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The Ambulance Driver's Perspective
by Kelly Grayson

Top 10 most commonly misinterpreted EMS abbreviations

A social worker may not understand why you called your dyspneic patient an SOB

By Kelly Grayson

While abbreviations and acronyms are a boon to poor spellers and slow writers, invariably one of your cases will get called to court, and some personal injury lawyer will gleefully ask you what ETOH stands for, and how it is spelled. And when you stumble, he'll try to draw nasty parallels between your subpar spelling skills and your patient care.

And for twelve people who are too naive to know how to get out of jury duty, it might even sound plausible.

So, I urge my students and younger partners to adopt the law enforcement officer's approach to documentation; abbreviate nothing, and make sure everything is spelled correctly. Everything the cop writes is, by definition, probably going to wind up in court one day. They have long experience in countering those sneaky lawyer tricks.

Besides, many of the acronyms and abbreviations we use in EMS are unique to our profession. To a cop, CID means "Criminal Investigation Division," whereas an EMT would say it means "Cervical Immobilization Device." A social worker may not understand why you called your dyspneic patient an SOB.

Heck, abbreviations aren't even universally recognized between members of the same crew. I've watched enough of my partners over the years to know what they really mean when they abbreviate something, and with that in mind, I've compiled a list of the Top Ten Most Commonly Misinterpreted EMS Abbreviations:


"WNL." Sure, everybody knows that is supposed to mean "Within Normal Limits." But if you've worked with the same kind of people I have, it means "We Never Looked."

"EMT." The US Department of Transportation says EMT means "Emergency Medical Technician," but anyone who has ever worked for a transfer service knows that EMT really stands for "Eggcrate Mattress Technician," or "Every Menial Task."

"NKDA." Normally, most healthcare professionals take that to mean "No Known Drug Allergies." But after comparing my patient's history to the reports I sometimes get from first responders, I think it actually means, "Not Known, Didn't Ask."

"IABP." Sure, you critical care medics who have strapped one of the these little babies to the floor of your rig may know it means "Intra-Aortic Balloon Pump," but all it takes is a look at the vital signs on some of the patients it's attached to, and you realize it means, "I Am Barely Perfusing."

"ECMO." While the ICU nurse may tell you that it means "Extra-Corporeal Membrane Oxygenation," given the long-term prognosis of some of these patients, it more likely means "Extra Cash-Making Opportunity," or perhaps, "Even Corpses May Oxygenate."

"EMS." Sure, we know that it means "Emergency Medical Services," but anyone who has ever worked an event standby knows that it means "Earn Money Sleeping."

"LOL2." No, it's not some new form of text-speak. It's LOL Squared, meaning "Little Old Lady, Lying On Linoleum."

"IDDM." Taber's Medical Dictionary defines it as "Insulin Dependent Diabetes Mellitus," but judging from some of my hypoglycemic frequent flyers, it means "I Don't Do Meals."

"BLS and ALS." Sure, they're supposed to mean "Basic Life Support" and "Advanced Life Support," but judging from the way some of my colleagues treat their EMT-B partners, they mean "Basic Lifting Service" and "Ain't Lifting Sh*t."

"DCAP-BTLS." EMT textbooks since 1994 have used that mnemonic to teach students what to look for in a secondary survey; "Deformities, Crepitus/Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations and Swelling…" But any medic who has ever served as a skill station examiner can tell you that many of the exam candidates "Didn't Comprehend Any Part of Basic Trauma Life Support."

Got any misinterpreted EMS abbreviations of your own? Chime in with your comments!

About the author

Kelly Grayson, NREMT-P, CCEMT-P, is a critical care paramedic in Louisiana. He has spent the past 18 years as a field paramedic, critical care transport paramedic, field supervisor and educator. He is a former president of the Louisiana EMS Instructor Society and board member of the LA Association of Nationally Registered EMTs.

He is a frequent EMS conference speaker and contributor to various EMS training texts, and is the author of the popular blog A Day In the Life of an Ambulance Driver. The paperback version of Kelly's book is available at booksellers nationwide. You can follow him on Twitter (@AmboDriver) or Facebook (, or email him at

The comments below are member-generated and do not necessarily reflect the opinions of or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.
Peter Hicklin Peter Hicklin Thursday, June 19, 2014 6:55:30 AM Unfortunately being on a motorcycle and a volunteer , EMS meant to some "Emergency Motorcycle Security" or Emergency Motorcycle Service" as we always got asked to watch the other bikes or for repairs or gas . :-) from Peter former EMS White Knights Medic .
John Bennett John Bennett Thursday, June 19, 2014 7:40:55 AM instead of on our arrival-- WWGT-- when we got there
Linda Gossler Linda Gossler Thursday, June 19, 2014 7:44:15 AM Sob. Someone thought I called them son of a bitch
Josie Cheung Josie Cheung Thursday, June 19, 2014 9:59:56 AM This is really cool I like the LOL squared one :)
John Evans John Evans Thursday, June 19, 2014 2:58:40 PM DRT......dead right there
Randy Miller Randy Miller Friday, June 20, 2014 12:51:08 AM TMB..... too many birthdays
Karyn LeBlanc Trantham Karyn LeBlanc Trantham Friday, June 20, 2014 1:59:25 AM FUBAR-F¥€KED UP BEYOND ALL RECOGNITION
Rob Horn Rob Horn Friday, June 20, 2014 5:50:11 AM ABC's... with those frequent flyers it merely means Another Bullshit Call
Matt Germain Matt Germain Friday, June 20, 2014 8:19:19 AM FTD... fix'en to die
Mark Conner Mark Conner Friday, June 20, 2014 10:21:32 PM CHAOS!: Chief Has Arrived On Scene! ART: Assuming Room Temperature CPR: Chief Presumed Responsible (everyone has a CPR card, kind of like "get out of jail" card)
Mark Conner Mark Conner Friday, June 20, 2014 10:32:58 PM "We arrived to find the patient was ART. Then CHAOS happened. The crew began CPR procedures...."

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