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The EMS Provider’s Guide to Southern Medical Terminology

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1 The EMS Provider’s Guide to Southern Medical Terminology
Bryan E. Bledsoe, DO, FACEP Midlothian, Texas

2 Southern Medical Terminology

3 Southern Medical Terminology
“You can be a little ungrammatical if you come from the right part of the country.” - Robert Frost

4 Southern Medical Terminology
“The educated Southerner has no use for an ‘r,’ except at the beginning of a word.” - Mark Twain

5 Southern Medical Terminology
Some things happen in the South that just don’t happen in other parts of the country.

6 Southern Medical Terminology
It is really hard to determine where errant Southern Medical Terminology developed.

7 Southern Medical Terminology
Factors include: High illiteracy rates. Southern language trends. Influence of folk medicine and other belief systems. Religion. Influence of freed slaves and other ethnic groups.

8 Southern Medical Terminology
Abbominable pain = abdominal pain Acid in the blood = a summer rash due to eating too many tomatoes. Actin’ drunk = vertigo Arthuritis = meanest of those “itis” brothers. Athletic seizure = epileptic seizure Augres = violent, shaking chills

9 Southern Medical Terminology
Bad = tendency. (“I’m bad to eat sweets.”) Bad blood = positive syphilis serology. Bate = abate. “The pain bates down.” Bealed = gather matter, come to a head (often in reference to ear infections) Bottom = perineum

10 Southern Medical Terminology
Cadillacs = cataracts Cascade = vomit; also referred to as: Technicolor yawn Yelling at the concrete Hollerin’ for Ralph Wantin’ a Buick Drivin’ the porcelain bus Chicken breath = “she can’t breathe” Chicken Pops = chicken pox


12 Southern Medical Terminology
Clabber = What happens to milk in the stomach. Felt to be significant when seen in vomitus. Clogs = clots (“Dem blood clogs is comin’ down”) Clutter Headache = cluster headache Cold = any unexplained inflammation above the waist (“I got a cold in my shoulder”)

13 Southern Medical Terminology
Courage = potency (also see “nature”) Deathly sick = nauseated Down there = delicate reference to the genitals Drawin’ Spell = hyperventilation with carpopedal spasm. Dropsy = heart failure Evicted = addicted

14 Southern Medical Terminology
Fester = to become infected Fireballs of the Eucharist = fibroids of the uterus Flustrated = Flustered and frustrated all in one. Gape = Gasp (“He had to gape for his breath”)

15 Southern Medical Terminology
Gaulded = Scalded appearance (usually refers to a groin rash) Give out = completely exhausted Goober = penis (often used with prefix “little”) Goozle = throat Goin’ Down = Getting weaker

16 Southern Medical Terminology
Hard attack = heart attack (“He had a couple of hard attacks, but he’ll be OK”) Hark = cough or clear throat Hawk = cough or clear throat, often used with the terms: Loogie Lung Oysters


18 Southern Medical Terminology
High blood = hypertension High hernia = hiatal hernia Hope = help (“That medicine didn’t hope me”) Hunker = squat Hurt = steady discomfort Ill = angry, not sick Infantigo = impetigo

19 Southern Medical Terminology
Itch = scabies Intestinal flu = gastroenteritis Kernals = lymph nodes Leaders = tendons Light heart attack = angina Light stroke = transient ischemic attack Locked bowels = constipation

20 Southern Medical Terminology
Low blood = anemia (“I got high blood and low blood too!”) Matter = accumulated thick secretions Mess = a lot Mighty Internal Fart = myocardial infarction Monthly = menses (“Damn that man, my monthly is late again.”)

21 Southern Medical Terminology
Nature = potency Nerves = any psychiatric disorder Nervous bust-up = nervous breakdown Node = was aware of Null = diminish (“My pain nulled down”) Numbin’ medicine = local anesthetic Octagen = oxygen


23 Southern Medical Terminology
Old Timers Disease = Alzheimer’s disease Old timey flu = true influenza Pain = sharp pain (“There ain’t no pain, just a dead hurt”) Pass wind = flatulence Perireptile risin’ = perirectal abscess Peanut butter balls = phenobarbital Prostrate = prostate


25 Southern Medical Terminology
Persh to death = waste away Piles = hemorrhoids Pity party = feeling bad for self Plumb = completely or truly Poke = sack containing medication (also intercourse) Pone = Smooth, rounded subcutaneous nodule

26 Southern Medical Terminology
Privacies = genitalia Proud = glad (“I’m proud I don’t have cancer”) Regulate my bowels = give something for constipation or diarrhea Rift = belch Right = very (“I am right tired”) Risin’ = small, inflammatory nodule

27 Southern Medical Terminology
Roaches on my liver = cirrhosis of the liver Root Drop = impotence Seeds = testicles Shy kidneys = can’t urinate while watched Sick as hell anemia = sickle cell anemia Sick rag = wet cloth to forehead

28 Southern Medical Terminology
Skim = haziness (“There is a skim over my eyes”) Smilin’ Mighty Jesus = spinal meningitis Sprangles = paresthesias Straddle = crotch Stubborn = constipated Swimmin’ = vertigo

29 Southern Medical Terminology
Technical shot = tetanus shot Terrify = annoy greatly Thick blood = imaginary condition whereby the doctor gives blood thinners Throwing up his toenails = impressive vomiting Trots = diarrhea Tylon = Tylenol

30 Southern Medical Terminology
Vomick = vomit Weak kidneys = incontinent Weasles = measles Wen = sebaceous cyst (usually on head) Whelps = hives Workin’ medicine = laxative Worry = to bother


32 Southern Medical Terminology



35 Redneck Trauma Score Chances of Survival: 0-5 points…………………….30%
Greater than 12 points……..95%

36 Redneck Trauma Score ETOH level: 100-299………..………………….2 pts
300 – more…..……………………4 pts Injured while riding motorcycle: with helmet……………………….1 pt without helmet……………………2 pts Arrives wearing biker shirt…………..1 pt

37 Redneck Trauma Score Patient coming from or going to jail...4 pts
Spouse in jail…………………………. 1 pt Arrives via helicopter between 1:00-5:00 AM…………………………………… 1 pt Known by at least 5 persons in ER… 1 pt Tattoo….…1 point each (maximum 5 pts) If homemade…………….……1 extra pt

38 Redneck Trauma Score Last bath more than 2 weeks ago…..1 pt
Forty pounds or more overweight……1 pt “Bad Back” and must be lifted by staff for all x-rays…………………………….1 pt Beard longer than 2 inches………….1 pt

39 Redneck Trauma Score Known seizure disorder secondary to previous closed head trauma, but doesn’t know the name of medications that he is not taking……………….. 2 pts Routinely “vomicks” two or more times a week………………………………… 1 pt Has two children with the same first name………………………………… 1 pt

40 Redneck Trauma Score Number of abortions – 1 point each (maximum of 3 points) Number of previous episodes of PID or VD -1 point each (maximum of 3 points) Previous suicide attempts…………..1 pt Previously shot or stabbed………….2 pts Allergic to Tylenol, Aspirin, Motrin, or Darvon…………………………….…1 pt

41 Redneck Trauma Score Allergic to Kwell……………………… 1 pt
Drinks more than 2 cases of beer per week………………………………… 1 pt Smokes more than 2 cartons of cigarettes per week……………………………. 1 pt Education less than 10th grade…….. 1 pt Sells blood every other month……… 1 pt

42 Redneck Trauma Score On disability…………………………. 1 pt
Seeking disability…………………… 1 pt Found at scene without shoes or socks and ambient temperature < 30 degrees…………………………….. 1 pt Calls EMS personnel “ambulance drivers”……………………………… 2 pts

43 Redneck Trauma Score Found at scene with stool or urine in shoes………………………………. 1 pt Found at scene with holes or excretions in underwear…………………………. 1 pt Calls a male paramedic “a good looking bitch”………………………………... 1 pt Patient or next of kin is named “Bubba”……………………………… 1 pt


45 Medical Humor - Mark Twain
“Laughter without a tinge of philosophy is but a sneeze of humor. Genuine humor is repeat with wisdom.” - Mark Twain

46 Medical Humor “Humor is mankind’s greatest blessing.” - Mark Twain

47 Medical Jargon “That’s about as clear as the ostomy club swimming pool.” “That ain’t right” Testicles: they do dress a fellow up. “Never let knowledge or reason substitute for dogma.” “Never examine a child who is wearing cowboy boots.” “Never trust a naked baby.”

48 Medical Jargon “All bleeding stops.”
“Don’t let the skin stand between you and the diagnosis.” “The hurtin’ stops when the pain goes away.” “When everything is going right, you’ve done something wrong.” “The three most over rated things in the world: Mayo Clinic, the US Postal Service, and the Seattle Fire Department.” Self-explanatory Said often to internists What to tell patients about pain.

49 Medical Jargon “Crimson Tide” = menstrual period
“Dropping the roses” = menstrual period “Two Beers” = always the answer to, “How much did you have to drink?” “Some Dude” = always the answer to “Who stabbed you?” “He looks like a Baptist to me” = unconscious Jehovah’s Witness who needs an emergent transfusion

50 Medical Jargon “A hospital visitor in a three-piece suit carrying a brief case is a lawyer until proven otherwise.” “A patient’s ability to survive illness or major trauma is inversely proportional to his value to society.” “Why are we all here and what does this all mean?” “It’s better to have a positive VDRL than to never have loved at all.” If the patient is well enough to eat his grits, then he is well enough to go home.


52 Medical Jargon “Do not ridicule large people carrying weapons.”
“Car Bite” = automobile accident “Crispy Critter” = burn patient “Crunch” = automobile accident “Pus Butt” = perirectal abscess “Triage tragedy” = what happens when a ruptured AAA is triaged to OB as a term pregnancy.

53 Medical Jargon “Tachylordia” = lordy, lordy, lordy
“Tachylordia with a Junctional Jesus” = lordy, lordy, lordy, Jesus, lordy, lordy, lordy “Trols ‘R Us” = emergency department “Pit” = emergency department Phi Lacka Tacka = fraternity of ED trolls “Tar Baby Cases” = the more you try to get free, the more you get stuck.

54 Medical Jargon “Gomers are like yogurt, you can’t tell when they go bad” “The amount of screaming and hollering is inversely proportional to the severity of the injury.” “Gome” = diminutive of GOMER “Gome from a home” = nursing home patient. “Gome from a home in a come” = unconscious nursing home patient

55 Medical Jargon “GOMER Toter” = non-emergency ambulance
Signs of a dead GOMER: more than 2 days worth of juice glasses still full at bedside Temperature less than 90 degrees Stool velocity = test ordered by interns when working up GOMERs with diarrhea “No mother is ever satisfied with the amount or quality of food her child eats.”

56 Medical Jargon “In the “pit” (ED), if you don’t know what is wrong, keep putting in tubes until someone who does arrives.” “Pone Belly” = acute surgical abdomen “Aye Sign” = found in Latin OB patients where “oh, oh, oh” changes to “aye, aye, aye” when cervical dilation is complete. Status hispanicus = aye, aye, aye


58 Medical Jargon “Shake and Bake” = MVC with trauma and burns
“Death is not always the enemy” “Bug Juice” = antibiotics “Gorrilacillin” = potent antibiotics “Incision of the Blue Cross” = unnecessary surgical procedure “If I had a uterus in me, I’d want them to take it out.”

59 Medical Jargon “If she doesn’t have appendicitis, then she should take down the sign.” “If it takes more than 3 people to hold down a child for a spinal tap, he probably doesn’t need to have it done.” “When in doubt, order the drug on your pen.” “Idiopathic” = the doctor is an idiot, the patient is pathetic.

60 Medical Jargon “You don’t need to run a Chi Square test on common sense.” “Anything not worth doing, is worth not doing well.” “If two things can go wrong, the worst one will happen.” “If good intentions are combined with stupidity, it is impossible to out think them.” “Beware of the paramedic who is great at getting out of trouble.”

61 Medical Jargon “Ohms Law of Hospital Telephones” = the person who answers the phone can never help you. “Smoking the White Owl” = intubated Vagina = most powerful organ in the human body “You’re not the one who is sick, they are; and it’s not your fault.” “In aphasia, swear words go last.”

62 Medical Jargon: “20% of the patients have 80% of the diseases”
“Hemophiliacs are accident-prone.” “Positive lipstick sign” = female patient’s condition improvement marked by sudden interest in appearance “Doc in a Box” = urgent care center “Air Conditioned” = multiple GSWs

63 Medical Jargon “Age/Weight Ratio” = when the age exceeds the weight, it’s going to get bad “Urban outdoorsman” = homeless person 1 tattoo = 1 drunken party 2 tattoos = 2 drunken parties 3 tattoos = 1 sociopath

64 Medical Jargon Motorcycles / Motorcycle Riders:
“ORTA” = orthopedic resident training apparatus “Murder cycle jockey” “Honda hero” “Dead head” “Kawasaki Kamikaze” “Crotch rockets” “Give your son a motorcycle for his last birthday.” “Any motorcycle rider in an accident without a helmet is an organ donor until proven otherwise.”

65 Medical Jargon Psychiatric Patients:
“Walnut Storage Disease” = nutty patient “Serum Porcelain Level” = blood test for crocks “Spook” = a sick crock “Ring Sign” = When a patient has more rings on a hand than fingers (usually requires a serum porcelain level) Elevated serum succotash Skewed bean/pea ratio

66 Medical Jargon Psychiatric Patients:
Terminal microdeckia = not playing with a full deck “Elevator doesn’t go to the top floor” “Toys in the attic.” Serum peanut butter level “That patient has only three neurons. One’s infected, one’s infarcted, and the other one is inhibitory.” “Granola Ward”: psych ward; fruits, nuts, & flakes

67 Medical Jargon Obesity: Chronic biscuit abuse Cornbread poisoning
Land whale Dunlops Disease Sea World consult “Scrub dorsal fin TID, routine blow hole care.”

68 Medical Jargon Hysterical Patient Scoring System (10 pts is diagnostic) Golden slippers 3 pts Calls Dr. by first name 3 pts Seductive behavior 4 pts Satin pillow from home 2 pts Multiple drug allergies (1 point per drug) La belle indifference 5 pts

69 Medical Jargon Sick patients:
“He may not have bought the farm, but he made a big down payment.” “Don’t put anything on layaway.” “He’ll have to get better to die.” “Looks like death eating a cracker.” “O Sign” = obtunded, mouth open “Q Sign” = obtunded, mouth open, tongue sticking out “Dotted Q Sign” = obtunded, mouth open, tongue sticking out, fly on tongue

70 Medical Jargon Dying patients: “Hang the black crepe.”
“He’s got buzzards sitting on his shoulder.” “Give them a bottle of whiskey and a short book to read.” “He is about to receive a celestial discharge.” “Subacute dead” “Swarming Sisters Sign” = seen at Catholic hospitals

71 Medical Jargon Dying patients: “Pillow Rounds Needed”
Stat Pathology Consult “Circling the drain” “A-line to wall suction” “Got his skates on.” “His porch lights are getting dim.”


73 Abbreviations ADR = ain’t doing right
ADS due to TMB = acute dying spells due to too many birthdays AGA = acute gravity attack AGMI = ain’t gonna’ make it ALS = advanced lizard slinging AQR = ain’t quite right ART = assuming room temperature AVD = acute Vistaril deficiency

74 Abbreviations BLS = basic lifting service
BOHICA = bend over, here it comes again BSS = bilateral Samsonite syndrome CC = cancel Christmas CCFCP = “coo coo for Cocoa Puffs” CNS-QNS = central nervous system - quantity not sufficient CPR = can’t possibly recover CTS = crazier than sh**

75 Abbreviations D&C = dusting and cleaning DFO = done fell out
DIB = dead in bed DRT = dead right there DVR = Darth Vader respirations DWO = death warmed over DWO = driving while oriental EMD = early morning discovery (woke up dead)

76 Abbreviations FDGB = fall down, go boom FIBD = found in bed dead
FLB = funny looking beat FLK = funny looking kid FLK-GLM = funny looking kid, great looking mom FOF = found on floor FOIC = fell out in church FTD = fixin’ to die (call the florist) FUAB = found under a bridge

77 Abbreviations FUAR = found under a rock
FUBAR = fu**ed up beyond all recognition GOA = gone on arrival GPH = God damns per hour HGD X 3 = he’s gonna die, he’s gonna’ die, he’s gonna’ die HMO = heave mom out HVLT = high-velocity lead therapy

78 Abbreviations LMC = low marble count LOL = little old lady
LOL-NAD = little old lady, no apparent distress OLFDGB = old lady fall down, go boom OTD = out the door PBAB = pine box at bedside PGS = positive grits sign PID = pus in dere.

79 Abbreviations PID = pus** in distress PPP = piss poor protoplasm
QID = queen in distress SAS = sick as sh** SSDD = same sh**, different day SWAG = scientific wild-assed guess SWI-GOK = something’s wrong inside, God only knows SWW = sick, wet and whiney

80 Abbreviations TBC = total body crunch
TDS = terminal deceleration syndrome TID = transient in distress TMB = too many birthdays TOBASH = take out back and shoot in head TOBASH-GHF = take out back and shoot in head-give heparin first

81 Abbreviations TPW = therapeutic pistol whipping TRO = time ran out
TSS = toxic socks syndrome WADAO = weak and dizzy all over WNL = we never looked WWI = walking while intoxicated YOYO = you’re on you’re own


83 Medical Specialties Surgeons (AKA “blades”)
If a surgeon was asked to name the three greatest surgeons, he would be hard pressed to name the other two. “Knife rhymes with life.” “A chance to cut is a chance to cure.” “Nothing heals like stainless steel.” “A surgeon is an internist who can operate.”

84 Medical Specialties Surgeons (AKA “blades”)
“Internists can only shake the Christmas present, surgeons get to open it.” “Cold steel is the best deal.”

85 Medical Specialties Emergency Physicians
“Are you an intern or a real doctor?” “Is you the doctor what’s waitin’ on me?” “We just lost the last patient. Who is next?”

86 Medical Specialties Internists (AKA “fleas”, “swamis”) “Herb doctors”
“The primary function of the internist is to find cases for the surgeon.” “He may have died—but at least his electrolytes were in balance.”

87 Medical Specialties Orthopedists (AKA “Orthopods”)
Orthopedic surgeon: twice as strong as an ox, half as smart. Orthopedic surgeon: smarter than a rock, dumber than a plant Double blind study = 2 orthopedists looking at an ECG Orthopedists point = area near the xiphoid where placing a stethoscope will allow you to hear breath, heart, and bowel sounds.

88 Medical Specialties Orthopedists (AKA “orthopods”)
Orthopedic Law of the Heart = The purpose of the heart is to pump Ancef to the bones. BBMF = standard orthopedic consent form, “bone broke, me fix” Orthopedic ooze = when the blood pulsates through the plaster after the tourniquet is removed.

89 Medical Specialties Radiologists (AKA “electrons” or “rads”)
“Shadow merchants” “Throckmorton’s Sign” = On x-rays, the penis points to the pathology. ”Positive Radiology Sign” = arrows and circles drawn on x-rays

90 Medical Specialties Obstetrician/Gynecologists Vaginicologists
Spreader of old wives tales Tuna boat captains Rule of the OB Clinic = love is blind; and it has no sense of smell 2nd Rule of the OB Clinic = everybody loves somebody

91 Medical Specialties Pediatricians (AKA “pediapods”) Midget medicine
“Give me a pediatrician with testicles, and I’ll kiss his feet.”

92 Medical Specialists Dermatologists
“The monkeys that pick things off of the other monkeys.” “A doctor who tells you in Latin what you told him in English.” Axiom of Dermatology in the ED = if it is dry, wet it; if it is wet, dry it; if you don’t know, use steroids.

93 Medical Specialists Urologists (AKA “plumbers” or “prostatologists”)
The worst shriek you have ever heard = there is a urologist in the ED “Priapism is better than no ‘ism’ at all”

94 Medical Specialists Proctologists (AKA Rear Admirals)
Super duper pooper snoopers “Ride the silver rocket” = proctoscope exam. “Dance with the black stallion” = colonoscope exam Snake pit = endoscopy suite

95 Medical Specialists Neurosurgeons (AKA brain bone cutters)
“There are only two types of neurosurgical patients—those that live and those that die. The Dressing = the only difference between the preop and postop neurosurgical patient. Neuro ICU = vegetable garden

96 The End


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