New EMS Terms, Rules And Axioms

July 1, 1999
It's summertime! Summertime usually means some fun times and with this column we can have some fun when we explore some of the acronyms, "snigletts" and axioms some creative people have come up with when talking about the delivery of emergency medical care.

Each of us deals with stress in different ways. Many psychologists and sociologists will tell you the reason so many jokes develop after a horrendous tragedy is because it is a coping mechanism. However, we seem to draw the line when the incident is too appalling. Although there were plenty of jokes surrounding the O.J. Simpson murder trial, it appears the nation drew the line with the Oklahoma City bombing and the Columbine High School shootings.

Our primary mission is to save lives. However, there can be a lighter side to the delivery of emergency medical care. Part of that lighter side entails creating new EMS terms, rules and axioms. For example, we all know the acronym "EMS" normally means "Emergency Medical Service." But a deviation of the acronym EMS might mean "Every Marriage Suffers" or "Earn Money Sleeping." Most chief officers will tell you that the last three letters of the word "problems" are "EMS."

Snigletts is another way humor can be found in the delivery of emergency medical care. For example, you can take two words and combine them to provide an explanation for a situation. If we say someone is "ambudexterous," we are saying that person has the ability hold the face mask with both hands while squeezing the ambubag with an elbow.

There are also axioms which some innovative people have created. For example, there is the "Rule of Carry Down," which says that a patient's weight is directly proportional to the floor he or she lives on - the heavier the person, the higher the floor (and usually without an elevator). The "Second Rule of Carry Down" states that the ability to walk is indirectly proportional to a person's weight and the floor he or she lives on.

The following are some acronyms, snigletts and axioms which I have compiled for this column.

Acronyms

EMS - Eat More Sandwiches.
ABCs - Ambulate Before Carry; Airway, Breathing, Chopper; Ambulance Before Cops.
BLS - Band-Aids, Lights, Siren; Barely Life Support.
CHAOS - Chief Has Arrived On Scene.
VIP - Very Intoxicated Person.
EMT - Extraordinary Masochistic Tendencies; Every Menial Task.
TWA - Traveling With Angels.
MARP - Mind-Altering Recreational Pharmaceuticals.
ALS - Absolute Loss of Sense

Snigletts

Code Surfing - Riding the stretcher into the emergency room while performing CPR.
Slide Ride - What happens when your partner slips and you ride the 300-pound patient down the stairs holding the top of the stretcher.
Wailenyelps - Exciting new noises created by holding the siren down between clicks.
Wildcatting - Repeated plunging of an IV needle in an attempt to find a vein. (Wildcatting comes from an oil field term for exploratory drilling.)
Acute Traumatic Lead Poisoning - Gunshot victim.
Bug Zapper (or The Welder) - Defibrillator.
Mobiloid - Anyone of any age who is driving and should not be.
Kingsford Cocktail - Activated Charcoal and Sorbitol.
Garage Queen - Any ambulance that spends more time in the shop than on the street.
Stare of Life - Look on a rookie's face on first code or first serious trauma.
Nocturnal Pharmaceutical Transaction - A drug deal.
Positive Samsonite Sign - Victim requests an emergency response and upon arrival is standing at the curb with a suitcase.
Twodude Syndrome - Victim reports minding his own business when two dudes beat him for no apparent reason.
Telexaggeration - A situation in which dispatch information does not match actual patient condition.
Yelpswerve - A sudden, violent, evasive maneuver performed by civilian drivers who have just realized that there is an ambulance behind them.
Kevlodor - The pungent aroma that comes from body armor after several hours of continuous wear, particularly on a hot day.
Levassistants - Helpful bystanders at the scene who attempt to help stretcher into the ambulance, usually upsetting the balance.
Opsculate - To visually measure a patient's vital signs without actually taking them.
Flaffing - Hand motion by drivers stopped at intersection; intended to help responding ambulance through intersection.
Golden Four Minutes - The critical period prior to shift change and your relief has yet to report for duty when calls come in.
Dash Trash - Paperwork, fast-food wrappers and other assorted litter that accumulates on ambulance dashboard.
Frequent Flyer - Any person who constantly calls for an ambulance with no true emergency.
Ecabmuloid - Any person who asks why "AMBULANCE" is spelled backwards on the front of your vehicle.
Ambuslaps - Sharp double blows delivered to the back door of an ambulance, presumably to signal the driver to pull away.
Ambusneak - Shutting down all lights and sirens several blocks away from the emergency.

Axioms

EMS Rule of Threes in a Cardiac Arrest - Greater than 300 pounds, 30 minutes prior to shift change, and three stories up in the building.
Second EMS Rule of Three in a Cardiac Arrest - If you get a call at 3 A.M., the patient will live on the third floor, and weigh at least 300 pounds.
Intoxicated Driver Axiom - The number of beers drunk drivers tell you they drank is directly proportional to the number of six-packs they had. Therefore, if they tell you they only had a couple of beers, multiple by six packs.

Other EMS rules include:

  • The severity of the injury is directly proportional to the difficulty accessing, as well as the weight of the patient.
  • Air goes in and out, blood goes round and round, any variation of that is a bad thing.
  • If the child is quiet, be concerned.
  • Always honor a threat.
  • The patient with the pointed loaded weapon is the incident commander.
  • The address is never clearly marked.
  • The larger the house, the farther from a door the patient will be.
  • If the patient fell and was moved by the family, they will have moved the person so that climbing the stairs is involved.
  • Furniture will always be arranged so that a stretcher or stairchair will not fit easily.
  • Pain never killed anyone.
  • f you respond to an auto accident after midnight and you do not find anyone intoxicated, keeping looking, you've missed a patient.

Remember, this is only humor. The mission we are asked to do every day is a serious one. Thousands of times every day, we are asked to respond without hesitation or prejudice to someone requiring help. I have never heard an engine company or a paramedic company get on the radio and say they are returning to quarters because the call is too hard. Without question, we fulfill our mission. Enjoy your summer!

Gary Ludwig, MS, EMT-P, a Firehouse® contributing editor, is the chief paramedic for the St. Louis Fire Department and is the vice chairman of the EMS Executive Board for the International Association of Fire Chiefs. He holds a master's degree in management and was awarded Missouri's EMS Administrator of the Year for 1998. He can be reached at [email protected].

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