Common terms, practices and abbreviation
by BlueBadger 1 Apr 10:49
A few helpful terms and abbreviations for you here. I'll probably add to these as time goes on.
ABG - Arterial Blood Gas - common blood test used to measure exchange of oxygen and carbon dioxide within the body. Generally obtained by sampling direct from an artery in the wrist. Generally more uncomfortable than a standard blood test.
Values of interest are roughly: Blood pH 7.35-7.45
pCO2(carbon dioxide) 4-6
HCO3(sodium bicarbonati) 22-26
Tests generally take about 60 seconds to run and the machines can also test for things like blood glucose, haemoglobin and some electrolytes, although these results aren't as accurate as a full lab test.
If you're interested in how to fully read one, I recommend this:
AF - Atrial Fibrillation. Irregular heart beat. Can be chronic or acute, 'fast' or 'slow'. Treated in a variety of ways
AKI - Acute Kidney Injury(sometimes called acute renal failure). Sudden(as in 'occurs within the past 7 days') loss of kidney function due to damage to the kidneys. Most commonly caused by dehydration, but can happen in response to drugs or illness. Has three 'stages' of severity with 3 being the worst
ANP - Advanced Nurse Practitioner. Have a variety of roles around the place. Are usually able to prescribe as well.
Asytole - one of the rhythms of cardiac arrest. The 'flatline' beloved of films and TV. Contrary to media myth, you don't shock this one(shocks need some kind of electrical activity to work. There is effectively none in asystole). Treated with chest compressions, adrenaline and hope.
Bi Level Postive Airway Pressure - a form of non-invasive ventilation, administered by tight-fitting face mask. Often used on those who are unsuited to mechanical ventilation but used on those that are in an attempt to avoid having to intubate and ventilate. Used to manage a number of respiratory issues but I mostly use it for treating type 2 respiratory failure(discussed down the page).
Cardiac arrest - total loss of cardiac output. Doesn't neccessarily mean your heart has 'stopped'. There may be a rhythm that means the organs cannot perfuse or function, instead of the complete 'stop' of aystole.
Cannula - any tube that can be inserted into the body. For the purposes of this thing, when I say 'cannula' I'm referring to IV cannulas used for administering drugs.
CO2 - Carbon dioxide
Consultant - the most senior doctor or surgeon in a team. Will be an expert practitioner in their specialist field. Hold ultimate responsibility for patients and teaching of junior staff.
CPAP - Continuous Positive Airway Pressurea mode of Non-Invasive Ventilation(NIV) used to treat type 1 Respiratory Failure(discussed down the page). Administered via a tight fitting face mask. Also commonly used treat obstructive sleep apnea. Works by applying constant air pressure to hold open airways and, at higher pressures re-inflate bases of lungs which may have become 'sticky' due to infection or the presence of fluid. Often used on those who are unsuited to mechanical ventilation but used on those that are in an attempt to avoid having to intubate and ventilate.
CRP - C-reactive protein. blood test. An 'inflammatory marker' indicating the presence(or lack of) infection. Rises in the event of infection.
CPR - Cardiopulmonary Resuscitation. Emergency procedure for the event of cardiac arrest.
Critical Care - For the purposes of this thing, Intensive Care. Involves a higher level of monitoring and nurse-to-patient ration than ward-level care. Ward level care patients are generally about 1 nurse to 7 patients, Critical care is 1 nurse to 1 or 2 patients. If someone is sick enough, it's not unknown to go 2 nurses to one patient. Also known as CCS(Critical Care Services), ITU(Intensive Therapy Unit) or ICU(Intensive Care Unit). I generally favour 'ITU'.
ED - Emergency department. A&E. Place for drunks and hypochondriacs to have a day trip out to.
ETT - Endotracheal Tube. Tube passed into the airway to allow mechanical ventilation.
FBC - Full Blood Count - blood test looking at types and numbers of cells in the blood - most common cells and values we're interested in are red blood cells, white blood cells and platelets. The other biggie here is haemoglobin(the main protein resposible for the trasportation of oxygen within the body.
FY1/FY2 - Foundation Year 1/Foundation Year 2. The most common species of junior doctor. They are generally 1-2 years out of medical school and in 'basic training'. Used to be known as 'junior' and 'senior' House Officers(JHO/SHO).
Hb - Haemoglobin - main protein used for the transport of oxygen in the blood. Low levels are usually a sign that you don't have enough blood in you.
Intubation - name of the procedure of inserting an ETT - HAS to be performed by someone 'airway trained', usually an anaesthetist.
Medic Bleep - a phone app used at [redacted] hospital in place of bleepers. It's basically WhatsApp for medical professionals. It has its advantages and disadvantages.
Med Reg - Medical Registar. Bar maybe the porters the hardest-working people in the hospital. Specialists in their own right they are the next generation of consultants and shoulder a lot of the day-to-day decision-making and planning of care. 'Night Med Reg' is usually responsible for every medical patient in the hospital, will see unwell patients that the more junior doctors can't manage, usually 'lead' at cardiac arrests and have a 'clerking' responsibility(that they will usually share with an FY2) for any medical patient admitted to hospital.
NEWS/CREWS score - National Early Warning Score/Chronic Respiratory Early Warning Score. Tool used to help ward staff identify patients at risk of deterioration. Anything more than about 5 is a concern.
For more info, see here:
NIV - Non-Invasive Ventilation. Form of ventilation administered by means of a tight fitting face mask rather than the insertion of an ETT. Comes in two forms - BiPAP and CPAP
O2 - Oxygen
Obs - observations, vital signs.
Outreach Nurse - Me. A senior nurse with a background in acute, emergency or intensive care medicine who works 'on call' to support wards and departments in various ways.
At [redacted] hospital our job is three-fold - 1. Early identification and management of the deteriorating patient 2. Support of the post-ITU patient 3. Other Things. Can be anything from taking bloods, placement of various invasive devices, attending cardiac arrest or giving directions around the building to lost pensioners.
PEA - Pulseless Electrical Activity. Another of the main cardiac arrest 'arrhythmias'. Presents as a normal ECG on a monitor but the activity of the heart, whist organised, is too feeble to actually move any blood. Hence the term. Another rhythm that is called 'non-shockable' because the activity is organised and won't benefit from being 'reset' by a shock. It's treated with adrenaline and chest compressions.
Respiratory Failure - Condition in which you either have not enough O2 or too much CO2 or sometimes both at the same time. Both will kill you, but Type 1(insufficient O2) will kill you a LOT faster than Type 2(excessive CO2). Treated in a variety of ways from simple oxygen therapy to NIV to mechanical ventilation.
Saturations - 'sats' - Oxygen saturation. Quick and simple method of measure oxygen levels in the blood. Done by infrared and measure in percentages. Normal adult reading is 94-98%.
'Site' - At [redacted] hospital, the name for the site co-ordinator. Fancy term for 'night sister'. The senior nurse with ultimate responsibility for patient flow and safety. Probably the busiest person in the hospital at night after the porters and the med reg.
Ventilation - for the purposes of this thing, mechanical ventilation. sometimes abbreviated in notes to 'IPPV'(Invasive Positive Pressure Ventilation). Requires the patient to be intubated and sedated in order to be able to tolerate the ETT.
U&E - Urea and Electrolytes. Blood test measuring kidney function and body chemistry. Typical values we're interested in are Urea and Creatinine(measures of kidney function), potassium and sodium.
VT/VF - Ventricular Tachycardia/Ventricular Fibrillation - the two 'shockable' rhythms in cardiac arrest. Characterised by rapid activity of the heart which may be regular(VT) or irregular(VF)
Both can be reverted into normal rhythms by shocking during CPR
Cardiac arrest rhythms:
Normal values -
Pulse - 60-80 beats/minute
Blood pressure - around 120/80 mm of mercury
Oxygen saturation - 94-98%
Respiratory rate - 12-20 breaths/minute
Urine output - 0.5ml/kg of body weight per hour.