Working in a "distressed urban area" like I did until recently has its unique challenges. People who ignore lights and sirens on the ambulance, people calling for foolish reasons (that's a whole other post), and language barriers. Usually when people say language barrier they mean that people are trying to communicate but they each speak different languages. But in the Great White North, I mean my patients use strange medical phrases and a lovely "language" known as Ebonics. Phrases that new EMTs have never heard of. Phrases that, frankly, boggle the mind.
So, here are the phrases you need to learn to work in EMS in an urban area.
Ammalance: Personally my favorite word. This is how your properly say "That giant box on wheels with the flashy lights that comes when we calls 911". You'll notice that the word Ammalance has no "b" in it. I have actually trained everyone I know to pronounce the word this way. Ammalance, that's what I work on.
Fell out: Ah, the most common. And one of my favorites. Fall out means passed out, lost consciousness or had a syncopal episode. It does not mean they fell out of a car, out of a tree or off a building. And this isn't a slang phrase as best I know. This is honestly the only term some of my patients know to express this idea. I've had people deny passing out but a little further questioning reveals that they definitely "fell out"
I got the sugar: Pretty common and pretty simple to understand. This means that they have diabetes. A little more probing with reveal how compliant they are with meds, how often the check there blood sugar, what type of diabetes, etc. If they say this, taking a blood sugar is never a bad idea.
Worser: I hate this 'word'. It’s like fingernails on a chalkboard, Paris Hilton on the radio or a cheese grater vigorously rubbed against your nipples. Just painful. Worser means the pain is increasing. Frequently it really means that the pain started 4 days ago, the concept of primary care doctor is completely unknown to the patient and right now there's nothing good on TV so they'll call 911 for a ride to the ER. 90% of the time "worser" means low levels of pain and a whinny person.
My ______ is painin' me: The National Grammer Chancellor started sobbing inconsolably when he heard this. This phrase means that a particular area or organ is causing pain/distress/discomfort/annoyance. However, very few people who say this are well versed in basic anatomy. So it's possible that your "heart" is painin' you/you're having a "heart attack" but that the pain is actually in your abdomen. Kidney pain may be felt in your epigastric area and a headache can occur in the groin. You should not just write down what they say on you run report. Ask them to point to the pain and go from there.
10/10 pain or Pains a TEN!!!: Some asshat decided we needed a way to measure pain, a self-reported number. So we have a 0-10 scale, 0 being no pain and 10 being "the worst pain you can possibly imagine".
Let me paint a picture of true 10/10 pain....you're walking down the street, minding your own business, drinking a glass of wholesome milk, when Sumdude shoots you in the knee for no reason. You stagger a little on what remains of your knee and end up wandering into the street, where you are promptly hit by a bus going 40 miles per hour. So now you have 6 broken ribs, broken clavicle, dislocated shoulder, bruised kidney, lacerated liver and spleen, multiple random bruises and lacerations plus the gunshot to the knee. And miraculously your spine is totally intact and you are totally awake and alert and aware of your surroundings. You plead with god for unconsciousness or, failing that, death because the pain is so bad. Then when I roll up in the ammalance, my partner accidentally drops the backboard on your face breaking your nose. You got that mental picture??? Great, that is 10/10 pain. Pain as bad as you can imagine. Pain that makes death seem like a damn fine idea.
I had a 14 year old girl who "may" have mildly twisted her ankle try tell me she had 10/10 pain. After I watched her walk to the hallway and get her shoes for her trip to the ER. The most mild of limps was questionably present. I lost my cool a little bit. A 'discussion' ensued between me and the patient. We ended up calling it 8/10 pain. And when the first thing you say when I walk in the door, while smoking a cigarette, is "Pains a TEN!", that makes me 95% sure that your complaint is BS.
I take peanut butter balls: Um, okay we all like peanut butter balls but I don't know what would make you think they are a medication. Oh wait. You take them for your seizures? Ahhhh, is it possible the doctor meant Phenobarbital?? An old school medication for seizures?? Yes, I did hear this once. You kids will her it less and less since Phenobarbital is being slowly replaced by a variety of better medications with less side effects and less funny names. But yeah, that man with the "shakes" takes peanut butter balls
Part Duex will follow soon.