Common ER abbreviations for charting

  1. 0
    Hello, I'm a new grad in the ER and was wondering if any of you could give me common abbreviations used in the ER charting? When charting my initial assessment I feel like I'm spelling everything word for word and it's taking me longer. Any suggestions would be greatly appreciated.
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  3. 13 Comments so far...

  4. 3
    Most hospitals have an approved list of abbreviations. So go to you policy Manuel locate it and print it for your clipboard. That way if you ever need your charting to support your action your documentation will be clear, In a lawsuit they can get that approved abbreviation list or if there is an incident report they will understand your charting.
    Syrenia, Esme12, and simonemesina like this.
  5. 0
    Wctm = will continue to monitor
    NSR - Normal sinus rhythm
    ST - Sinus tachycardia
    RBBB/LBBB - right and left bundle branch block
    PIV - peripheral i.v.
    S/L - saline lock aka heplock
    CP- Chest pain
    Sob - short of breath
    DIB - diff. In breathing
    IVDA - intravenous drug abuse
    NTG SL - nitroglycerin sublingual
    C/O - complains of

    If I think of more I'll post them
  6. 6
    gomer - get out of my er
    tstl - too stupid to live
    ctd - circling the drain
    tntc - too numerous to count (useful when charting a cutter)
    echphm - extra cheese half pepperoni half mushroom
    sk/ft - slip knot into franklin's tower
    Murse901, silverbat, psu_213, and 3 others like this.
  7. 0
    Quote from emtb2rn
    gomer - get out of my er
    tstl - too stupid to live
    ctd - circling the drain
    tntc - too numerous to count (useful when charting a cutter)
    echphm - extra cheese half pepperoni half mushroom
    sk/ft - slip knot into franklin's tower
    Lol i love it, don't know how to use most of em but still love em!
  8. 0
    GOMER is from the book....The house of GOD! They are not approved abbrevations for charting but are used in the lingo with each other.

    YOu might find this interesting.The House of God - Wikipedia, the free encyclopedia
  9. 0
    s/p = status post (I swear, it took me forever to learn this.. I'd always forget what it stood for)
    ETOH = ETOH. Or, alcohol.
    d/t = due to
    r/t = related to
    pt = patient
    gtt = drip
  10. 0
    a&ox4 = alert and oriented to person, place, time and situation
    NAD = no acute distress
    CTA = clear to auscultaion
    +BSx4 = bowel sounds present in all 4 quadrants
    FROMx4 = full range of motion in all 4 extremities
    MAE = moves all extremities
    CR<2 = capillary refill less than 2 seconds
    BKA = below the knee amputation
    AKA = above the knee amputation
    IDDM = insulin dependent diabetes mellitus
    NKDA = no known drug allergies
    PERRLA = Pupils equal round, reactive to light and accomadating
    RAMs intact = capable of rapid alternating movements (neuro)
  11. 0
    CTA also means "catt scan angio" so be sure to check for correct usage of this one.
    BS is used for Bowel sounds or Breath sounds,
    due to the dual meanings of many abbreviations, it may be wisest to follow the first advice
    and check for policy at your facility, seek out a list of their approved abbreviations
    before using ones suggested here. Not all are universal anymore.
  12. 0
    Definitely go with the abbreviation list for your facility. For instance at one facility for which I worked: Rt. was right...had to be capitalized and have the period. R/T was related to...capitalized with the slash. RT (again, capitalized) was respiratory therapy. Other places I've worked does not have the abbreviation for respiratory therapy.

    Point is, abbreviations need to be precise and they can vary from place to place.


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