Commonly used Medical Abbreviations and their Meaning

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Medical/Clinical Laboratory

Medical/Clinical Laboratory

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Abbreviations have a long tradition in medicine and used correctly can assist in the rapid communication of information about a patient. However, since some abbreviations can have multiple meanings, or are only used regularly within one speciality, using them can represent a hazard to the patient if the abbreviation is misinterpreted.

Whilst writing information in full will always be preferred as the best way to avoid ambiguity, it is accepted that they are commonly used in medical communications.

As a means of promoting the accurate transfer of information between professionals and striking a practical balance, this document acts as a list of approved abbreviations which can be used in interagency communications. It will also provide patients with a dictionary of medical abbreviations helping them to understand medical records and correspondence.

The most obvious use of such a directory will be the transfer of information between primary and secondary care. However, it is also useful for writing patient notes to assist trainees, locums and other specialities, or when primary care notes are transferred between practices as patients move.

Abbreviations not included in this document should be written in full in correspondence between agencies.

ABBREVIATIONS MEANING
AAA Abdominal Aortic Aneurysm
ABG Arterial Blood Gas also “Sats”
ACEI Angiotensin Converting Enzyme (ACE) Inhibitor
ACL Anterior Cruciate Ligament
A/E Air Entry to Lungs
A&E Accident and Emergency
AF Atrial Fibrillation
ARB Angiotensin Receptor Blocker
ASD Atrial Septal Defect
AXR Abdominal X-Ray
BCC Basal Cell Carcinoma
BEZ Bendroflumethiazide
BMI Body Mass Index
BNO Bowels Not Opened
BO Bowels Open
BP Blood Pressure
DBP Diastolic Blood Pressure
SBP Systolic Blood Pressure
CABG/S or CAG/S Coronary Artery (Bypass) Graft/Surgery
CCB Calcium Channel Blocker
CFS Chronic Fatigue Syndrome
CHD Coronary Heart Disease
CNS Central Nervous System
C/o Complains of
COAD Chronic Obstructive Airways Disease (COPD preferred)
COCP Combined Oral Contraceptive
COPD Chronic Obstructive Pulmonary Disease
Cr Creatinine
CSU Catheter specimen of urine
CT Computerised Axial Tomography
CTG Cardiotocograph
CVA Cerebrovascular Accident
CVD Cardiovascular Disease
CVS Cardiovascular System
CX or Cx Cervix
CXR Chest X-ray
D&V Diarrhoea and Vomiting
D/H Drug History
DIP, PIP Dorsal/proximal interphalangeal joints
DLE Discoid Lupus Erythematosus
DM Diabetes Mellitus
DNA Did Not Attend
DNAR Do Not Attempt Resuscitation
DVT Deep Vein Thrombosis
DXT Deep X-ray Treatment
ECG Electrocardiograph
EEG Electroencephalogram
ENT Ear, Nose & Throat
EPAU Early Pregnancy Assessment Unit
ESR Erythrocyte Sedimentation Rate
FBC Full Blood Count
FBG Fasting Blood Glucose
F/H or FH Family History
FHH/R Foetal Heart Heard/Regular
FRH Freeman Road Hospital
FROM Full Range of Movement
FTND Full Term Normal Delivery
GCS Glasgow Coma Scale
GI or GIT Gastro Intestinal/Tract
GORD Gastro-Oesophageal Reflux Disease
GUT or GUS Genito Urinary Tract/ System
GUM Genito-Urinary Medicine
Hb Haemoglobin
HI Head Injury
HNPU Has Not Passed Urine
HR Heart Rate
HS Heart Sounds
Ht Height
Hx History (of complaint)
IBD Irritable Bowel Disease
IBS Inflammatory Bowel Syndrome
IGT Impaired Glucose Tolerance
IGTN In Growing Toenail
IMB Intermenstrual Bleeding
IOP Intra-ocular Pressure
IUCD Intra-uterine contraceptive device
IUD Intra-uterine death
IUS Intra-uterine system
IVP Intravenous Pyelogram
Ix Investigations
JVP Jugular Venous Pressure
K+ Potassium
KUB Kidneys, Ureters, Bladder (xray)
LFT Liver Function Test
LIF Left Iliac Fossa
LIH Left Inguinal Hernia
LOC Loss of Consciousness
LN Lymph Node
LP Lumbar puncture
L/R/ IH Left or Right Inguinal Hernia
LSCS Lower (Uterine) Segment Caesarean section
LUQ Left Upper Quadrant
LVDD Left Ventricular Diastolic Dysfunction
LVSD Left Ventricular Systolic Dysfunction
MAU Medical Admissions Unit
MCV Mean Corpuscular Volume
ME Myalgic Encephalomyelitis (Chronic Fatigue Syndrome preferred)
MET/S Metastases
MI Myocardial infarction (NSTEMI or STEMI preferred)
MRI Magnetic Resonance Imaging
MS Multiple Sclerosis (Write in full: Mitral Stenosis)
MSK Musculo-Skeletal System
MSE Mental State Examination
MSU Mid-Stream Urine Sample (for culture and sensitivity)
MTX Methotrexate
Na+ Sodium
NAD Nothing Abnormal Discovered
NBI No Bone Injury
NSTEMI Non ST Elevation Myocardial Infarction
N&V Nausea & Vomiting
OA Osteoarthritis
o.d. Once a Day
O/E On Examination
OGD Oesophago-gastro-duodenoscopy
OGTT Oral Glucose Tolerance Test on At Night (when written next to medication dosing only) om In the Morning (when written next to medication dosing only)
OM Otitis Media
ORIF Open Reduction and Internal Fixation (of fracture)
otc Over the counter (bought medication)
P Pulse
PAD Peripheral Arterial Disease
PCB Post Coital Bleeding
PE Pulmonary Embolism
PERLA Pupils equal and reacting to light and accommodation
PF / PEFR Peak Flow / peak expiratory flow rate
Plt Platelets
PM Post mortem examination
PMB Post menstrual Bleeding
PMH also PHx Previous Medical History
PND Paroxysmal Nocturnal Dyspnoea
PO Per Orim (by mouth)
POP Progesterone Only Pill
PR Per Rectum
PRN As Required
PTCA Percutaneous transluminal coronary angioplasty
PTSD Post-Traumatic Stress Disorder
PU Peptic Ulcer OR Passed urine
PV Per Vagina
PVD Peripheral Vascular Disease
qds (or) qid Four times a day
QEH Queen Elizabeth Hospital
Resp / RR Respiration (Rate)
RA Rheumatoid Arthritis
RDS Respiratory Distress Syndrome
RIF Right Iliac Fossa
RIH Right Inguinal Hernia
R/LIF Right/Left Iliacfossa
RS Respiratory System
RSI Repetitive Strain Injury
RTA Road Traffic Accident (write renal tubular acidosis in full) Note that whilst
Road traffic accident is in common use, RTC is the preferred term.
RTC Road Traffic Crash
RUQ Right Upper Quadrant
RVI Royal Victoria Infirmary
Rx Prescription or Treatment
SBG Serum Blood Glucose
SLR Straight Leg Raising
SMR Submucosal Resection
SOB Short of Breath
SR Sinus rhythm
SRH Sunderland Royal Hospital
STD Sexually Transmitted Disease
STEMI ST Elevation Myocardial Infarction
STI Sexually Transmitted Infection
SVD Spontaneous Vertex Delivery
Sx Symptoms
SkXR Skull X-ray
T Temperature
TATT Tired all the Time
TB Tuberculosis
TCI To come in-date or fact that a person is due to be admitted to hospital
tds (or) tid Three Times a Day
TFTs Thyroid Function Test
THR Total Hip Replacement
TIA Transient Ischaemic Attack
TKR Total Knee Replacement
TM Tympanic Membrane
TOP (MTOP/STOP) Termination of pregnancy (Medical ~ / Surgical~)
TShR Total Shoulder Replacement
TURP/T Transurethral resection of Prostate / (Bladder) Tumour
UC Ulcerative Colitis
U&Es Urea and Electrolytes
USS Ultra Sound Scan
UTI Urinary Tract Infection
VF Ventricular Fibrillation
VT Ventricular Tachycardia
VTE Venous Thromboembolism
wbc White Blood Cell Count
Wd Ward
Wt Weight

 

NON-PREFERRED ABBREVIATION LIST

Fracture – May be written on hand written discharge letters. However, should not be used within EMIS. (Depending on EMIS settings may display either as # or as £)

AR Ambiguous – could refer to Aortic Regurgitation or Aortic valve replacement. Write in full

AS Ambiguous – could refer to Abdominal System or Aortic Stenosis. Write in full

BS Ambiguous – could refer to Bowel sounds or breathe sounds. Write in full.
Ca Ambiguous – could refer to Carcinoma or calcium. Write in full CCF / CHF / HF Congestive cardiac (heart) failure. Use of more precise LVSD / LVDD is preferred. If diagnosis uncertain, CCF may be used.

ED Ambiguous – could refer to Erectile Dysfunction or Emergency Department. Write in full

GU Ambiguous – could refer to Genito-urinary or Gastric ulcer. Write in full
MI

Ambiguous – could refer to Mitral incompetence or Myocardial infarction.
However, MI in regular use by all specialities, so may be used for
Myocardial Infarction. Ideally write in full or use STEMI or NSTEMI, and write Mitral Incompetence

MS Ambiguous – could refer to Multiple Sclerosis or Mitral Stenosis. However,
MS is widely used by public for Multiple Sclerosis. Therefore, accepted for
use as multiple sclerosis. Mitral stenosis should be written in full. PID Ambiguous. Could refer to Pelvic Inflammatory Disease OR Prolapsed Intervertebral Disc. Write in full

RFT Ambiguous – could refer to Renal (Kidney) Function tests OR Respiratory Function tests. Write in full R / L Right and left should be written in full

STI Ambiguous – could refer to soft tissue injury OR sexually transmitted illness. Use NBI for non-bony injury and STD for sexually transmitted disease.

VE Ambiguous – could refer to vaginal examination or ventricular ectopic. Should be written in full.

UNITS OF MEASURE

km / m / cm / mm kilometre / metre / centimetre / millimetre
kg / g / mg / microg /pg Kilogramme / gramme / milligramme / microgramme / Picogramme.

SOURCE: Coverghana.com.gh

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