To abbreviate or not abbreviate.

[fortsmithman]

In my dept's office at our local hospital we have a listing with every possible abbreviation that is used in EMS for use on PCRs. At the nurses station in the hospital there are posters that say not to abbreviate but. write down the complete word or phrase. I would like to know if that is similar to pther services/hospitals and which do you prefer.

 

[LucidResq]

I tend to really write things out. I only use abbreviations that are extremely common and well-known.

Unless I'm in dispatch, but that's a whole 'nother story.

 

[abckidsmom]

Since we went to electronic PCRs, I don't abbreviate any more. When space was an issue on the paper PCRs, I abbreviated more.

 

[CAOX3]

I voted not sure, if your service has an accepted list then its fine. I write everything out before I abbreviated everything, I even made up my own (not a smart thing to do) now a couple of courtroom appearences have cured me of that little habit.

Better to go into court recieve your paperwork and be able to read it in its entirety rather then trying to decipher abbreviations.

We now have computers no more problems.

 

[Ewok Jerky]

we have a long list of acceptable abb. (get it?) I try not to use many and also stick to the most common. I never make them up on the fly because I was told if it's not approved my whole tag would not be acceptable as a reliable report of the call. so I mostly write just about everything out.

 

[Shishkabob]

I only abbreviate long words when the abbreviation is known. Screw writing "shortness of breath" when SoB/SOB works and is well known.


However, I typically have no more then 4ish abbreviations in my whole report... I don't do what some do and abbreviate every word I possibly can. Typically only "PERRL / PERL" and "SOB" are the only abbreviations I use.

 

[medicRob]

In my dept's office at our local hospital we have a listing with every possible abbreviation that is used in EMS for use on PCRs. At the nurses station in the hospital there are posters that say not to abbreviate but. write down the complete word or phrase. I would like to know if that is similar to pther services/hospitals and which do you prefer.

I abbreviate in my charting using the appropriate abbreviations where necessary. JCHO has a list of unapproved abbreviations. I have no problem with writing out,

"pt complaining of sob" or "I administered 1 Liter NS TKO".

 

[Epi-do]

Like several others, I only use the most common abbreviations, and write everything else out.

 

[looker]

I abbreviate in my charting using the appropriate abbreviations where necessary. JCHO has a list of unapproved abbreviations. I have no problem with writing out,

"pt complaining of sob" or "I administered 1 Liter NS TKO".

So you're calling your patient SOB?:lol: Yes i know it's shortness of breath but i am sure you got my point.

 

[lightsandsirens5]

SoB is not on the JAHCO list, so as far as I'm concerned, it is a go. I abbreviate a little bit. Pt. SoB. Neuro. lac. abd. Hx. Fx. LOI. EBL. LUQ, LLQ, RUQ, RLQ. IV (duh) IO (again, duh). NS. LR. D50. D5W. TKO/KVO. LOC. GCS. NSR. VF. NSIAD. SPO2. PEEP. C-PAP. NTG. BGL. RBBB. LBBB. WNL. JVD. C-Spine. ETCO2.

Many more.


So my answer would be, if it is approved AND you KNOW EXACTLY what it means, then use it.

 

[medicRob]

:glare:

So you're calling your patient SOB?:lol: Yes i know it's shortness of breath but i am sure you got my point.

I did warn one person here, can't remember who about using SOB on your chart with an elderly patient. Before we went to the Tough books, I was real bad about setting my chart on the patient's stomach while I fooled with the monitor, etc. Let's just say the older gentleman that I was transporting that picked up his chart wasn't too happy when he saw, Patient is SOB. lol.

 

[Hockey]

It takes me more time when typing using abbreviations than spelling out the word

 

[Aprz]

I am not working as an EMT, but I've gotten used to using abbreviations and acronyms when I chart in my class. As I've been told in school, and as you can see on here, use only approved abbreviations or acronyms, or "abbreviate when appropriate", hehe.

 

[llavero]

Like Linuss, I also abbreviate the words when they are known, for example "Tensión Arterial -> TA" (Blood Pressure -> BP)

 

[Hellsbells]

It takes me more time when typing using abbreviations than spelling out the word

Why?

As long as they are recognized by the health authority you for, then go for it. When we used to have paper PCR's I found it nessesary to use them often, in order to have enough space. I still use them on the electronic reports.