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The Ambulance Driver's Perspective
by Kelly Grayson

Top 10 words that should be in the EMS dictionary (but aren't)

"Anyone who has ever watched television knows that without Ambuslaps, the EMTs would never know when it's time to take the patient to the hospital."

By Kelly Grayson

"Why is it that the cops and firefighters feel the need to beat on the side of the rig after they close the rear doors?" Rookie Partner asked me the other night. "Do they not see that I'm sitting right there in the driver's seat, watching them in the side mirror? Heck, half the time they do it, I'm still in the back with you!"

"They're called Ambuslaps," I informed him. "Anyone who has ever watched television knows that without Ambuslaps, the EMTs would never know when it's time to take the patient to the hospital."

By the blank look on his face, I could tell he had no idea what I was referring to, so with a brief Google search, I was able to introduce my partner to those wonderful words that should be in Taber's Medical Dictionary, but aren't: EMS Sniglets.

While I was helping my partner broaden his horizons, one thing that struck me was that a great many commonly used EMS Sniglets don't appear on any of the existing lists. So on that note, I give you the top ten words that should be in the EMS dictionary, but aren't:

Incarceritis: A constellation of medical complaints brought upon by the imminent threat of legal confinement. Symptoms include, but are not limited to: dyspnea, chest pain, syncope, seizures, incontinence, and coma. See also stainless steel allergy and post-Miranda syncope.

Malignorance: Combination of the words "malignant" and "ignorance," when ordinary, every day "stupid" doesn't even begin to describe the patient's behavior.

Tachylawdia: Condition in which the patient or family member repeats "Lawdy!" more than 100 times per minute. The condition often presents with PJCs (Premature Jesus Complexes) and, depending upon the patient's religious fervor, intermittent "Amens." Often considered a hallmark sign of status dramaticus.

Example: "The patient exhibited tachylawdia with bigeminal PJCs and intermittent Amens."

Polybabydaddia: Condition affecting females under age 25, who have three or more children by different fathers.

Status dramaticus: Disorder in which the patient exhibits seizure-like activity characterized by the lack of urinary incontinence, presence of coordinated muscle movements, and the absence of an appreciable postictal state.

Patients suffering from status dramaticus usually skip the tonic phase altogether. The condition is often exacerbated by an audience of medical professionals or concerned family members. Usually, the seizure-like activity is broken by the insertion of a nasopharyngeal airway or the phrase, "Hold still, big stick..."

Sub acute status dramaticus may often mimic tachlawdia, and many experts believe they are the same disorder.

Chronic hickory deficiency: Often mistakenly diagnosed as Attention Deficit Hyperactivity Disorder, or more rarely, Oppositional Defiant Disorder. Easily cured by topical application of hickory to the patient's gluteus maximus, PRN. See also chronic leatheremia.

ECU admit: Admit to the Eternal Care Unit; recently deceased patient.

Wallet biopsy: The act of going through an unconscious patient's wallet, looking for identification, Medic Alert information, or insurance cards.

Low marble count: Manifestations of psychosis in the psychiatric patient with therapeutic psychoactive medication levels. See also chronic microdeckia (not playing with a full deck).

Googlechondria: Condition in which patients look up their symptoms on Google before seeking medical assistance.

Example: "I've been having fever, body aches and this weird rash for about a month. I looked it up on Google, and I'm pretty sure I have ebola."

Got any new EMS Sniglets of your own? Let's see 'em in the 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.
Pamela Leonard Pamela Leonard Tuesday, May 20, 2014 6:43:24 AM Cabulance. When you have Medicaid and need a ride to the Dr.
Rui Geraldes Rui Geraldes Tuesday, May 20, 2014 6:55:38 AM Jacobyandmieritis...
John McDonald John McDonald Tuesday, May 20, 2014 6:57:20 AM Insurancitis: a condition that afflicts people involved in motor vehicle accidents, particularly ones involvinga rear end collision with speeds that mimic the movements of a 3 toed sloth. Chief complaints can include "severe" neck and back pain, inability to walk or get out of vehicle. Cures usually include full c-spine immobilization and the threat of the removal of car doors and roofs.
Charles E. Struble Charles E. Struble Tuesday, May 20, 2014 7:01:55 AM D.R.T. (Dead right there)
Kathy Mahar Stephenson Kathy Mahar Stephenson Tuesday, May 20, 2014 7:05:10 AM Comproblem - A bit more than a complaint, but not quite a full blown problem......
Raquel Rocky Digati Raquel Rocky Digati Tuesday, May 20, 2014 7:09:38 AM DFO. Typically diagnosed when you ask a bystander about the events leading up to a reported syncopal episode and they say " I don't know, he was just walking and then he 'done fell out'." Yep, he DFO-ed.
Jason Lyda Jason Lyda Tuesday, May 20, 2014 7:23:04 AM CTD circling the drain
Gary England Gary England Tuesday, May 20, 2014 7:28:49 AM Awww you beat me to it lol!
Mike Jones Mike Jones Tuesday, May 20, 2014 7:42:39 AM Positive Samsonite Syndrome - When pt is standing on curb with suitcase in hand for the cab ride to the hospital.
Hubert Brown Hubert Brown Tuesday, May 20, 2014 7:44:45 AM KMSCPHOBIA Keep My Stuff Covered !
Roselie Winn Roselie Winn Tuesday, May 20, 2014 7:52:58 AM eyerectomy --- severing cord from rectum to eye to reduced crappy outlook on life
Bryon Cox Bryon Cox Tuesday, May 20, 2014 7:54:38 AM ART. Assuming room temperature.
Sharron J Kelly Sharron J Kelly Tuesday, May 20, 2014 8:48:53 AM DRT - Dead Right There, when a patient has begun ART prior to the arrival of all emergency personnel.
Steven Eisenberg Steven Eisenberg Tuesday, May 20, 2014 8:50:12 AM The Ambulance Dance - The frantic waver(s) in the street in front of your scene, and FDGB - Fall Down Go Boom
ChrisJessica Dahlen ChrisJessica Dahlen Tuesday, May 20, 2014 8:52:14 AM at a EMS event, i was talking to a nurse, who just out of high school, worked at my childhood doctor's office. she told me in some pt.'s charts were the letter OGK for cause of illness. she asked another nurse what that stood for. Only God Knows
Jessica Montgomery Jessica Montgomery Tuesday, May 20, 2014 9:06:02 AM Whip cash- when the pt realizes the driver that hit them has insurance
Russell Whitehead Russell Whitehead Tuesday, May 20, 2014 9:25:42 AM Can also be construed as Drown Right There
Chris C. Sanders Chris C. Sanders Tuesday, May 20, 2014 10:13:29 AM Bradyation. The tendency for all things linear (ECG leads, IV tubing, straps, tape etc) to become instantly braided together in transport despite all medic attempts to keep them neat and straight.
Chris C. Sanders Chris C. Sanders Tuesday, May 20, 2014 10:21:45 AM Optirectitis (aka - "OR")- When optic nerves intersect with rectal nerves resulting in crappy outlook on life. Acute OR may be treated with a sure swift kick to the buttocks of the effected individual. Chronic OR requires optiretomy or eyrectomy ( per Rosalie's post below) .
Kathy Curran Kathy Curran Tuesday, May 20, 2014 10:42:13 AM Cerebropeania -a pea-brain.
Jason Esthay Jason Esthay Tuesday, May 20, 2014 10:52:52 AM Bi-Lateral Samsonitis: condition evidenced when the patient meets you at the curb or on the porch with a suitcase, overnight bag, etc. in each hand
Carl Grohs Carl Grohs Tuesday, May 20, 2014 11:16:13 AM Smurfitis: cyanosis
Billy Howell III Billy Howell III Tuesday, May 20, 2014 11:25:23 AM Hangxiety. Bad hangover induced anxiety following a weekend of partying,
Robert E. Goodman Robert E. Goodman Tuesday, May 20, 2014 11:47:06 AM Fabulously funny. My twin brother went from EMT to Paramedic to a Medical Doctor specializing in Emergency Medicine. He could keep me in stitches (pun intended) with his wacky stories and funny phrases.
Libby Collins Libby Collins Tuesday, May 20, 2014 11:48:03 AM This can also be seen occasionally as GOK- God Only Knows
Rick Wyatt Rick Wyatt Tuesday, May 20, 2014 11:52:40 AM Also know as "EMS Calisthenics"
Rick Wyatt Rick Wyatt Tuesday, May 20, 2014 11:54:47 AM TMB Syndrome: Too Many Birthdays. FDGB: Fall Down, Go Boom. The "Smiling Jesus": Spinal Meningitis. ART, DRT already mentioned.
Meghan Shannon Meghan Shannon Tuesday, May 20, 2014 12:16:38 PM I call this "spaghetti syndrome"
Mike Collier Mike Collier Tuesday, May 20, 2014 12:26:13 PM #1 Should be WebMDPhobia
Ronald Allen Schulz Ronald Allen Schulz Tuesday, May 20, 2014 12:32:12 PM clever ... I would have expected that encopresis would have been list right beside enuresis under the category incarceritis
Greg Leeb Greg Leeb Tuesday, May 20, 2014 12:37:09 PM Got two for you: 1) 'Too much drinky' (used as a primary complaint) and 'sidewalk inspector' (person found face down on sidewalk after consuming 'too much drinky')
Linda Munroe-Philbrick Linda Munroe-Philbrick Tuesday, May 20, 2014 12:42:23 PM FTD - Fixing to Die. Celestial Discharge AKA Transfer to the ECU (Eternal Care Unit). Sinkhole - when the pt just kind of melts into the floor. Not a fall, not syncope, just kind of slides down in a puddle like a sinkhole just opened up under him/her.
Robert Farrish Robert Farrish Tuesday, May 20, 2014 1:58:02 PM ODHG, in the context of elderly that faint in church, Overdose of the Holy Ghost
Christi Prentice Wiggins Christi Prentice Wiggins Tuesday, May 20, 2014 3:00:43 PM DFOIC - done fell out in church
Greg Papadatos Greg Papadatos Tuesday, May 20, 2014 3:29:52 PM AllState-itis: see "Insurance-itis", defined below. Incarceritis is also referred to as an allergy to chrome. (Handcuffs are chrome-plated.) Status dramaticus in female patients of Hispanic origin is sometimes called (in a blatant display of political incorrectness) "Satus Hispanicus." I-tach is when a patient indicates distress by screaming "Aye-yi-yi-yi-yi-yi-yi..." very loudly and very rapidly for a period of time so long that their lung capacity is shown to be superlative. (See also "Status Hispanicus.") Don't even get me started on my list of not-yet-authorized abbreviations.
Greg Papadatos Greg Papadatos Tuesday, May 20, 2014 3:31:50 PM Meghan Shannon I have also used that phrase, and experienced that phenomenon.
Matthew Alves Matthew Alves Tuesday, May 20, 2014 4:31:39 PM Yes! Should that not be Medicaid Fraud... not according to Fallon
Tim Crabtree Tim Crabtree Tuesday, May 20, 2014 5:56:20 PM A variation on Ambuslaps - When the person you have been following for five or six miles with lights and sirens a blazin' finally looks up and sees a mirror full of ambulance, they often perform a back-and-forth-across-all-lanes maneuver called an Ambuswerve. Ambuswerves are not evasive maneuvers. They are designed to take up as much asphalt as possible. Like blocking in NASCAR.
Tim Crabtree Tim Crabtree Tuesday, May 20, 2014 5:57:04 PM I have also heard that called Allstatus Hemorrhagicus.
Jennifer Lowery Jennifer Lowery Tuesday, May 20, 2014 6:19:10 PM Squirrel: any type of psych. pt. Tree: any facility that the squirrel is getting admitted to for psych. Help. Landwhale: any pt. Whose weight is beyond stretcher and crews lifting ability.
Jennifer Lowery Jennifer Lowery Tuesday, May 20, 2014 6:32:10 PM Lunch box: aed. Weeble wobble/ nodder: heroine user.
Lisa Constant Lisa Constant Tuesday, May 20, 2014 7:17:18 PM Tachycardia in my neck of the woods is called tachylordy syndrome with a conjuctional Jesus. " oh lordy lordy Jesus lordy help me now" more often seen at Baptist church picnics and urban settings with large family gatherings
Steve Pepper Steve Pepper Tuesday, May 20, 2014 7:24:53 PM ISIMS. I Smell Insurance Money Settlement. when the severity of the patients neck and back pain is inconsistent with the minor scratch on their bumper.....
Chris Cornils Chris Cornils Tuesday, May 20, 2014 7:27:21 PM Bumritto: when you wrap up a foul smelling bug infested urban camper inside of sheets, tarps, emerg blankets or other bedding
Karl Krzuk Karl Krzuk Tuesday, May 20, 2014 7:48:17 PM ICU: Intensive Chair Unit: waiting room
Kevin Cooper Kevin Cooper Tuesday, May 20, 2014 8:07:10 PM Pharmaceutical Aspirant. aka drug seeker.
Jessica Miller Jessica Miller Tuesday, May 20, 2014 8:29:49 PM ODG- overdose of gravity.. When patients fall go boom
Nancy N. Meade Nancy N. Meade Tuesday, May 20, 2014 9:17:13 PM PUHA: Pick UP HAUL ASS!!!!!!! This is used in the even that your patient is going to be DRT (Dead right there) unless you provide prompt diesel therapy!
Emiliano Richards Emiliano Richards Tuesday, May 20, 2014 9:31:46 PM Frequent Flyer Syndrome (otherwise knows as, "I-need-me-a-fix-doc"); symptoms include acute, phantom-like pains which suddenly go away when the patient leaves the ER with a prescription..
Pavel Mohr Pavel Mohr Tuesday, May 20, 2014 10:58:48 PM RDD - Retarded Driver Day. Days where there are multiple stupid people accidents. Usually Tues and Thurs for some reason..
Brandon Desch Brandon Desch Wednesday, May 21, 2014 12:04:32 AM TMB- Too many birthdays Drama Alert The best size up I've heard for a homeless drunk was -"on scene with an overturned urban outdoorsman on a park bench, cancel any other incoming, we can handle"
Janelle Grapes Janelle Grapes Wednesday, May 21, 2014 4:03:17 AM Frequent flyer miles: One that has State Insurance and wants a free ride and nothing wrong with them. Usually a 3am call.
Janelle Grapes Janelle Grapes Wednesday, May 21, 2014 4:06:20 AM "Sick Person", after arrival, find the person dead. OR call was needed upgraded to ALS instead of BLS.
Mark Rudy Mark Rudy Wednesday, May 21, 2014 5:12:12 AM Great list. Scizeten therapy(need for pts who exhibit low cerebral function). Scizenine therapy may be used as substitute for Scizeten.
Pamela Smith-Barrett Pamela Smith-Barrett Wednesday, May 21, 2014 5:42:57 AM DRT dead right there
Danny Molinar Danny Molinar Wednesday, May 21, 2014 10:13:49 AM Should be no age discrimination with 'Polybabydaddia'. Condition is a dx at any child bearing age in pt with SS.
Neil Tackett Neil Tackett Wednesday, May 21, 2014 11:02:37 AM NEPS Syndrome: Especially prevalent around the holidays; the family that has been caring for their elderly relative in their home call with a vague complaint to have said elderly relative transported to the hospital just before guests start arriving for a dinner party, "Not Enough Place Settings Syndrome"
Patrick Gomer Roberson Patrick Gomer Roberson Wednesday, May 21, 2014 11:33:12 AM lackofleatheritis otherwise know as chronic hickory deficiency
Charles David Smith Charles David Smith Wednesday, May 21, 2014 12:05:37 PM Too funny!
Frank Miranda Frank Miranda Wednesday, May 21, 2014 5:49:51 PM Severetotalfecaltoma. Total and utter bullshit
JohnDavid Lomax JohnDavid Lomax Wednesday, May 21, 2014 6:40:35 PM Initiated the PUHA protocol, started a Diesel drip at 75mph...
JohnDavid Lomax JohnDavid Lomax Wednesday, May 21, 2014 6:42:07 PM POBIT. We have a Patient On the Backboard, In Transit.
JohnDavid Lomax JohnDavid Lomax Wednesday, May 21, 2014 6:42:44 PM Remainder of patient exam was WNL. No, not Within Normal Limits, We Never Looked.
Kayla Bevins Kayla Bevins Wednesday, May 21, 2014 6:42:59 PM Homeboy Express (i.e. the GSW dropped off by who knows and left)
Rapscallion McBollox Rapscallion McBollox Wednesday, May 21, 2014 8:02:44 PM ART.... Assuming Room Temp
William Warburton William Warburton Wednesday, May 21, 2014 9:17:19 PM Also the "rule of three's" 3rd floor, 3am and 300 pounds.
Gerry Larrivee Gerry Larrivee Wednesday, May 21, 2014 9:34:18 PM Kirshenbaum Collar - Named in R.I. (70's) for a famous personal injury atty.
Sophia Garey Specht Sophia Garey Specht Thursday, May 22, 2014 1:26:06 AM Allstate-itis. When your pt has complaints from an MVA in which there is no visible damage to the car
Tony Ward Tony Ward Thursday, May 22, 2014 7:36:49 AM I asked a ''pt'' a 81/2 mo pregnant ''lady'' who called ''cuz she was having belly pains'' I had to have been pregnant for 8 months,why is it a emergency now????how did you plan on getting to the hospital ??!?!? she looked at me without even thinking about it and said .....''THATS WHAT I GOT YOU FOR''!!!!!! Here is your sign,...get in da bus.......
Bob Morgan Bob Morgan Monday, May 26, 2014 12:06:51 PM Pt A.R.T. Similar to ecu admit. Assuming room temperature.
John Saffelo John Saffelo Wednesday, August 06, 2014 10:03:51 AM Barium = What you do when CPR fails. Hormone = What happens when you don't pay the hooker. Pt suffering from DRT = Dead Right There
James R Olejarczyk James R Olejarczyk Thursday, September 25, 2014 6:26:13 AM TMJ (Too Much Jesus): when pt. has been sitting at church too long and stands up, experiencing syncope or near-syncope.
James R Olejarczyk James R Olejarczyk Thursday, September 25, 2014 6:29:42 AM Peter Pan Syndrome: When pt. crashes and is not wearing a seat belt and ends up being "pre-extricated for your convenience."
Jim Reginelli Jim Reginelli Thursday, September 25, 2014 6:42:55 AM Demerol deficiency was one a doc one told me for nac seekers
Shannon Edwin Wiles Shannon Edwin Wiles Thursday, September 25, 2014 6:50:31 AM Fell out........ Often referring to the episode of syncope, or any other pseudo loss of consciousness, or in worse cases cardiac arrest.
Scott Bicknell Scott Bicknell Thursday, September 25, 2014 6:57:55 AM The diagnosis of "TMB". Applied to an individual who is at an advanced state of age and not thriving. And yet the will not die. Too Many Birthdays.
Rhonda Coles-Nelson Rhonda Coles-Nelson Thursday, September 25, 2014 7:02:54 AM Bigot!!!!!
Scott Bicknell Scott Bicknell Thursday, September 25, 2014 7:11:12 AM The three O's of a bad driver: Old, Oriental and Ovaries.
Scott Bicknell Scott Bicknell Thursday, September 25, 2014 7:13:39 AM cranial recital inversion - Having ones head up their ass.
David Walton David Walton Thursday, September 25, 2014 7:16:09 AM You forgot; neuro-fecal disorder, drop and flop, woke up dead
John O'Keefe John O'Keefe Thursday, September 25, 2014 7:28:22 AM Liquid Compliance - when an unruly psych transfer is adamantly opposed to transport, and they are given the following (but not limited to) the following encouragements: Ativan, Geodon, Haldol.
Rebecca Bute Rebecca Bute Thursday, September 25, 2014 8:47:58 AM FOS. Full of shit. Constipation, bowel obstructions
Erin Siefert Lewellen Erin Siefert Lewellen Thursday, September 25, 2014 9:10:04 AM Benzodiazepenia: often seen in correlation with tachycardia
Justin ManiacTalkington Justin ManiacTalkington Thursday, September 25, 2014 9:16:46 AM Benchwarmer: a patient with minor flu - like symptoms that calls an ambulance for transport because they have no ride.
Susan Britt Susan Britt Thursday, September 25, 2014 9:45:09 AM "My leg gone green" = Gangrene "They removed my kitten" =kidney
Isabel C Kessler Isabel C Kessler Thursday, September 25, 2014 10:03:55 AM Malingererspasm - a weak, non-productive cough experienced during a phone conversation with your supervisor to call out sick.
Mary Catherine Mary Catherine Thursday, September 25, 2014 10:27:40 AM LOL Squared: Little Old Lady Lying On Linoleum (ground level fall)
Ryan Satterberg Ryan Satterberg Thursday, September 25, 2014 10:58:27 AM Retro bulbar disuria - pain behind the eyeballs upon urination, a symptom which will get you 20 points in the mess with seekers game if you get them to admit they have it.
Mike Isabel Mike Isabel Thursday, September 25, 2014 10:59:05 AM forgot to include FUBAR I don't think I have to write the definition for it though
Joshua-Paul Gardner Joshua-Paul Gardner Thursday, September 25, 2014 2:16:05 PM FITH Syndrome - F#€¥?d In The Head Syndrome FITH BUNDY - F#€¥?d In The Head, But Unfortunately Not Dead Yet
John Hunter John Hunter Thursday, September 25, 2014 2:28:51 PM We had Acute COS (Crock o' Shit), which, all too often, became Chronic COS
Chris Bowen Chris Bowen Thursday, September 25, 2014 2:31:32 PM I'm cracking up because that's the VERY first word that came to my mind!!!
Ger Hartigan Ger Hartigan Thursday, September 25, 2014 3:14:33 PM pfo. pissed fell over.
Kevin Marks Kevin Marks Thursday, September 25, 2014 5:09:29 PM Untangling wires, lines, etc. Despaghetize.... ART Assuming Room Temperature..... PITA Pain In The A**....
Brett Tower Brett Tower Thursday, September 25, 2014 5:57:32 PM CRANIALRECTUMITTIS: commonly known as head up ass. usually found to be the action leading to the MOI in trauma in drunks and adolescent males.
Patrick Dotson Patrick Dotson Thursday, September 25, 2014 7:08:33 PM Nomasalene... 10cc prefilled syringe used to cure associated symptoms of tachlawdia and other similar diagnoses. This solution when given properly post "big stick" can subside most if not all symptoms of pts suffering from FOS.
Sandra Young Sandra Young Thursday, September 25, 2014 8:03:20 PM Bringing in a patient with a high porcelain titer. (Otherwise known as a crock.).
Jason Clatterbuck Jason Clatterbuck Thursday, September 25, 2014 10:11:41 PM SOUTHERN COMFORT= So-Co= NaCl= Sodium Chloride
Betsy King Betsy King Friday, September 26, 2014 12:40:32 AM Benzodiazepenia...multiple causes, but usually ETOH withdrawal without chemical support.
Allison M. Miller Allison M. Miller Friday, September 26, 2014 3:19:53 AM Thespianitis=drama queen

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