The EMS Provider’s Guide to Southern Medical Terminology

1. The EMS Provider’s Guide to Southern Medical Terminology Bryan E. Bledsoe, DO, FACEP Midlothian, Texas

2. Southern Medical Terminology

3. Southern Medical Terminology “You can be a little ungrammatical if you come from the right part of the country.” - Robert Frost

4. Southern Medical Terminology “The educated Southerner has no use for an ‘r,’ except at the beginning of a word.” - Mark Twain

5. Southern Medical Terminology Some things happen in the South that just don’t happen in other parts of the country.

6. Southern Medical Terminology It is really hard to determine where errant Southern Medical Terminology developed.

7. Southern Medical Terminology • Factors include: • High illiteracy rates. • Southern language trends. • Influence of folk medicine and other belief systems. • Religion. • Influence of freed slaves and other ethnic groups.

8. Southern Medical Terminology • Abbominable pain = abdominal pain • Acid in the blood = a summer rash due to eating too many tomatoes. • Actin’ drunk = vertigo • Arthuritis = meanest of those “itis” brothers. • Athletic seizure = epileptic seizure • Augres = violent, shaking chills

9. Southern Medical Terminology • Bad = tendency. (“I’m bad to eat sweets.”) • Bad blood = positive syphilis serology. • Bate = abate. “The pain bates down.” • Bealed = gather matter, come to a head (often in reference to ear infections) • Bottom = perineum

10. Southern Medical Terminology • Cadillacs = cataracts • Cascade = vomit; also referred to as: • Technicolor yawn • Yelling at the concrete • Hollerin’ for Ralph • Wantin’ a Buick • Drivin’ the porcelain bus • Chicken breath = “she can’t breathe” • Chicken Pops = chicken pox

12. Southern Medical Terminology • Clabber = What happens to milk in the stomach. Felt to be significant when seen in vomitus. • Clogs = clots (“Dem blood clogs is comin’ down”) • Clutter Headache = cluster headache • Cold = any unexplained inflammation above the waist (“I got a cold in my shoulder”)

13. Southern Medical Terminology • Courage = potency (also see “nature”) • Deathly sick = nauseated • Down there = delicate reference to the genitals • Drawin’ Spell = hyperventilation with carpopedal spasm. • Dropsy = heart failure • Evicted = addicted

14. Southern Medical Terminology • Fester = to become infected • Fireballs of the Eucharist = fibroids of the uterus • Flustrated = Flustered and frustrated all in one. • Gape = Gasp (“He had to gape for his breath”)

15. Southern Medical Terminology • Gaulded = Scalded appearance (usually refers to a groin rash) • Give out = completely exhausted • Goober = penis (often used with prefix “little”) • Goozle = throat • Goin’ Down = Getting weaker

16. Southern Medical Terminology • Hard attack = heart attack (“He had a couple of hard attacks, but he’ll be OK”) • Hark = cough or clear throat • Hawk = cough or clear throat, often used with the terms: • Loogie • Lung Oysters

18. Southern Medical Terminology • High blood = hypertension • High hernia = hiatal hernia • Hope = help (“That medicine didn’t hope me”) • Hunker = squat • Hurt = steady discomfort • Ill = angry, not sick • Infantigo = impetigo

19. Southern Medical Terminology • Itch = scabies • Intestinal flu = gastroenteritis • Kernals = lymph nodes • Leaders = tendons • Light heart attack = angina • Light stroke = transient ischemic attack • Locked bowels = constipation

20. Southern Medical Terminology • Low blood = anemia (“I got high blood and low blood too!”) • Matter = accumulated thick secretions • Mess = a lot • Mighty Internal Fart = myocardial infarction • Monthly = menses (“Damn that man, my monthly is late again.”)

21. Southern Medical Terminology • Nature = potency • Nerves = any psychiatric disorder • Nervous bust-up = nervous breakdown • Node = was aware of • Null = diminish (“My pain nulled down”) • Numbin’ medicine = local anesthetic • Octagen = oxygen

23. Southern Medical Terminology • Old Timers Disease = Alzheimer’s disease • Old timey flu = true influenza • Pain = sharp pain (“There ain’t no pain, just a dead hurt”) • Pass wind = flatulence • Perireptile risin’ = perirectal abscess • Peanut butter balls = phenobarbital • Prostrate = prostate

25. Southern Medical Terminology • Persh to death = waste away • Piles = hemorrhoids • Pity party = feeling bad for self • Plumb = completely or truly • Poke = sack containing medication (also intercourse) • Pone = Smooth, rounded subcutaneous nodule

26. Southern Medical Terminology • Privacies = genitalia • Proud = glad (“I’m proud I don’t have cancer”) • Regulate my bowels = give something for constipation or diarrhea • Rift = belch • Right = very (“I am right tired”) • Risin’ = small, inflammatory nodule

27. Southern Medical Terminology • Roaches on my liver = cirrhosis of the liver • Root Drop = impotence • Seeds = testicles • Shy kidneys = can’t urinate while watched • Sick as hell anemia = sickle cell anemia • Sick rag = wet cloth to forehead

28. Southern Medical Terminology • Skim = haziness (“There is a skim over my eyes”) • Smilin’ Mighty Jesus = spinal meningitis • Sprangles = paresthesias • Straddle = crotch • Stubborn = constipated • Swimmin’ = vertigo

29. Southern Medical Terminology • Technical shot = tetanus shot • Terrify = annoy greatly • Thick blood = imaginary condition whereby the doctor gives blood thinners • Throwing up his toenails = impressive vomiting • Trots = diarrhea • Tylon = Tylenol

30. Southern Medical Terminology • Vomick = vomit • Weak kidneys = incontinent • Weasles = measles • Wen = sebaceous cyst (usually on head) • Whelps = hives • Workin’ medicine = laxative • Worry = to bother

32. Southern Medical Terminology

33. REDNECK TRAUMA SCORE

35. Redneck Trauma Score Chances of Survival: 0-5 points…………………….30% 5-12 points…………………..60% Greater than 12 points……..95%

36. Redneck Trauma Score ETOH level: 100-299………..………………….2 pts 300 – more…..……………………4 pts Injured while riding motorcycle: with helmet……………………….1 pt without helmet……………………2 pts Arrives wearing biker shirt…………..1 pt

37. Redneck Trauma Score Patient coming from or going to jail...4 pts Spouse in jail…………………………. 1 pt Arrives via helicopter between 1:00-5:00 AM…………………………………… 1 pt Known by at least 5 persons in ER… 1 pt Tattoo….…1 point each (maximum 5 pts) If homemade…………….……1 extra pt

38. Redneck Trauma Score Last bath more than 2 weeks ago…..1 pt Forty pounds or more overweight……1 pt “Bad Back” and must be lifted by staff for all x-rays…………………………….1 pt Beard longer than 2 inches………….1 pt

39. Redneck Trauma Score Known seizure disorder secondary to previous closed head trauma, but doesn’t know the name of medications that he is not taking……………….. 2 pts Routinely “vomicks” two or more times a week………………………………… 1 pt Has two children with the same first name………………………………… 1 pt

40. Redneck Trauma Score Number of abortions – 1 point each (maximum of 3 points) Number of previous episodes of PID or VD -1 point each (maximum of 3 points) Previous suicide attempts…………..1 pt Previously shot or stabbed………….2 pts Allergic to Tylenol, Aspirin, Motrin, or Darvon…………………………….…1 pt

41. Redneck Trauma Score Allergic to Kwell……………………… 1 pt Drinks more than 2 cases of beer per week………………………………… 1 pt Smokes more than 2 cartons of cigarettes per week……………………………. 1 pt Education less than 10th grade…….. 1 pt Sells blood every other month……… 1 pt

42. Redneck Trauma Score On disability…………………………. 1 pt Seeking disability…………………… 1 pt Found at scene without shoes or socks and ambient temperature < 30 degrees…………………………….. 1 pt Calls EMS personnel “ambulance drivers”……………………………… 2 pts

43. Redneck Trauma Score Found at scene with stool or urine in shoes………………………………. 1 pt Found at scene with holes or excretions in underwear…………………………. 1 pt Calls a male paramedic “a good looking bitch”………………………………... 1 pt Patient or next of kin is named “Bubba”……………………………… 1 pt

44. END OF PART 1

45. Medical Humor “Laughter without a tinge of philosophy is but a sneeze of humor. Genuine humor is repeat with wisdom.” - Mark Twain

46. Medical Humor “Humor is mankind’s greatest blessing.” - Mark Twain

47. Medical Jargon • “That’s about as clear as the ostomy club swimming pool.” • “That ain’t right” • Testicles: they do dress a fellow up. • “Never let knowledge or reason substitute for dogma.” • “Never examine a child who is wearing cowboy boots.” • “Never trust a naked baby.”

48. Medical Jargon • “All bleeding stops.” • “Don’t let the skin stand between you and the diagnosis.” • “The hurtin’ stops when the pain goes away.” • “When everything is going right, you’ve done something wrong.” • “The three most over rated things in the world: Mayo Clinic, the US Postal Service, and the Seattle Fire Department.”

49. Medical Jargon • “Crimson Tide” = menstrual period • “Dropping the roses” = menstrual period • “Two Beers” = always the answer to, “How much did you have to drink?” • “Some Dude” = always the answer to “Who stabbed you?” • “He looks like a Baptist to me” = unconscious Jehovah’s Witness who needs an emergent transfusion

50. Medical Jargon • “A hospital visitor in a three-piece suit carrying a brief case is a lawyer until proven otherwise.” • “A patient’s ability to survive illness or major trauma is inversely proportional to his value to society.” • “Why are we all here and what does this all mean?” • “It’s better to have a positive VDRL than to never have loved at all.”