BODY WATCH : DOCTOR’S ORDERS : Medical Dramas are the hot hits on TV, but understanding them is another story--here’s a translation
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On “ER” and “Chicago Hope,” medical terms are quickly barked and bandied about--and are sometimes incomprehensible to our untrained ears. But thanks to a dose of expert advice from technical consultants, writers from prime-time to daytime soaps know when it’s time to script “Get a blood gas!”
We asked the pros to clue us in on the most-used terms and phrases. Here’s a primer to help you through your next show--or your next real-life emergency room visit.
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“Give me an amp of D 50 and point eight of Narcan.”
The patient was probably found in an “altered mental state” such as a drug overdose. The ampul (vial) of 50% dextrose is given in case of low blood sugar. The .8 milligrams of Narcan is an antidote for heroin and other narcotics. Both are given intravenously.
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“Type and cross six units.”
Draw blood, type it and match the type with six units of the same type from the blood bank for transfusion.
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“Clear!”
This means you should stand clear--particularly away from metallic bed frames and rails--as a medical team prepares to defibrillate, or restore normal heart beat, via brief electric shock. The warning is necessary because there is enough electricity in the defibrillator to damage a person’s heart.
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“Let’s tube ‘im.”
Place an endotracheal tube into the mouth, through the vocal cords and into the trachea or windpipe (the process is called endotracheal intubation). Then a balloon is inflated to make a seal so the patient can be helped to breathe.
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“He’s got a pneumothorax.”
The patient has a collapsed lung.
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“Get the crash cart.”
Get the medical supply cart equipped for patients with cardiac and respiratory arrest.
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“MVA with altered LOC.”
A motor vehicle accident victim with an altered level of consciousness. This could be a concussion (bruise on the brain) or a much more serious condition such as bleeding inside the brain.
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“She’s got bilateral tib-fib fractures.”
Patient has broken both the tibia and the fibula (that would be the leg bones below the knee) on both legs.
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“We have to crack the chest.”
If done in the ER, the physician makes a foot-long incision between two ribs on the left side to gain access to the heart.
If done in the OR, the physician uses a bone saw to cut through the breastbone in preparation for open-heart surgery.
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“Blown pupil on the left.”
Left pupil is abnormally dilated compared to the right. Dilation following a blow to the head is a dangerous sign; it could mean increased intracranial pressure, usually caused by hemorrhage in the brain.
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“Let’s put him on bypass.”
Get ready to put the patient on a heart-lung machine.
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“Let’s put a Foley in him.”
Place a urinary catheter.
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“Put a Swan-Ganz in.”
Insert a catheter through the subclavian vein (below the collarbone) or the internal jugular (in the neck) to assess heart function.
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“She’s got a ruptured aortic aneurysm.”
The main artery that arises from the heart has ruptured.
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“Hang some blood.”
Get ready to transfuse blood.
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“What are his pressures?”
What are the patient’s blood pressures at different sites, including the arteries, the veins and within the chambers of the heart.
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“Get an amp of epi and an amp of atropine.”
Give epinephrine and atropine--two drugs to treat cardiac arrest.
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“Get ‘im prepped for surgery.”
Shave the patient or give him medications to get ready for surgery.
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“He’s tachin’ away at 140. “
The patient has tachycardia, a fast heart rate that in this case is 140 beats per minute. A normal heart rate is 60-100 beats per minute.
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“Get a blood gas.”
Take a blood sample from an artery--usually at the wrist--to compute the blood level of oxygen and carbon dioxide and the pH of the blood.
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“Let’s pit this baby out.”
Administer Pitocin, a hormone given intravenously to stimulate uterine contractions.
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“She PROMed.”
The woman had premature rupture of her membranes. The bag of waters broke too early and the unborn baby is at risk for infection.
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“What’s the Apgar?”
Apgar scores, taken at one minute and five minutes of life, reflect the general health status of a newborn, including how well the baby is moving and breathing and other parameters. Perfect score is 10; many healthy babies score 9.
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“We’ve got a BOA.”
A woman is giving birth in the hospital lobby or in a car, known medically as a birth out of asepsis (or in non-sterile conditions).
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“He’s bleeding out.”
Hemorrhaging is very severe and the patient is bleeding to death.
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“Failure to progress.”
This means the baby is not dropping or the woman’s cervix is not dilating. Depending on the stage of labor, a C-section might be done or a hormone, Pitocin (oxytocin), could be administered.
The Closing Credits
Dr. Joe Sachs: Medical-technical adviser, “ER”; emergency physician, Northridge Hospital Medical Center; UCLA Medical Center clinical faculty.
Nurse Linda Klein: Medical-technical consultant, “Chicago Hope”; registered nurse; former OR nurse.
Nurse Lori Robertson: Medical-technical consultant, “General Hospital”; registered nurse, Presbyterian Intercommunity Hospital, Whittier.
