Substance abbreviations

OnceAnEMT

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The most common "not-so-good-for-you" substance abbreviation I can think of is ETOH, but I am curious if any of your systems use anything else as well. For instance, THC for marijuana. In the past I've always just written it out if the patient stated it, never thought anything of it until now. Looked in protocol "approved abbreviations" and ETOH was the only one I could find.

So, I am curious, why are others not as common? I've always been under the impression that ETOH is used in front of patients to avoid offending the patient with words like "alcohol" and "drunk", and potentially causing a mood swing that may lead to a physical swing. Or is ETOH just a way to more professionally document your findings? I'm sure the same patient would be just as offended knowing you are giving them up as a heroin or marijuana user in a radio report.

Thanks!
 

RedAirplane

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We are told to use EtOH because 'drunk' would be a diagnosis without going down a differential for altered mental status.
 

Tigger

Dodges Pucks
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I rarely use abbreviations anyway. Some here use MMJ for medical marijuana as it's very common here.
 

cprted

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"Signs of ETOH impairment." I'll use MJ sometimes. Otherwise I write it out. If you think the patient has used recreational drugs, do you ask them? I've never had someone offended that I said they've used 0.3mg of heroin IV if they just told me they shot "3 points of down." Most people who use drugs are pretty open to telling me about it. When I ask I make sure the cops aren't around and I'm non-judgemental about it.
 

NomadicMedic

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We are told to use EtOH because 'drunk' would be a diagnosis without going down a differential for altered mental status.

That'll also get you in trouble unless is worded very specifically, as in "I observed that the patient had slurred speech, difficulty in walking and an odor consistent that that of alcoholic beverages about his person".

But, you better make sure you've had some training that shows you can identify "an odor consistent with that of an alcoholic beverage". A night or two in a bar isn't quantifiable training. :)

As a BLS provider, it's better to leave out any mention of alcohol unless the PT states that he'd been drinking. (...and they ALWAYS say yes when you ask them. I've NEVER had anyone deny it when I say, 'dude, you reek like booze, been drinking?")
 

RedAirplane

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That'll also get you in trouble unless is worded very specifically, as in "I observed that the patient had slurred speech, difficulty in walking and an odor consistent that that of alcoholic beverages about his person".

But, you better make sure you've had some training that shows you can identify "an odor consistent with that of an alcoholic beverage". A night or two in a bar isn't quantifiable training. :)

As a BLS provider, it's better to leave out any mention of alcohol unless the PT states that he'd been drinking. (...and they ALWAYS say yes when you ask them. I've NEVER had anyone deny it when I say, 'dude, you reek like booze, been drinking?")

I typically work special events, so the patient is either holding a can of beer or his friend is doing a poor job of hiding the handle of vodka.
 

RedAirplane

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That'll also get you in trouble unless is worded very specifically, as in "I observed that the patient had slurred speech, difficulty in walking and an odor consistent that that of alcoholic beverages about his person".

But, you better make sure you've had some training that shows you can identify "an odor consistent with that of an alcoholic beverage". A night or two in a bar isn't quantifiable training. :)

As a BLS provider, it's better to leave out any mention of alcohol unless the PT states that he'd been drinking. (...and they ALWAYS say yes when you ask them. I've NEVER had anyone deny it when I say, 'dude, you reek like booze, been drinking?")

Also, I tend to ask "how much alcohol have you drank?" instead of "did you have anything to drink?" It gets more honest answers.
 

Tigger

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Pt demonstrated several signs consistent with clinical intoxication to include slurred speech and an ataxic gait.

Leave the more subjective stuff out unless you can quote the patient or someone else. Or get a PPT.
 

ERDoc

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I think people get way too hung up on this sometimes. When you are reporting your objective findings, you are just reporting what you observe. Saying something as simple as, "pt appears intoxicated" is pretty simple and straightforward. They don't appear normal, and your observations lead you to think that they appear to have some substance affecting them (it doesn't even imply what that substance is). You are not definitively saying, "This person is legally drunk."

As to the OPs question about abbreviations, just remember where some of these abbreviations come from. EtOH is the organic chemistry shorthand with -OH meaning an alcohol and Et for ethyl. I haven't personally used it to hide from a pt, just quicker to write it that way. Same thing for using TCH for marijuana. It's the chemical name, so why would it not be acceptable? It's really not different than writing O2 for oxygen.
 
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