 trial - polite term for experimenting on a patient

NAD - Not actually done

Nastioma – mass that looks like aggressive neoplasia

NARS - Not a rocket scientist (low IQ)

Nebulopathy- strange clinical signs with no "normal" disease apparent

Necrophiles - derogatory term for Pathologists (the love the dead)

Nectar of the Gods - coffee; without which many hospital services would shut down

Negative Wallet Biopsy - (US) patient transferred to cheaper hospital because s/he has no insurance/funds

NETMA - Nobody Ever Tells Me Anything (generally a doctor's gripe on a patient's chart)

Neuro-faecal Syndrome - s**t for brains

Neuron - Neurologist.

Neuroslavery - Derogatory term for Neurosurgery based on the extreme long hours compared to orthopaedic surgery

NFF - Normal Fae Fife (Scottish version of NFN below)

NFN - Normal for Norfolk (rural area, suggests inbreeding or quaint rural oddness), might explain FLK

NFP - Normal for Portsmouth - repeat abortion, said to be particularly rife in Portsmouth, Hampshire, UK (a sailing port)

NFR - Not For Resuscitation; used on elderly patients’ charts where the DNR (Do Not Resuscitate) instruction is without the knowledge of the patient themselves or their family

NGMI - Not Going to Make It

NKDA - Not known, didn’t ask

NLPR - No longer playing records (dying)

NOCTOR- Nurse tht has done a 6 week training course and acts like s/he's a Doctor

No Hopeamine - Dopamine

Not even in the ball game - confused, senile patient

NPS - New Parent Syndrome

NQR - Not Quite Right

NQRITH - Not Quite Right In the Head

NSA - Non-Standard Appearance (what a FLK grows into)

O sign - Patient unconscious with mouth open

OAP - Over-Anxious Patient

OB/GYN - actually means Obstetric/Gynaecology, rumoured to mean "Oh Boy-Got You Naked"

OBE - Open Both Ends (known in UK as DNV - Diarrhoea and Vomiting)

OBECALP - placebo (the rationale being that patients don't realise it's "placebo" in reverse)

OBS - Obvious bullsh*t

Obs and gobs - obstetrics and gynaecology

OCWTL - Overcome With The Lord (Tachylordia)

OFIG - One Foot In the Grave

OFIGATOOS - One Foot In the Grave And The Other One Slipping

Ohno-second - The time from making an error (e.g. dropping that hard-to-get sample immediately after you got it) to going "oh-no"

Oil slick - (1991, NZ) - appearance on CT scan of a porencephalic cyst

Old Man's Friend - (US) pneumonia, an illness which often carried off the elderly

Oligoneuronal - "few brain cells" i.e. thick (not very bright) (Note: In the UK, "dumb" means "mute")

OMGWTFBBQ - a person mangled in a car crash

Ooh-Aahs - Those who gather to gawk at an emergency and go "Oooh, Aaah"

OPD - Obnoxious Personality Disorder

Optorectomy- operation to disconnect the eyeball from the anus, due to such a sh*tty outlook on life

Organ recital - a hypochondriac’s medical history

Orthopod - orthopaedic doctor

Osteocephaly - boneheaded

Ostrich Treatment - pretend it's not there and hope it goes away

OTD&DDR - Out The Door and Down The Road.

OTDPDS - Out The Door Pretty Damn Soon

OTLP - n the launch pad (to be discharged to home)

Overpriced Carpenter - orthopaedic doctor

P4P - Penicillin for Prick (peniecille for penile discharge)

P5T/P-to-the-fifth (see PPPPP) - can also mean bad genetic material or syndromic patient with numerous medical system problems

PAAF - Pissed as a fart (also PIAF -PIssed as A Fart)

PAFO - Pissed [Drunk] And Fell Over

Paint - Betadine (medication)

Pale face - (Brazil) child with leukaemia/severe anaemia.

Paninvestigram - order all the tests; for when you haven't got a clue what's going on

Pan-man Scan - Whole body scan (e.g. after car crash)

Paperweight - (NZ) very small patient with severe congenital mental retardation

Papoterapia - (Brazil) to give the patient a pep talk, chitchat therapy ("papo" = chitchat).

Parentectomy - removing parents as an effective cure for a child's problems

Pathology consult - referral when the patient dies

Pathology outpatients - Follow-up for dead people

Paws Up - dead

PBAB - Pine Box At Bedside

PBABLTO - Pine Box at Bedside, Leave Top Off

PBTB - "pine box to bedside"; indicates an imminent demise

PBS - Pretty bad shape

PBOO - Pine Box On Order

PD - Pencil D**k. General US insult. It gets applied to lazy doctors who pass work on to their peers and should not be confused for that other PD, Program Director (US terminology)

Peanut Butter Balls - Phenobarbital

Pecker Checker - either a urologist or a sexual diseases doctor (also the ship's doctor in Naval slang)

Peek and Shriek - open a patient surgically, discover an incurable condition, and close the incision immediately

Pee Pee Docs - urology

PEFYC - Pre Extricated For Your Convenience (RTA victim that has gone through windscreen)

Penal Colony - renal ward/dept, especially when a superbug is on the loose

Percussive maintenance - the sharp tap/bang which cures faulty equipment

Permanent room - as in "He's here so often we should just give him his own room"

Pest control - term applied to psychiatrists by casualty officers

PFH - Parent(s) from Hell (custodians of BFH - Brat From Hell)

PFO - Pissed [Drunk] and Fell Over

PGT - Pissed [Drunk] and Got Thumped

Pharmaceutically Enhanced Personality - stoned or medicated

Pharmaceutically Gifted - admissions with altered mental states as a result of drug use

PHALS - Post-Harmless Accident Lawsuit Syndrome

PHAT - Pretty Hot and Tempting (warning to others)

PHD = Pakistani Healing Dance (a useless procedure performed for benefit of patient and family)

PIA - Pain in the ass

PIAF - PIssed as a fart (also PAAF -Pissed As A Fart)

Pediatron - paediatrician

PID - Pus In 'Dere (PID actually means Pelvic Inflammatory Disease)

PID shuffle - spot diagnosis in A&E (Pelvic Inflammatory Disease)

Pig In A Blanket - Patient (esp an overweight one) in Bed With Fevr

Piles - (at beach resort clinics), sunburn cases: angry, hot and red (better known as lobsters)

Pillow Consult - wanting to smother a difficult patient

Pillow positive - (Wales) patients who are repeated admissions for prolonged periods with no physiological cause of their problems. It is joked they go to hospital with their own pillows ready for admission

Pillow Therapy - describes the urge to smother annoying patient (aggressive euthanasia, tontine treatment).

PIMBA - (Brazil) swollen-footed, drunk, run-over beggar ("Pé Inchado Mulambo Bêbado Atropelado")

Pineboxatosis - collection of conditions which lead to transfer to the ECU, usually accompanied by PBTB with positive Q-sign or O-sign

Pink puffer - patient breathing rapidly due to lung disease

Pinky Cheater - Latex finger cover used in gynecological and proctological examinations.

Pit - the emergency room

PITA - Pain in the ass

Pitiático - (Brazil) patients feigning illness.

Plank Positive - stupid, as in "thick as 2 short planks"

Plano Pafúncio - (Brazil) alleged preferential treatment of relatives of hospital employees.

Player - complaining, irritating patient

Please Consult Us If New (Surgical) Issues Arise - please never page me again

Please Optimize Medical Treatment - don't call us until you've done your job first

PLH - Pray Long and Hard

PLTDP - Practice Limited To Dead People

Plumbii Pendulosus - swinging the lead (malingering) anecdotally used on medical certificates to be presented in Court, esp in Magistrates' Court where the Magistrate is known to the Doctor

Plumboscillation - swinging the lead (malingering)

Plumbum oscillans - Latin for "swinging the lead" (malingering) i.e seeking a sick note to take time off work

Pneumo-cephalic - airhead

PNR - person needed ride i.e. minor ailment but called ambulance instead of taxi

Podo-Oral - Foot in Mouth (i.e. put one's foot in it - rarely used BY senior staff, sometimes used ABOUT them)

Pokemon (pronounced Pokey-man) - the medic who drains abscesses (Lancelot (lance-a-lot) in the UK)

Policeman Lesion - lesion on an X-ray so obvious that a policeman would spot it

Poliesculhambado - (Brazil) multi-f*cked-up patient.

Polybabydaddia - a mother who presents to the ER (Casualty) dept with 8 or 9 kids in tow, most of whom were fathered by a different men

Polydipose Dysfunction - big, fat patient (polydipose being invented plural of adipose [fat])

Pop Drop - granny dumping (dumping elderly relative at Casualty dept)

POPTA - Passed Out Prior To Arrival

Porcelain Level - fictitious blood test ordered to communicate to colleague that the patient is malingering (crock of sh*t)

Porch People, Walmart Greeters - Confused patients sitting in chairs in hall for close observation

PORG - Person Of Restricted/Retarded Growth (dwarf/midget)

Positive Blue Legs Sign - (US) resuscitation behind closed curtains (US ER medics wear blue scrubs)

Positive Gobbler - turkey i.e. faking illness to get out of drill (used by army medics)

Positive Hilton Sign - demanding patient expects Hilton Hotel luxury; indicates patient well enough to leave!

Positive Suitcase Sign - patients who are repeated admissions for prolonged periods with no physiological cause of their problems. They turn up at hospital with packed suitcases ready for admission

Possible This Possible That - consent form in case exploratory surgery

Post-Weekend Fatigue Syndrome - an ailment which presents at GP surgeries on Monday mornings

Pot Plant - person in a Persistant Vegetative State (often used in plural to mean coma ward)

Pox Docs - clap clinic (sexually transmitted disease clinic) doctors

PPP - Piss poor protoplasm

PPP,PPP - Piss-Poor Protoplasm, Probable Placement Problem

PPPPP - piss poor protoplasm poorly put-together (really old and/or decrepit)

PPA - Practicing Professional Alcoholic

PRATFO - Patient Reassured And Told to F*** Off

Pre-Detention Stress Disorder - a person who feigns medical symptoms when police handcuff him

Pre-stiff - terminally comatose patient.

PSLM (Por Si Las Moscas - because of the flies) (South America) - try some medications just in case (on a no-hope case)

Psychoceramics - psycho-geriatrics

Psycode - Code Blue in a psychiatric hospital i.e. patient passing out from the side effects of medication

Pucker Factor - the degree/speed of constriction of the surgeon's anal sphincter is directly proportional to the patient's risk of sudden death

Pumpkin Positive - a penlight shone into the patient's mouth/ear would encounter a brain so small that the whole head would light up

Purple (code purple) - when paramedics are called out to a dead body

Purple Plus - called out to collect a dead body that's started to fester

PVC Challenge - To intubate someone.

PWT - Po' (poor) White Trash (with a condition related to their lifestyle)

Q sign - Patient unconscious/terminal with mouth open and tongue hanging out; "Dotted Q" means flies land on tongue (dead/dying). Reversible Q-sign means you can push the patient's tongue back into the mouth to form the O-sign. Irreversible Q-sign means the tongue keeps falling back out of the mouth after it’s pushed back in (very bad sign)

Q-Tip - Elderly person (white haired old person) (Q-Tip is a cotton bud)

Quackpractor - chiropractor

Qwertyitis - what a doctor suffers from when he spends more time on a computer than with actual patients

QID - Queen in distress (hissy fit)

Rabbit - over-talkative (from slang "Rabbit & Pork - talk)

Radio-I-suppose-otope - imaging agent used in Unclear Medicine (Nuclear Medicine)

Raisin Farm - old person's home, geriatric ward etc (also Raisin Farmer - person who runs old persons' home)

Ralphie McYakkers - young drunks vomiting

Rapid Lead Infusion - obnoxious patient ought to be shot

Rays - radiology dept

RBG - Received by God (a person in receipt of a Celestial Transfer)

RBS - Really Bad Shape

Rear Admiral - proctologist

Rear Admiralty - proctology dept

Rectoencephalitis - head-up-own-ar5e syndrome

Red dot - physicians from India, relates to red dot on their forehead

Red pipe - artery (as opposed to "blue pipe" or vein)

Reeker - smelly patient

Removal men - dept of care of elderly people

Retrospectoscope - instrument of hindsight

Rheumaholiday - rheumatology (considered by hard-pressed juniors to be a less busy dept)

Ringo – (after Beatles drummer Ringo Starr) an expendable team member

Roach - a patient, usually a dirtbag/ingrate, that can't be killed despite near lethal complications of an already serious ailment

ROAD - Dermatologist. Acronym "Retired On Active Duty" Akin to "dermaholiday"

Road Chilli - Unrestrained driver/motorcyclist or passenger, ejected and splattered

Road Map - injuries incurred by going through a car windshield face first.

Road Map Abdomen - scarred from multiple ops (same as Gridiron Belly, Zorro Belly)

Road Pizza - Unrestrained driver/motorcyclist or passenger, ejected and splattered

Road Test - to get a drunk patient to walk up and down a corridor; if they pass they are turfed, if they fail they need a bit longer to sober up.

Roasted Goober - tumour after intensive cobalt treatment.

Rock - a patient that stays on your service forever

Rocket Room - a ward/unit where there are many deaths (many transfers to heaven)

Rocking horse stool - even rarer than hen's teeth

Rooters - indigents and hangers-on who gather in big-city emergency rooms in order to be entertained by legitimate cases.

Rose cottage - mortuary

Rothman's sign - tobacco staining of fingers

Rounding Up The Usual Suspects - Ordering a set of tests for a given set of symptoms

RPVU - Relative Porsche Value Unit: surgical index of potential income from the repair of patient injuries, usually orthopaedic in nature. Fractured finger = a windscreen wiper; a fractured hip = new tyres etc.

RT - Room Temperature (dead)

RTT with a BBB - Rat-a-Tat-Tat with a Baseball Bat (hit with blunt instrument).

Rudy Baga - Patient with terminal brain injury, persistent vegetative state (rutabaga is a vegetable).

Rule of Five - if more than five of the patient's orifices are obscured by tubing, he has no chance

Running Towards the Light - dying

S2 - Sit the f**k down and shut the f**k up

Saddles - Maternity sanitary towels (napkins), so called for their size and the bow-legged effect of wearing them

Samsonite Positive (Positive Samsonite Test) - someone who turns up in emergency with all their luggage (and insists on being admitted to a ward)

San Fran Twist - performing a prostate examination by hooking the index finger in a half-circle upon insertion into the rectum

Sarcoidosis - an actual disease, but a perfectly acceptable answer that may be included in ANY differential diagnosis

SAS - Sick As Sh*t

SBI - Something Bad Inside e.g. undiagnosed cancer/unexpected serious condition found when performing surgery

SBLEO - (pronounced S-B-Leo) Suicide By Law Enforcement Officer

SBOD - Stupid bitch/bastard on drugs

Scepticaemia - chronic condition suffered by two doctors in a debate over which therapy

Scrape and Staple - burns unit

Scratch and sniff - gynaecological examination

Scumdex - 1 pt for every tattoo, extra piercing, IVDU scar, etc. The higher the scumdex, the greater the likelihood of survival. See also TTI

Search and Rescue - Medics allocated to look after the patients dotted in non-medical wards

Sellout - Derogatory term for plastic surgeon in private practice

Sent Over the Hedges - sent to radiology

SEP - Somebody else's problem (not to be confused with sepsis)

September club - the students who have to return after summer holidays for retakes

Serum porcelain - battery of blood tests on an elderly patient

Serum rhubarb - What they test for at tertiary centres

SFS - Stinky Foot Syndrome (often related to homeless)

SF Scale - Sphincter Factor Scale: 1 to 10 scale indicating degree of bowel-loosening in response to an emergency

SHA - Ship His Ass (when patients refuse to be discharged).

SHAD - Syphilitic, Hypochondriac, Alcoholic Degenerate

Shadow gazer - radiologist

Shandy Tap - bloodless lumbar puncture

Shit and Get - to access a trauma patient, say to yourself "Oh Shit!", stabilize and transfer

Sh*ts & Spits - lab tech term for a patient's stool and sputum samples; also the instruction to obtain these samples

Short-Order Chefs - mortuary workers.

Shotgun Labs - to order many lab tests, hoping one will turn up an answer to a puzzling case

Shotgunning - Ordering of a vast array of tests in the hopes that one or other of them will give an idea of what is wrong with a patient

SHPOS - Sub-Human Piece of Sh*t

SHS - Sullen, Hostile, Stupid (often an inner city drug/alcohol addict)

Shy Turd - severe constipation

Sick - Really sick i.e. FTD (Fixing To Die) or CTD (Circling The Drain)

Sidewalk Souffle - (US) suicide-by-jumping

Sieve - a doctor who admits almost every patient he sees

SIG - Stroppy Ignorant Girl

SIG - (certain US regions) self-inflicted gerbil (anecdotal)

Significant History - HIV positive

Silver Bracelet Award - patient is a prisoner brought in wearing cuffs

Silver Goose, Silver Stallion - proctoscope.

Síndrome JEC - (Brazil) terminal patient ("Jesus Está Chamando" = "Jesus is calling").

SIO - Sleeping It Off

Slashers - general surgeons

Slough - a patient inappropriately or unfairly unloaded from one hosptial unit on another

Slow Code (to China) - elderly very ill patient who wants everything done so they will not die. Everyone on the medical team disagrees

Smashola - patient with multiple blunt trauma injuries e.g. from car smash

Smellybridge - area between the anus and the back of the scrotum (perineum)

Smiling Mighty Jesus - (US) spinal meningitis (also Screamin' Mighty Jesus)

Smoke the Anaesthetic Cigar/Smoke the Camel - intubated

Smurf Sign - patient blue or going blue

SNEFS/M SNEFS - Subnormal (or Mentally Subnormal) Even For Suffolk (a rural English county)

Snow - to accidently give a patient too much medication/mixed medication so they go into an altered state of consciousness ("Don't snow that patient with Drug X and Drug Y at the same time!)

Snowed - being in a state of altered consciousness due to too much/mixed medication

SNUD - Sick Nigh Unto Death

SOB, SOB, SOB - Silly Old Bugger/B*stard/Bitch, Sitting Out of Bed/Sitting On Bed, Short Of Breath

SOCMOB - Standing On Corner Minding Own Business (when inexplicably injured)

SODDI - Some Other Doctor Did It (when one medic's botched jobs must be put right/answered for by someone else)

Sofa Surfer - homeless person who sleeps on friends' sofas and floors (ends up at A&E for "3 hots and a cot" when s/he has nowhere else to stay)

Soft Admission - an admission that only a "Sieve" would accept

SOG - Sick Old Guy (male version of LOL (Little Old Lady))

Solomf yoyo - So long, mother-f*****, you're on your own (see "amyoyo syndrome")

Space cadet/Buzz Lightyear - confused patient (dementia or drug-related)

SPAK - Status Post Ass Kicking

Speed bumps - haemorrhoids

Spin the Patient - CT scan

Spots and dots - traditional set of childhood diseases - measles, mumps, and chicken pox

Squash - brain.

Squirrel - eccentric or hypochodriac ("squirrelly") patient who can make life difficult. Found in the phrase "squirrels get sick too" to remind staff that even eccentric patients may have a real medical problem

SRI - Something Wrong Inside (undiagnosable problem)

SSDD - Same Sh*t Different Day (in conjunction with Frequent Flyer)

Stage Mother - person accompanying patient and encouraging patient to exaggerate the complaint (often to obtain a particular diagnosis or to get an unnecessary prescription)

Stamp - skin graft

Status Hispanicus - (US) much like Acute Puerto Rican Syndrome.

Steel Sign - surgical metalwork from previous ops visible on x-ray

St Elsewhere - medical academia's term for any non-teaching hospital

Stem to Stern - throat to pubis incision

Stream team - urology dept

Stupidity Panel - lab test (for patient stupidity) that, when invented, will earns its inventor a fortune (i.e. thick patient)

Sturgeon - surgeon

Sucking The Peace Pipe – intubated

Summer Teeth - some are teeth and some aren't ...

Sunshine - how one addresses an entitled, arrogant patient

Supratentorial - above the falx tentorium/cerebellum i.e. psychosomatic e.g. supratentorial pain

SVRI - Something Very Wrong Inside (usually terminal)

SWAG - Scientific Wild Ass Guess

Sweet Milk/ Mother's Milk - Propofol; a reference to its milky appearance and pain-relieving use

SWI - Something Wrong Inside

SWW - Sick, wet and whiny (infant)

SYB - Save Your Breath (for patients who don't take advice)

Tachylordyosis (with the junctional Jesus) - Usually a middle-aged to older black female American with a complaint of "lordy, lordy, lordy, lordy, lordy, lordy", occasionally with the interspersed "Jesus" i.e. "lordy, lordy, lordy, lordy, Jesus help me, lordy, lordy"

Tachylawdia - as above (variant spelling), but without the "Jesus"

TAPS - Thick As Pig Sh*t

TARFU - Things are really f**cked up

Tash Test - observation suggestive of HIV status (presence of a Freddie Mercury-esque moustache)

TATT (or TAT) - Talks All The Time (also "Tired All The Time")

Tattoo Titre/T&T Sign - indication of patient insanity: more than 5 tattoos indicates likely crazy person

T&T Sign - Tattoo-to-Teeth Sign: survival indicator; those who are tattooed and toothless will survive major injuries

Taint Spot - Perineum: "It ain't this and it ain't that"

Taxidermy Consult - call for a taxidermist's consultation i.e. person about to die

Tax-Sucker - Someone who does not need an ambulance, but calls anyway because it's free

TBC - Total Body Crunch: multiple injuries

TBD - total body dolor i.e. complains of pain everywhere

TBP - Total body pain

TDS - Terminal deceleration syndrome (e.g. RTA death, high-rise syndrome, jump-suicides and parachute-failed-to-open)

TEC - Transfer to Eternal Care i.e. dead

TEETH - Tried Everything Else, Try Homeopathy

Testiculation – (male) consultant holds forth on a subject with expressive hand gestures, but has little knowledge of the subject.

TF BUNDY - Totally f*cked, but unfortunately not dead yet

TFO - Too F*cking Old (person dying of old age).

TFTB - Too Fat To Breathe

Thank You For This Interesting Consult - this is complete b*llsh*t

THC - Three hots and a cot; sought in A&E by the local homeless

The Fish Plant - Gynaecology/Obstetrics Ward (from Newfoundland, where fisheries is the main industry)

The Garden - neurological ICU where the vegetables (coma patients) live

The Promised Land - private practice/final year of medical school

Therapeutic Monitoring - monitoring a patient purely because it makes the doctor feel better.

Thorazine shuffle - the slow, lumbering gait of psychiatric patients dosed up on phenothiazines

Three-toed sloth - patient with diminished capacities, usually from long-term alcoholism

Throckmorton’s Sign - in the unconscious male, the penis points to the injury

TLC - Tube, Lavage & Charcoal (given to poisoning victim)

TLGP -Two Legged Guinea Pig - patient undergoing experimental or extreme treatments

TLR - Two Legged Rat - refers to a patient undergoing experimental or extreme treatments

TMB - Too Many Birthdays: person dying of "old age"

TMI - Three Meaningless Initials (e.g. John Smith, TMI - applied to medics with qualifications rather than ability)

Toaster - defibrillator

TOBP - Tired of Being Pregnant (especially patient demanding caesarian)

TOG - Tears of Gratitude

Tontine Treatment - Urge to put pillow over face of irritating patient (Tontine is a leading brand of pillows in Australia, also a type of will)

Tooth to Tattoo Ratio - Visual determination of basic intelligence. A positive ratio (more teeth then tattoos) is generally better than a negative ratio is bad.

Torture Room - Intensive Care Unit (due to invasive tubes and monitors and experimental treatments).

Tough stick - patient whose veins are hard to find when drawing blood

Toxic Confusional State - Confused, usually elderly, person whose problem is due to constipation (toxic build up in body)

Train Wreck / Shipwreck - a person with more hospital visits/diagnoses then they have years of life

Trambiclínica - (Brazil) a clinic staffed by medical students in order to maximise profits ("fraudulent clinic").

Transcranial Lead Therapy - gunshot wound passing through head

Trans-occipital implants - bullet wound to the head

Trauma Gods - Mythological deities whom A&E personnel believe to be the cause of major emergencies

Trauma Handshake - digital rectal examination - every major trauma patient gets one

Trauma Twinkie - ambulance (one of the smaller or European-style ones)

Treat ’n’ street - A&E's term for quick patient turnaround

Trick cyclists - psychiatrists

Trigger Happy - a medic that gives a shot [injection] for everything or patient that used call button excessively.

TRO - Time ran out

Trubufu - (Brazil) African-Brazilian obstetric patient (literally "fat, ugly black woman").

T-sign (UK) - the number of untouched cups of cold tea at a deceased patient's bedside. Used as an indicator of approximate time of death (i.e. the patient died but nobody noticed)

TSL - To Stupid to Live

TSS - Toxic Sock Syndrome (often related to homeless)

TTFO - Told To F*ck Off

TTJ – transfer to Jesus

TTR - (UK) Tea Time Review (a ripping yarn?)

TTOAST - Take Them Out and Shoot Them

TTR - (US) Tattoo-to-Tooth Ratio (Dirtbag Ratio)

TUBE - Totally Unnecessary Breast Examination (might happen to a GLM)

Turf - get rid of patient by referring to another team (see also buffing, sloughing and bouncing)

Turn and Baste - incontinence care (roll and clean up patient after a code brown)

Turtle's Head - in severe constipation where the anus is dilated and a faecal mass is visible (aka "shy turd") - the problem is, it starts to come out and then, like a turtle's head, it goes back in again!

TVTP - Tried Vancomycin, Try Prayer (Vancomycin is anti-MRSA drug – it’s resistant to anything else)

TWA - third world assassins. Slang for the allegedly poor medical care delivered by physicians who went to medical school in foreign countries

Twitch - hypochondriac

Two beers - the number of beers every patient involved in an alcohol-related automobile accident claims to have drunk before the accident

Two Dudes - a patient who was in a fight "Two dudes jumped me for no reason" (implying the patient would have one against one assailant)

Two Stops Short of West Ham - (Psychiatry) Barking mad. Barking is slang for "mad" and also the name of a station; it is 4 stops from West Ham, but the psych slang follows the formula "2 sandwiches short of a picnic", "Tuppence short of a shilling" (simple-minded/nuts) - the deficit is alway 2 items. Severe madness is "Dagenham" i.e. "3 stops beyond Barking".

TWSAM - Trash Will Survive And Multiply

UBI - Unexplained Beer Injury

UDI - Unidentified Drinking Injury

UFO - Unidentified Frozen Object: unidentified dead homeless person in the winter

UGLI – Ugly: a patient (usually a child) who looks a bit odd but has nothing wrong with them ULPP - Unlicensed Pharmaceutical Provider (drug dealer)

Unborn Farts/Retained Farts - abdominal bloating due to trapped wind (gas)

Unclear medicine - nuclear medicine

Unfascinectomy - long slog of a procedure

Unfascinoma - long procedure, now getting longer or a procedure that fascinates specialist diagnosticians, but isn't fascinating surgeons

UNIVAC - Unusually Nasty Infection, Vultures are Circling

UPF - Un-Passed Fart (gaseous distended abdomen)

Urban Outdoorsman - Homeless person

VAC - Vultures are Circling (dying)

Vampires - those who take blood samples, e.g. lab techs (also slang for blood donor service)

VBA - Valuable Breathing Air i.e. what some patients or doctors are wasting

VBT - Very Bad Thing

VD - Veak and Dizzy; older person feeling vaguely unwell and presents at ER at 2am complaining of feeling "weak and dizzy"

Vedgy - a patient requiring intensive care, incapable of movement

Vegetable garden - Coma ward

Velcro - Family or friends accompanying patient everywhere

Veranda - area in front of nurse's station where the porch people sit (see Porch People)

Very Close Veins - varicose veins

Viaggravation - what a doctor gets from a patient who is demanding erectile dysfunction medication on the NHS (not all areas of the UK provide this on NHS)

VOMIT - Victim Of Modern Imaging Technology (i.e. try treating the patient, not the report from radiology; particularly referring to invasive procedures for false positives.

VIP - Very intoxicated person

Virgin Abdomen - patient that has never had abdominal surgery before and therefore has little intra-abdominal scarring

Vitamin A - Ativan

Vitamin D – Diesel (ambulance term). "Give it some Vitamin D" means drive faster

Vitamin H - Haldol; in the case of a drug addict, it means Heroin

Vitamin K - Ketamine. Also called "Special K" (street name)

Vitamin L - Lasix, Levaquin or other familiar drug beginning with L

Vitamin M – Morphine

Vitamin P - Lasix (diuretic) given to stimulate urination (peeing) in post-operative patients; can also mean Prozac

Vitamin V - Valium, Diazepam or any intravenous sedative; in General Practice it is Viagra

Vitamin Z – Zosyn or Zoloft

VOMIT - Victim Of Modern Imaging Technology (i.e. try treating the patient, not the report from radiology; particularly referring to invasive procedures for false positives.

VTMK - Voice To Melt Knickers (the voice deliberately cultivated by some doctors)

WADHAO - weak and dizzy and hurt all over

WAFTAM - ("woff-tam"): Waste Of F***Ing Time And Money

Wall - a doctor who resists admitting patients at all costs

Wallet Biopsy - (US) free medical test performed by hospital insurance department before patient is treated (UK) similar test in private health sector

Walmart Greeters (Porch People) - Confused patients sitting in chairs in hall for close observation

Ward 101 - The source of referrals that fills the recipient with dread. (after Room 101 in George Orwells novel 1984)

Ward X - the morgue

Weed Puller - Obstetrician

White cloud - a on-call doctor who has uneventful call nights. As opposed to a Black Cloud

White Lizard - the white coloured "cocktail" given for stomach problems (Black Lizard is similar "cocktail" but contains activated charcoal)

White Mice - tampons

Wifty - Mildly confused, but seems oriented most of the time Wig picker - therapist or psychologist

Wilkinson's Syndrome - a patient who has slashed their wrists with a razor blade (after a popular brand of razor)

Will Follow From A Distance - will check your lab results, but will never set foot in your room again

William - (UK) chiropedist i.e. William the corn-curer (William the Conqueror)

Win the Game (or Yahtzee) - to discharge all of the patients from your service, so that you have no inpatients (i.e. no ward rounds) next day.

Winner - a patient with very good luck

Witch doctor - specialist in internal medicine

WITPOMS - Why Is This Patient On My Service

WNL - (Ambulance/casualty) Within Normal Limits, but more often interpreted as We Never Looked

WNL - Will Not Listen; patient won't take medical advice

WoGS - Wrath of God Syndrome (visited upon junior medics by more senior staff)

WOMBAT - Waste Of Money, Brains And Time

Woolly jumper - any non-acute physician

Woolworth's Test - (UK anaesthesia) if you can imagine patient shopping in Woolies, it's safe to give a general anaesthetic

WWI - Walking while intoxicated (and fell over)

Wrinkly - geriatric

YAVIS - Young, attractive, verbal, intelligent, successful.

YMRASU - Your Medical Records Are Screwed Up

YOYO - You're on your own; see "amyoyo" and "solomf yoyo" (also message passed from one doctor to another regarding problem/mystifying cases)

Zebra - an unusually strange or unexpected disease (from the saying "When you hear hoofbeats, the smart money is on horses, not zebras")

Zorro belly - (Brazil) patient who has had multiple abdominal surgeries.

Note: Any dept ending in "-ology" is likely to be nicknamed "-holiday" by those working in busier depts.

THE INFORMAL FAECAL HARDNESS SCALE

As used in microbiology depts runs from "Hard as Bullets" (self-explanatory) to "Could go through the Eye of a Needle" (watery, no solids) with appropriate analogies inbetween.

VETERINARY ACRONYMS

Agroceryosis - lack of groceries i.e. owner hasn't been feeding the animal

BDLDLDL big dog, little dog, little dog lost (usually Chihuahuas that try to fight a German Shepherd)

BSBF buy small bags of food (almost dead)

CFT - chronic food toxicity i.e. obese

CSTO - Cat Smarter Than Owner

DIC - dead in cage or death is coming (technically, it means Disseminated Intravascular Coagulation, which is just as lethal)

DSTO - Dog Smarter Than Owner

HBC - hit by car

HBO – hit by owner

PU - paws up (dead)

ROBO – run over by owner

SBI - something bad inside (undiagnosed cancer etc discovered during surgery) A number of the human ones are also used e.g. TTJ (Transfer to Jesus), Nastioma/Cheerioma (aggressive tumour). CRAP Score - Cynical Real Alternative Pain Score CRAP Score = (OPS+AF) x (SC)x (EC) OPS = 10-point pain score (Old Pain Scale)

AF = Adjustment Factor (see below)

SC = Story Credibility

EC = Exam Credibility For LPT (Low Pain Threshold) patients; calculate CRAP score:

* If the patient reports their pain as being more than 10 on the conventional 10-point pain scale, subtract 1 point for every point over

10. If a patient claims their pain is 12, subtract 2 points and start with an 8.

* For every visit the patient has had to your a&E in the past 12 months claiming a "chronic" or "undiagnosed" painful condition subtract 1 point.

* Every time the patient says "ow" when you push on a non-painful or uninjured area of their body, subtract 1 point.

* For every claimed allergy to a non-narcotic pain relief medication, subtract 1 point.

* If they are wearing sunglasses/wrist-splints/neck-brace/insist on wheelchair/lying down, subtract 1 point.

* If they have tape or ECG lead residue on their body from a prior hospital exam, subtract 2 points.

(Waive the wheelchair/neck-brace penalty is the patient is registered with a disability) For HPT (High Pain Threshold) patients, you add to their reported pain score:

* If a spouse or family member forced them to come in, add 1.

* If patient history shows that every A&E visit for a painful condition related to something torn, broken, ischaemic or perforated, add 2.

* If they have no allergies add 1.

* If they are tachycardic (racing heart) or hypertensive (high blood pressure) add 1.

* If they have visible major injuries they may be in shock and won't feel the true pain till the endorphins wear off Worked example 1

Young guy/gal goes to A&E for the 7th time in the past year for migraine (-6) reporting his headache as 12 on a 10 point scale (-2). He claims to be allergic to 5 over-the-counter pain meds (-5). He has been to A&E 5 times in the past year claiming other painful ailments e.g. back pain, belly pain, but tests found no disease or injury (-5). He is in the examination cubicle eating crisps/choccy and yelling into his mobile phone. He claims his migraine is a killer. When his abdomen is pressed he claims it is tender (-1), but he hadn't noticed due to the migraine being so bad.

CRAP score = (10 -6 -2 -5 -5 -1) x (0.5) x (1) = -4.5.

Even without Story Credibility of 0.5 and Exam Credibility of 1 that's a CRAP score of -9. Worked example 2

Limping guy/gal is taken to A&E by spouse, but reports "fuss about nothing" and pain score of 4. Blood pressure and heartbeat are increased (+1). They've taken a couple of aspirin. Examination finds torn ankle ligaments, probable fractured tarsals plus fluid retention around ankle plus abrasions to forehead and forearms. Patient states s/he fell on icy pavement. Patient history over several years shows 3 previous visits for fractures/torn ligaments/open wounds requiring stitching.

OPS + AF = (4 +1 +1 +2) = 7

Even without a Story Credibility and Exam Credibility, that's a CRAP score of +8 and they've sustained real damage.

WHY SLANG?