Soundings Soundings

BIBA but LGFTD

BMJ 1999; 319 doi: http://dx.doi.org/10.1136/bmj.319.7222.1445a (Published 27 November 1999) Cite this as: BMJ 1999;319:1445
  1. George Dunea, attending physician
  1. Cook County Hospital, Chicago, USA

    The purist element in most of us dislikes the use of abbreviations. We tend to view them as unsightly, a blot on the language, a sign of laziness or ignorance. We are irritated that only a select few (but others than ourselves) understand what they mean.

    Take AB, a 59yo BM (a non-scatological term) S/P TURP/DES, BBPR, with elevated JVP from CCH (English), or JVD from CHF (American), Dx GOK or NYD. Or Dr William Bean's patient (Tower of Babel 1963), a “45 y.o SCF hsewfe G10 P6A4 c C.C SOB, 4mo PTA. Sn's & Sx's CHF c PND, DOE, & PE. LMD found m's of MS, MI, AS, AI&? IVSD (R/O IASD & PDA). EKG showed LVH, RVH, LAH, RBB, PVC's, AF, old MI….” Despite further w/o and Rx, “on the second day the patient jumped out of the window.”

    Nowadays computer literate residents prefer to write case insensitive histories, such as “49 hisp, fem, hd, sz, htn, sob, cp, ccu, dx esrd, dm, ams, cp, chf, gi obstr.” Some medical journals allow so many abbreviations that their articles cannot be read without constant reference to a glossary.

    Yet long words take a long time to write down, and people have always felt the need to use abbreviations. In the 19th century Jane Austen referred to her novels as P&P, S&S, and MP. A popular system used lower case superscripts, such as informn, communn, or realisan. A recent computer search disclosed 14 994 matches for “medical abbreviations”—lists, glossaries, dictionaries, and even books. Hospital committees periodically publish lists of “approved” abbreviations—largely ignored.

    How much more practical are the stock exchange's, where symbols for MCD (what we eat), BUD (what we drink), MO (what we smoke), or MRK and GLX (drug makers) are official, fixed, and universally recognisable. It is a pity that medicine does not have such a universally agreed system, at least for some commonly used terms. It would eliminate a great deal of confusion and errors, as well as much hd, aggr, and wc (writer's cramp).

    (For the unitiated: BIBA is “brought in by ambulance”; LGFTD—“looks good from the door”; BBPR—“bright blood per rectum”; SP/TUR—“status post-transurethral resection of prostate”; GOK—“God only knows”; NYD—“not yet diagnosed”; hd—“headache”; sz—“seizures”; cp—“chest pain”; ccu—“coronary care unit”; dm—“diabetes mellitus”; etc).

    View Abstract