Health Service Executive Code of Practice for Healthcare Records Management

Abbreviations
Date: June 2010

This is a controlled document and may be subject to change at any time Version 2.0

ReaDeR InfoRmatIon Directorate: title: Quality & Clinical Care Directorate HSE Code of Practice for Healthcare Records Management

Document Purpose: Publication Date: target audience:

Abbreviations June 2010 All staff in the HSE who work in healthcare records management This section is intended to encourage best practice while assisting healthcare professionals to make effective use of their time, by providing a list of agreed abbreviations, which are approved for use throughout the HSE

Description:

Superseded Docs: Version 1 June 2007 Review Date: Contact Details: June 2012 Winifred Ryan, Quality & Clinical Care Directorate, Health Service Executive. Email: winifred.ryan@hse.ie annmarie.heffernan@hse.ie gay.murphy@hse.ie Web: www.hse.ie

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table of Contents
Page

1. 2. 2.1 2.2 2.3 2.4 2.5 2.6

Rules for abbreviations Drugs and Prescribing Doses Frequency of Administration Days of the Week Time Abbreviations Routes of Administration Prescribing electrolytes and trace elements Interpretation of dose frequency instructions approved abbreviations List for Use in Healthcare Records notation for mobilisations and manipulations

4 7 8 9 10 11 11 12

2.7

13

3.

15

4.

53

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1. Rules for abbreviations

1.1 Abbreviations should be avoided if at all possible, but in the event of abbreviations being utilised, only those approved by the Quality & Clinical Care Directorate and contained within this document are permitted. If an abbreviation is used that is not contained within this document the full term used, followed by the abbreviation in brackets, should be written on each side of each page. All abbreviations must be written in Block Capitals (e.g. MI Myocardial infarction). Contractions can be expressed as a mixture of higher and lower case. Contractions used in this document omit the end of a word and are terminated with a full stop (e.g., Ausc. Auscultation). The following must neVeR be abbreviated. Any decision regarding resuscitation of a patient must always be written in full and signed. A decision of such gravity must never be abbreviated. Drug names must always be written in full and shall never be abbreviated under any circumstances. Right and left must be written in full. The exception to this rule is when right or left is contained within an abbreviation, e.g. LIF left iliac fossa.

1.2

1.3

1.4

never abbreviate decisions regarding resuscitation of a patient

never abbreviate drug names

never use R and L

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+++, < less than and > greater than should be avoided except where they are part of an official grading system (i.e. urinalysis results) never use these symbols +ve and ve

Accepted grading systems should only be used

+ve and ve are not acceptable. These can be abbreviated to Pos. and Neg.

any reference to the service The service user/patients given user/patient must never be name should always be used. abbreviated abbreviations must never be used on a consent form abbreviations must never be used in the completion of incident report forms 1.5 Laboratory tests may be abbreviated on typed reports but only approved abbreviations contained within this document may be hand-written in service user/patient healthcare records. If an abbreviation is used that is not contained within this document the full term used, followed by the abbreviation in brackets, should be written on each side of each page. Abbreviations pre-printed or typed on Health Service Executive documentation (and on computer) can remain unchanged, as they are generally understood. An explanatory footnote added to the document, prior to reprinting, in order to clarify the meaning of typed abbreviations is necessary. To deliver best practice it is essential that all of the abbreviation rules and recommendations apply to electronic clinical information also. With the move within the healthcare service to the development and delivery of integrated Electronic Patient Records, healthcare providers

1.6

1.7

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must endeavour to produce systems, which will contain and produce no abbreviations. In the interim: 1.7.1 Current systems can remain unchanged as they are already approved and agreed locally. 1.7.2 When current systems are upgraded or changed abbreviations must be omitted. 1.7.3 Information printed or shared from current systems must:
l

Contain no abbreviations If they contain abbreviations a footnote must be added that clarifies the meaning of the abbreviations.

1.8

References to referrals or discussions with other health professionals (e.g. doctors, nurses, health and social care professionals) must state their full name; title and bleep number if applicable (e.g. seen by Physio or Surgical IOC is not a substitute for their name). International chemical symbols are acceptable in clinical documentation e.g. Fe Al except in prescriptions and/or medication charts.

1.9

1.10 In designating time in clinical documentation the 24 hour clock must be used. 1.11 No abbreviations to be used in documentation or correspondence which is used for transfer, discharge or external referral letters. 1.12 This document is intended to reduce error and confusion by providing the generally accepted or preferred abbreviations and acronyms that have been approved by the Quality & Clinical Care Directorate.

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2. DRUgS anD PReSCRIbIng

always write clearly when prescribing, using un-joined lower case text, or bLoCK CaPItaLS. Where possible prescribe medications, including intravenous fluids, using approved generic name, where this is not possible the drug name used must be on the local approved list of trade name drugs except in the case of multi-ingredient preparations and modified release formulations when the brand names must be used. note: Always document patient drug allergies or idiosyncratic reactions and refer to documented allergies and reactions before prescribing any drug. Drug names must never be abbreviated under any circumstances

table 1 Checklist when Prescribing

YOuR HANDWRITINg MuST BE CLeaR & LegIbLe

uSINg uN-JOINED LOWER CASE TExT OR BLOCk CAPITALS

Allergies Drug Names Prescribing

Always check and document Never abbreviate drug names use approved (generic) names where possible. Where this is not possible the drug name used must be on the local approved list of trade name drugs.

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2.1

DoSeS

2.1.1 Units The following units may be abbreviated only as follows: table 2 Units approved abbreviation cm g kcal kg L mg mL mm Mmol Unit Centimetre(s) gram kilocalorie kilogram Litre Milligram Millilitre Millimetre Millimole

never abbreviate the following: International units, Micrograms, Nanograms, units e.g. Insulin Actrapid 8 units, Tinzaparin 10,000 International units Never use the unit cubic centimetre, or the abbreviations c.c. or cm3 to denote millilitres, e.g. Vancomycin1g/100ml, Fluconazole suspension 200mg/5ml 2.1.2 Decimal Points
l

Quantities less than 1 gram should be written in milligrams, e.g. 500mg, not 0.5g. When decimals are unavoidable a zero should be written in front of the decimal point where there is no other figure, e.g. 0.5mL. not .5mL The use of the decimal point is only otherwise acceptable to express a range, e.g. 0.5 to 1g

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2.2

fReqUenCy of aDmInIStRatIon
l

Always specify the dose and frequency.

In the case of preparations to be taken as required, always specify the minimum dose interval e.g. Paracetamol tablets 500mg 2 every 6 hours p.r.n. Directions must generally be in english without abbreviations (exceptions listed in Table 2.3)

table 3

acceptable Latin terms and abbreviations english meaning Twice daily In the morning At night When required Four times daily Immediately In the evening Three times daily

Latin terms and abbreviations b.d./b.i.d. Mane Nocte p.r.n. q.d.s./q.i.d. STAT Tarde t.d.s./t.i.d.

In the case of drugs that are being prescribed at particular hourly frequencies, the only acceptable way of writing these are: l 12 hourly or twelve hourly or every 12 hours or every twelve hours l 4 hourly or four hourly or every 4 hours or every four hours No other method of expressing this dosage is acceptable including q12h, 120, q4h, q.q.h., 40 no other abbreviation or Latin term may be used

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The left hand column of Table 2.4 contains abbreviations that should not be used. The correct term is given in the right hand column. table 4 Unacceptable abbreviation Alt Die o.d. q.d. q.q.h q.4.h q.6.h q.12.h m.d.u Ad lib 2.3 DayS of tHe WeeK Correct term (always write in full) On alternate days Once daily Once daily Every four hours Every four hours Every six hours Every twelve hours As directed As much as desired

Days of the week must not be abbreviated but must always be written in full. For drugs to be administered only on specific days of the week then those days must always be written in full. example 1 A Prescription for once weekly Methotrexate must state the drug name, dose and specific weekly day for drug administration, with no abbreviations other than the route, e.g. Methotrexate 2.5mg P.O. once weekly on Wednesdays. A prescription for thrice weekly Erythropoietin Beta must state the drug name, dose and the three specific days per week for drug administration, with no abbreviations other than the route, e.g. Erythropoietin Beta 2,000 units I.V. three times weekly on Monday, Wednesday and Friday.

example 2

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2.4

tIme abbReVIatIonS

The following abbreviations are applicable with regard to time and rates of administration of medicines: table 5 abbreviation h Mins. s 2.5 meaning Hour Minute Second RoUteS of aDmInIStRatIon

The following abbreviations may be used for routes of administration: table 6 abbreviation IV IM Ng PEg PO PV SC PR SL Route Intravenously Intramuscularly Nasogastric Percutaneous Endoscopic gastrostomy Per Oral (i.e. oral by mouth) Per Vaginal Subcutaneously Per Rectum Sublingually

abbreviations may not be used for other routes. Instead write the term in full, e.g. intradermally, intrathecally, intraperitoneally, transdermally.

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2.6

PReSCRIbIng eLeCtRoLyteS & tRaCe eLementS

onLy the following abbreviations for electrolytes are acceptable in prescriptions. table 7 approved abbreviation Ca2+ Mg2+ Na+ k+ CLelectrolyte Calcium Magnesium Sodium Potassium Chloride

The following terms must never be abbreviated in prescriptions: l Acetate l Aluminium l Bicarbonate l Chromium l Copper l Ferric l Ferrous l Fluoride l Iodide l Iron l Lactate l Manganese l Molybdenum l Phosphate l Selenium l Sulphate l Zinc

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2.7

InteRPRetatIon of DoSe fReqUenCy InStRUCtIonS

As the timing of drug administration rounds differs from institution to institution no specific guidance is provided regarding a unified policy on Standard Times for Drug Administration. Each hospital is, however, strongly encouraged to have a specific local policy on Standard Times for Drug Administration. table 8 abbreviation q.d.s./q.i.d. meaning Four times daily, this ideally means every six hours. It is generally impractical to administer any medicine at strictly six hourly intervals, as the service user/patient would have to be awakened. Three times daily, this ideally means every eight hours. Twice daily, this ideally means every twelve hours. For drugs that are prescribed twice daily and are not intended for administration at twelve hourly intervals, the specific instructions must be included on the prescription i.e. Diuretics 1 b.d. The dose must read, as appropriate, 1 in the morning and 1 at lunchtime etc.

t.d.s./t.i.d. b.d./b.i.d.

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abbreviation once Daily

meaning This means every 24 hours. For drugs that are intended for administration at a specific time the prescription must reflect this fact and not be prescribed simply as once daily i.e. diuretics in the morning, hypnotics at night. Care must be taken when a drug is prescribed once daily that the service user/patient will take the drug at the same time each day or else compliance problems can arise. Dietary considerations must be taken into account when drugs are being prescribed/ administered. If drugs are best taken on an empty stomach they must be given at least 30 minutes before the next mealtime. If drugs are best taken with or after meals then they must be given at meal times. It is generally more important that the dietary considerations take precedence over strict adherence to the optimum time of administration.

Drugs and meal times

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3. aPPRoVeD abbReVIatIonS LISt foR USe In HeaLtHCaRe ReCoRDS

misc. abbreviation 5Ds 9HPT a abbreviation A&A AAA AACg AAROM AB ABC Abd. ABg ABI ABO ABPA ABPI Abs. ACBT ACH ACJ ACL ACS ACT AD Add. ADEM Definition Aids and Appliances Abdominal aortic aneurysm Acute angle closure glaucoma Assisted active range of movement/motion Apnoea/Bradycardia Airway breathing circulation Abdominal Arterial blood gas Ankle brachial index Blood group system Allergic broncho pulmonary aspergillosis Ankle brachial pulse index Absorbable Active cycle of breathing technique After coming head Acromioclavicular joint Anterior cruciate ligament Acute coronary syndrome Airway clearance technique Alzheimers Disease Adduction Acute disseminated encephalomyelitis Definition Dizziness, diplopia, drop attacks, dysorthria, dysphagia Nine hole peg test

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abbreviation ADH ADHD ADL Adm. ADOM/N ADOPHN AE AEDF AET AF A. Fib. A. Flutter AFO AFR AFV Ag AgA AI AIDS AIIS Ak AkA AkI Alb. ALIF Alk. Phos. ALL ALR ALT a.m. AMI AML AMP ANA AND Anaes.

Definition Antidiuretic hormone Attention deficit hyperactivity disorder Activities of daily living Admission/admitted Assistant Director of Midwifery/Nursing Assistant Director of Public Health Nursing Air entry Absent end diastolic flow Atrial ectopic tachycardia Artificial feed Atrial fibrillation Atrial flutter Ankle foot orthosis Average flow rate Amniotic fluid volume Abdominal girth Appropriate gestational age Aortic incompetence Acquired immune deficiency syndrome Anterior inferior iliac spine Above knee Above knee amputation Acute kidney injury Albumin Anterior lumbar intervertebral fusion Alkaline Phosphatase Acute lymphoblastic leukaemia Anterior levator resection Alanine amino transferase Morning before twelve Acute myocardial infarction Acute myeloid leukaemia Advanced Midwife Practitioner Antinuclear Antibody Adverse neural dynamics Anaesthetic

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abbreviation ANP Ant. Anti-DVT Ant. Lat. Ant. Tibs. Ao. Ao. arch Ao. root Ao. valve AP AP2 AP4 APD APH Approx. Appt. APRS APTT APTTR AR ARDS ARF ARM ARMD AROM AS ASA ASAP Asc. Ao. ASD ASIS ASL ASR Ass.

Definition Advanced Nurse Practitioner Anterior Anti deep venous thrombosis Anterolateral Anterior tibialis Aorta Aortic arch Aortic root Aortic valve Antero-posterior Apical 2 chamber Apical 4 chamber Automated peritoneal dialysis Ante partum haemorrhage Approximately Appointment Aspiration-penetration rating scale Activated partial thromboplastin time Activated partial thromboplastin time ratio Aortic regurgitation Acute Respiratory Distress Syndrome Acute renal failure Artificial rupture of membranes Age related macular degeneration Active range of movement/motion Aortic stenosis American Society of Anaesthesiologists As soon as possible Ascending aorta Atrial septal defect Anterior superior iliac spine Alternate side-lying Articular surface replacement Assistance

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abbreviation AST ATNR AuC Ausc. AVA AVB AVC Pump Avl. AVM AVNRT AVR AVSD Ax. B abbreviation Ba. Ba. Enema Ba. Meal Ba. Swallow BAWO BBA BBB BBS BC BCg BCL b.d./b.i.d. BEE BF Bg BgL BHCg BHT BHx. BIA

Definition Aspartate amino transferase Assymetric tonic neck reflex Area under the curve Auscultation Aortic valve area Atrioventricular block Anterior venous compression pump Available Arteriovenous malformation Atrio-ventricular nodal re-entry tachycardia Aortic valve replacement Atrioventricular septal defect Assessment

Definition Barium Barium enema Barium meal Barium swallow Bilateral antral washout Born before admission/arrival Bundle branch block Berg balance scale Blood cultures Bacille Calmette-guerin Bandage contact lens Twice daily Basal energy expenditure Breast feed/fed/feeding Blood glucose/blood gases Blood glucose level Beta human chorionic gonadotropins Bucket handle tear Birth history Bioelectrical impedance analyzer

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abbreviation BIBA Bi Dir. Bi Dirg BiPAP Bk BkA BLS BMA BMI BMR BMT BNA BNO BO BOS BP BPD BPM BPP BSA BSO BSS BTL BT Shunt BuN BuPA Bx. C abbreviation C2H5OH C3F8 Ca. CA2+ CABg CAD

Definition Brought in by ambulance Bidirectional Bidirectional glenn Bi-level intermittent positive airway pressure Below knee Below knee amputation Basic life support Bone marrow aspirate Body mass index Basal metabolic rate Bone marrow transplant Borderline nuclear abnormality Bowels not open Bowels opened Base of support Blood pressure Biparietal diameter Beats per minute Bio-physical profile Body surface area Bilateral salpingooophorectomy Blood sugar series Bilateral tubal ligation Blalock-Taussig Shunt Blood urea nitrogen British united Provident Association Biopsy

Definition Alcohol Perfluoropropane Carcinoma Calcium Coronary artery bypass graft Coronary artery disease

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abbreviation CANC CAPD Cap. Refill CAVD CBC CBD CBg CBT C&C cc CCF CCPD CCT CCu CD CDAD C.diff. CEA CEO CF CFAM CFM CgA CHB CHD Chemo CHO Chol. CIN CJD CJRAT Ck CkMB CL CLD CLL

Definition Combined Antenatal care Continuous ambulatory peritoneal dialysis Capillary refill Complete atrioventricular block Capillary blood count Common bile duct Capillary blood gases Cognitive behaviour therapy Collar and cuff Copied to Congestive cardiac failure Continuous cycling peritoneal dialysis Controlled cord traction Coronary Care unit Catheter draining Clostridium difficile associated disease Clostridium difficile Carotid endarterectomy Chief Executive Officer Cystic fibrosis Cerebral function amplitude Cerebral function monitoring Contact guard assistance Complete heart block Coronary heart disease Chemotherapy Carbohydrate Cholesterol Cervical intraepithelial neoplasia Creutzfeldt-Jakob Disease Cubin Jackson risk assessment tool Creatine kinase Creatine kinase isoenzyme Chloride Chronic lung disease Chronic lymphocytic leukaemia

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abbreviation CLO cm CMCJ CML CMM 1,2,3 CMP CMSp. CMV CN CNM 1,2,3 CNS CNSp. CO2 CO COA Coag. Screen COD C of E C of I COLD Conc. Cons. Contd. COPD CORS CP CPAP CPC CPD CPk CPM CPR CRC CrCl CREST CRF

Definition Campbylobacter like organism Centimetre Carpal metacarpal joint Chronic myeloid leukaemia Clinical Midwife Manager 1,2,3 Chondromalacia pattellae Clinical Midwife Specialist Cytomegalovirus Cranial nerves Clinical Nurse Manager 1,2,3 Central nervous system Clinical Nurse Specialist Carbon dioxide Complaining of Coarctation of the Aorta Coagulation screen Change of dressing Church of England Church of Ireland Chronic obstructive lung disease Concentration Consultant Continued Chronic obstructive pulmonary disease Coronary Angiogram Cerebral Palsy Continuous positive airway pressure Clinical Placement CoOrdinator Cephalic pelvic disproportion Creatine phosphokinase Continuous passive movement Cardiopulmonary resuscitation Central Remedial Clinic Creatinine clearance Crest syndrome Chronic renal failure

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abbreviation CRP CRRT C&S CS CSE CSF CSII CSOM CSpine CSu CT CTA CTEV CTg CTR CTS CTSS Cu. CV CVA CVAD CVC CVL CVP CVS CVVH CVVHDF CWMS CWO Cx. CxR

Definition C-Reactive protein Continuous renal replacement therapy Culture and Sensitivity Caesarean section Combined spinal epidural Cerebrospinal fluid Continuous subcutaneous insulin infusion Chronic suppurative otitis media Cervical spine Catheter specimen of urine Computerised tomography Clear to auscultation Congenital talipes equina varus Cardiotocograph Carpel tunnel release Carpal tunnel syndrome Closed tracheal suction system Copper Cardiovascular Cerebrovascular accident Central venous access device Central venous catheter Central venous line Central venous pressure Cardiovascular system Continuous veno-venous haemofiltration Continuous veno-venous haemodiafiltration Colour, warmth, movement, sensation Community Welfare Officer Cervix Chest x-Ray

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D abbreviation DBE D&C Dc. DCIS DCR DDH DDx. DEASk Defib. Dept. Desc. Ao. DExA DF DHS DHx. DI DIC DILV DIPJ Disp. Dka. DL DLBCL DM DNA DOA DOB DOE DOM/N DOPHN DORV DOSS Definition Deep breathing exercises Dilatation and curettage Discharge Ductal carcinoma in situ Dacryocystorhinostomy Developmental dysplasia of the hip Differential diagnosis Descemets stripping endothelial automated keratoplasty Defibrillation Department Descending aorta Dual energy x-ray absortiometry Dorsiflexion Dynamic hip screw Diet history Detrusor instability Disseminated intravascular coagulation Double inlet left ventricle Distal interphalangeal joint Displacement Diabetic ketoacidosis Direct laryngoscopy Diffuse large B Cell lymphoma Diabetes mellitus Did not attend Dead on arrival Date of birth Dyspnoea on exertion Director of Midwifery/Nursing Director of Public Health Nursing Double outlet right ventricle Dysphagia outcome severity scale

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abbreviation DPM DPNS Dr. DRVs DSH DTs D&V DVT DW Dx/ E abbreviation EA EAC EBL EBM ECg ECHO ECLS ECMO E. Coli ECT ECV ED EDD EEg EER EF EFA EFM EFW e.g. EgA EHL EL EMg EMS

Definition Drops per minute Deep pharyngeal neuromuscular stimulation Doctor Dietary reference values Deliberate self harm Delerium tremens Diarrhoea & vomiting Deep vein thrombosis Discussed with Diagnosis

Definition Elective admission External auditory canal Estimated blood loss Expressed breast milk Electrocardiogram Echocardiogram Extracorporeal life support Extracorporeal membrane oxygenation Escherichia coli Electroconvulsive therapy External cephalic version Emergency Department Estimated date of delivery Electroencephalogram Estimated energy requirements Ejection fraction Essential fatty acids Electronic fetal monitoring Estimated fetal weight For example Estimated gestational age Extensor hallucis longus Endo laser Electromyography Elderly mobility scale

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abbreviation EMu EN Enc. ENT EOM EOR Eos. EPAu EPL EPS ERot. ERCP ERPC ESkD ESR EST Est. Req. ESWL ET Etc. ETCO2 EuA EuM EV EVAR EVLT Ex Prem. Exs. Ext. F abbreviation FA FAD FAS FB FBC

Definition Early morning urine Enteral nutrition Enclosed Ear nose and throat External ocular movements End of range Eosinophil Early Pregnancy Assessment unit Extensor pollicus longus Electrophysiology studies External rotation Endoscopic retrograde cholangio-pancreatography Evacuation of retained products of conception End stage kidney disease Erythrocyte sedimentation rate Exercise stress test Estimated requirements External shock wave lithotripsy Endotracheal Etcetra End tidal CO2 Examination under anaesthetic Examination under microscope Eversion Endovascular aneurysm repair Endovenous laser therapy Ex premature Exercises Extension

Definition Fetal anomaly Focus to axis distance Fetal assessment scan Foreign body Full blood count

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abbreviation FBM FBS FDP FDS Fe FEES FES FESS FET FEV1 FFD FFP FH FHH FHHR FHNH FHR FHx. Fi02 FLACC Flex. FLP FM FMF FN FNA FNAB FOB FOs. Fr. FROM FS FSE FSH

Definition Fetal breathing movement Fasting blood sugar Fibrin degredation products Flexor digitorum superficialis Iron Fibreoptic endoscopic examination of the swallow Functional electrical stimulation Functional Endoscopic Sinus Surgery Forced expiratory technique Forced expiratory volume in one second Fixed flexion deformity Fresh frozen plasma Fetal heart Fetal heart heard Fetal heart heard and regular Fetal heart not heard Fetal heart rate Family history Fractioned inspired oxygen Face Legs Activity Cry Consolability Flexion Fasting lipid profile Fetal movement Fetal movement felt Febrile Neutropenia Fine needle aspiration Fine needle aspirate biopsy Faecal occult blood Fructo olligosacharides French (catheter measurement) Full range of movement/motion Frozen section Fetal scalp electrode Follicle stimulating hormone

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abbreviation FT FTA FTND FTT Fu FVC FWB g abbreviation g gA gAMMA gT gastroc. gBS gCS gCSF gCT gd. gDM gest. gF gFR g&H gHJ gI gIT glut. Max. glut. Med. glut. Min. gluts. gO gORD gP g#P#

Definition Full term Failure to advance Full term normal delivery Failure to thrive Follow up Forced vital capacity Full weight bearing

Definition gram general anaesthetic gamma glutamyl transferase gastrocnemius group B streptococcus glasgow coma scale granulocyte colony stimulating factor glucose challenge test grade (mobilizations) gestational diabetes mellitus gestation gluten free glomerular filtration rate group and hold gleno-humeral joint gastro-intestinal gastro-intestinal tract gluteus maximus gluteus medius gluteus minimus gluteal gastro-oesophageal gastro-oesophageal reflux disorder/disease general Practitioner gravida# denotes total number of pregnancies Para# denotes total number of delivered pregnancies

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abbreviation gRBAS gT gTN gTT gu guIDE guM guR gVHD gxM gZF H abbreviation H Haem. Hams. HAV Hb HbA1c HBB HBcAb. HBH HBsAg. HBV HC HCA HCg HCO3 HcRN Hct. HCV HD HDL HDu

Definition grade roughness breathiness asthenic strain gastrostomy tube glyceryl Tri-Nitrate glucose tolerance test genito-urinary genito urinary and Infection Disease Clinic genito-urinary medicine genito-ureteric reflux graft versus host disease group and cross match gutter zimmer frame

Definition Hour Haematology Hamstrings Hepatitis A virus Haemoglobin glycosylated haemoglobin type A1c Hand behind back Hepatitis B core antibody Hand behind head Hepatitis B surface antigen Hepatitis B virus Head circumference Home care assistant Human chorionic gonadotropin Bicarbonate Healthcare record number Haematocrit Hepatitis C virus Haemodialysis High density lipoprotein High Dependency unit

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abbreviation HELLP HEP Hep. A/B/C HFOV HH HI HIE HIPE HIT HITS HIV HL HLA HM HMD HPHC HPOA HR HRT HSE HSP Ht. HTN HuS HV HVS Hx. HxPC Hydro

Definition Haemolysis elevated liver enzymes low platelets Home exercise programme Hepatitis A/B/C High frequency oscillator ventilator Home help Head injury Hypoxic ischaemic encephalopathy Hospital In Patient Enquiry Heparin induced thrombocytopenia Heparin induced thrombocytopenia syndrome Human immunodeficiency virus Hodgkins lymphoma Human lucocyte antigen Hand movements Hyaline membrane disease High protein high calorie Hypertrophic Pulmonary Osteoarthropathy Heart rate Hormone replacement therapy Health Service Executive Henock schonlein purpura Height Hypertension Haemolytic uraemic syndrome Home visit High vaginal swab History History of present complaint Hydrotherapy

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I abbreviation IABP IAS IBW ICP iCRBBB ICu I&D ID IDPN IDWg i.e. I:E Ratio IFT Ig IHD IHF IM IMB Imp. IMV Incl. Ind. Inf. Inferolat. Info. iNO In Pt. INR Int. Rot. Inv. I&O IOL IOP IP IPD IPJ Definition Intra-aortic Balloon Pump Interatrial septum Ideal body weight Intracranial pressure Incomplete right bundle branch block Intensive Care unit Incision & drainage Infectious disease Intradialytic parenteral nutrition Intradialytic weight gain that is Inspiratory to expiratory ratio Interferential therapy Immunoglobulin Ischaemic heart disease Irish Heart Foundation Intramuscular Intermenstrual bleeding Impression Intermittent mandatory ventilation Including/included Independent Inferior Inferolateral Information Inhaled nitric oxide In Patient International normalised ratio Internal rotation Inversion Intake and output Induction of labour Intra ocular pressure Intraperitoneal Intermittent peritoneal dialysis Interphalangeal joint

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abbreviation IPPB IPPV IRQ ISC ISQ IT ITP ITT ITu Iu IuCD IuD IugR IV IVC IVDu IVF IVH IVI IVP IVS IVSD IVSS IVT IVu IVuS IWA Ix. J abbreviation JIA JVP

Definition Intermittent positive pressure breathing Intermittent positive pressure ventilation Inner range quadriceps Intermittent self catheterisation In Status Quo Inspiratory time Idiopathic thrombocytopenia purpura Insulin tolerance test Intensive Therapy unit International unit Intrauterine contraceptive device Intrauterine death Intrauterine growth retardation/restriction Intravenous Inferior vena cava Intravenous drug user In vitro Fertilisation Intraventricular haemorrhage Intravenous infusion Intravenous pyelogram Interventricular septum Interventricular septum in diastole Interventricular wall in systole Intravenous therapy Intravenous urogram Intravascular ultrasound Irish Wheelchair Association Investigation

Definition Juvenile idiopathic arthritis Jugular venous pressure

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k abbreviation k+ kAFO kcal kCL kg. kJ kPs kuB kVO L abbreviation L LA LAA Lab. LADA Lap. & Dye LASER Lat. Lat. Men. Lat. Rot. Lat. Wall LAVH LBBB LBM LBP lbs. LCL LCT LCx LDH LDL LFTs LgA Lgt. Definition Litre Local anaesthetic Left atrial appendage Laboratory Left anterior descending artery Laparoscopy and dye Light amplification by stimulated emission of radiation Lateral Lateral meniscus Lateral rotation Lateral wall Laparoscopic assisted vaginal hysterectomy Left bundle branch block Lean body mass Low back pain Pounds weight Lateral collateral ligament Long chain triglyceride Circumflex artery Lactate dehydrogenase Low density lipoprotein Liver function tests Large for gestational age Ligament Definition Potassium knee ankle foot orthosis kilocalorie Potassium chloride kilogram kilo joules keratic precipitates kidneys, ureters and bladder keep vein open

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abbreviation LH LHS LIF LIH LL LLETZ LLQ LMA LMP LOA LOC LOL LOP LOR LP LRot. LRTI LSA LSCS LSF LSH LSL LSLy. LSO LSP LSpine LS Ratio LTC LTM LTS LuQ LuS LV LVAD LVDV LVEDP LVF

Definition Luthenising hormone Left height sensation Left iliac fossa Left inguinal hernia Lower limb Large loop excision of the transformation zone Left lower quadrant Laryngeal mask airway Last menstrual period Left occipito-anterior Loss of consciousness Left occipito-lateral Left occipito-posterior Loss of resistance Lumbar puncture Left rotation Lower respiratory tract infection Left sacro-anterior Lower segment caesarean section Left side flexion Long shoe horn Left sacro-lateral Left side lying Left salpingo-oophorectomy Left sacro-posterior Lumbar spine Leichithin/Sphyngomyelin ratio Long term care Long term memory Lateral tarsal strip Left upper quadrant Lower uterine segment Left ventricle Left ventricular assist device Left ventricular diastolic volume Left ventricular end diastolic pressure Left ventricular failure

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abbreviation LVH LVOT LVOTO LVS LVSV Ly. M abbreviation m2 Man. Dex. Mane MAP MAS MAu Max. MC MCA MCL MCPJ MCug MCV MDA MDR TB MDT MDu Med. Med. Men. Med. Rot. Meds. Mets. mEq. MFR mg Mg2+ MI

Definition Left ventricular hypertrophy Left ventricular outflow tract Left ventricular outflow tract obstruction Low vaginal swab Left ventricle systolic volume Lying

Definition Square metres body surface Manual dexterity Morning Mean arterial pressure Motor assessment scale Medical Assessment/Admission unit Maximum Metacarpal Middle cerebral artery Medial collateral ligament Metacarpo-phalangeal joint Micturating cystourethrogram Mean corpuscular volume Misuse of Drugs Act Multidrug-resistant tuberculosis Multidisciplinary team Medical Day unit Medial Medial meniscus Medial rotation Medication Metastases Milli-equivalent Maximum flow rate Millligram Magnesium Myocardial infarction

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abbreviation Micro. Min. Mins. mL MLB mm mmHg MMk mmol MMR MMSE Mn MNB MND Mob. Mobs. Mod. MPT MR MRCP MRI MROP MRSA MS Msg. MSSA MSu MSW MT MTPJ MuA MuFA MugA Multip. MV MVA MVR MWM

Definition Microbiology Minimum Minute Mililitre Micro laryngeal bronchoscopy Millimetre Millimetres of mercury Marshall Marchetti krantz Millimole Measles, mumps, rubella Mini mental state examination Manganese Manipulation of nasal bones Motor neurone disease Mobility/mobilising Mobilizations Moderate Maximum phonation time Mitral regurgitation Magnetic resonance cholangiopancreatography Magnetic resonance imaging Manual removal of placenta Methicillin resistant staphylococcus aureus Multiple sclerosis Message Methicillin sensitive staphylococcus aureus Midstream specimen of urine Medical Social Worker Metatarsal Metatarso-phalangeal joint Manipulation under anaesthetic Mono unsaturated fatty acids Multiple-gated arteriography Multiparous Mitral valve Mitral valve area Mitral valve replacement Mobilisation with movement

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N abbreviation N2 N2O NA Na+ NaCL NAD NAg NAI NAS NB NBFD NCA NCHD ND Neb. NEC Neg. NETZ Neuro. NFA NFR Ng NH NHL NIBP NICu NIEL NIPPV NIV NJ NkA NkDA NMS NND No. Definition Nitrogen Nitrous oxide Not applicable Sodium Sodium chloride No abnormality detected Natural apophyseal glide Non accidental injury Neonatal abstinence syndrome Note bene (important) Neville Barnes forceps delivery Nurse controlled analgesia Non consultant hospital doctor Naso duodenal Nebuliser Necrotising enterocolitis Negative Needle excision of transformation zone Neurological No fixed abode Not for resuscitation Naso-gastric Nursing Home Non hodgkins lymphoma Non invasive blood pressure Neonatal Intensive Care unit Not in established labour Non invasive positive pressure ventilation Non invasive ventilation Naso-jejunal No known allergies No known drug allergies Neuroleptic malignant syndrome Neonatal death Number

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abbreviation Nocte NOF NOk NP NPL NPO NPu NSAID(s) NSCL cancer NSR NSTEMI NTD NTT Nullip. N&V NWB O abbreviation O2 OA OAusc. Obj. Obs. Occ. Occ. Health OCP OCPD OD OE OFC Og OgD OgTT OHA

Definition Night Neck of femur Next of kin New patient No perception of light Nil per oral Not passed urine Non-steroidal anti-inflammatory drug(s) Non small cell lung cancer Normal sinus rhythm Non ST segment elevated myocardial infarction Neural tube defect Nasotracheal tube Nulliparous Nausea and vomiting Non weight bearing

Definition Oxygen Osteoarthritis On auscultation Objective Observations Occasional Occupational Health Oral contraceptive pill Optichoice peritoneal dialysis Overdose On examination Occipito-frontal circumference Orogastric Oesophago-gastroduodenoscopy Oral glucose tolerance test Oral hypoglycaemic agent

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abbreviation OHSS OM Onc. O&P OP OPD OPE ORIF ORQ Ortho. OT P abbreviation PA PAC Pa. CO2 PADL Paeds. PAF PAIVM Pa. O2 PAPVD PAPVR Para PASP PBSCH PC PCA

Definition Ovarian hyperstimulation syndrome Obtuse marginal Oncology Ova and parasites Outpatient Outpatient Department Oral peripheral examination Open reduction and internal fixation Outer range quadriceps Orthopaedics Occupational Therapy/Therapist

Definition Pulmonary artery Premature atrial contraction Partial pressure of arterial carbon dioxide Personal activities of daily living Paediatrics Paroxysmal atrial fibrillation Passive accessory intervertebral movements Partial pressure of arterial oxygen Partial anomalous pulmonary venous drainage Partial anomalous pulmonary venous return Parity Pulmonary artery systolic pressure Peripheral blood stem cell harvest Presenting complaint Patient controlled analgesia

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abbreviation PCEA PCI PCL PCR PCV PD PDA PDPH PE PEA PEARL Pec. major PEEP PEFR PEg PEJ PEM PEP Mask PERT PET Scan PF PFA PFJ PFO PFR PFTs PgE pH PHACO PHN PHT

Definition Patient controlled epidural analgesia Percutaneous coronary intervention Posterior cruciate ligament Polymerase chain reaction Packed cell volume Peritoneal dialysis Posterior descending artery Postdural puncture headache Pulmonary embolus/embolism Pulseless electrical activity Pupils equal and reacting to light Pectoralis major Positive end expiratory pressure Peak expiratory flow rate Percutaneous endoscopic gastrostomy Percutaneous endoscopic jejunostomy Protein energy malnutrition Positive expiratory pressure mask Pancreatic enzyme replacement therapy Positron emission tomography scan Plantarflexion Plain film of abdomen Patellofemoral joint Patent foramen ovale Pelvic floor repair Pulmonary function tests Prostaglandin E Log of hydrogen ion concentration Phacoemulsification Public Health Nurse Pulmonary hypertension

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abbreviation Physio. PI PICC PICu PID PIH PIIS PIP PIPJ PkB Pku PL PLAD PLAx. PLIF PLO PLTS p.m. PMB PMHx. PMs. P&N PN PND PNF PO PO4 POA POD PON&V POP Pos. Post. Post Op. PPAM aid

Definition Physiotherapist/Physiotherapy Pulsatility index Peripherally inserted central catheter Paediatric Intensive Care unit Pelvic inflammatory disease Pregnancy induced hypertension Posterior inferior iliac spine Peak inspiratory pressure Proximal interphalangeal joint Prone knee bend Phenylketonuria Perception of light Posterior lip augmentation device Parasternal long axis Posterior lumbar intervertebral fusion Pharyngolaryngoesophagectomy Platelets Afternoon Post menopausal bleeding Past medical history Passive movements Pins and needles Parenteral nutrition Paroxysmal nocturnal dyspnoea Proprioceptive neuromuscular facilitation Per oral Phosphate Persistant occipito-anterior Progression of disease Post operative nausea & vomiting Plaster of paris Positive Posterior Post operation Pneumatic post amputation mobility aid

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abbreviation PPH PPHN PPIVM PPN PPROM PPV PR Prem. Premed. Pre Op p.r.n. PROM Prox. PRP PRVC PS PSA PSAx. PSIS PSV PSW PSWD PT PTA PTB PTCA PTSD PTT PTTk Pu PuD PuFA PuJ

Definition Post-partum haemorrhage Persistent pulmonary hypertension of the newborn Passive physiological intervertebral movements Peripheral parenteral nutrition Pre-term premature rupture of membranes Pars plana vitrectomy Per rectum Premature Premedication Pre operation As required Prolonged rupture of membranes Proximal Pan retinal photocoagulation Pressure regulated volume control Pulmonary stenosis Prostatic specific antigen Parasternal short axis Posterior superior iliac spine Pressure support ventilation Psychiatric Social Worker Pulsed short wave diathermy Prothrombin time Post traumatic amnesia Patella tendon bearing Percutaneous transluminal coronary angioplasty Post traumatic stress disorder Partial thromboplastin time Partial thromboplastin time kaolin Passed urine Peptic ulcer disease Polyunsaturated fatty acids Pelvic-ureteric junction

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abbreviation Pulsed SWD Pul.V Pul.VI PuO PV PVC PVD PVL PWB PWD PWS Q abbreviation q.d.s./q.i.d. QRS Quads. R abbreviation RA RBBB RBC RBg RC RCA RCC RCJ RCN RD RDS Re. Recd Recom. REE Re.-ed.

Definition Pulsed short wave diathermy Pulmonary veins Pulmonary vein isolation Pyrexia of unknown origin Per vagina Premature ventricular contraction Peripheral vascular disease Periventricular leucomalacia Partial weight bearing Posterior wall in diastole Posterior wall in systole

Definition Four times daily Deflection on Ekg representing electrical activity Quadriceps

Definition Right atrium Right bundle branch block Red blood cells Random blood glucose Roman Catholic Right coronary artery Red cell concentrate Radio-carpal joint Registered Childrens Nurse Retinal detachment Respiratory distress syndrome Regarding Received Recommended Resting energy expenditure Re-educate

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abbreviation Reg. Rehab. REM Reps. Resp. Rev. RFA RgN Rh. RhA. RHS RICE RIF RIg RIH RIP RLQ RM RNI RNID RNP RNT RO ROA ROL ROM ROP ROS Rot. RPN RQ RR RRot. RRT RSA RSD RSF RSI RSLy.

Definition Registrar Rehabilitation Rapid eye movement Repetition Respiration Revision Radio frequency ablation Registered general Nurse Rhesus Rheumatoid arthritis Right height sensation Rest, ice, compression, elevation Right iliac fossa Radiology inserted gastrostomy Right inguinal hernia Rest in peace/Deceased Right lower quadrant Registered Midwife Reference nutrient intake Registered Nurse Intellectual Disability Registered Nurse Prescriber Registered Nurse Tutor Removal of Right occipito-anterior Right occipito-lateral Range of movement/motion Right occipito-posterior Removal of sutures Rotation Registered Psychiatric Nurse Respiratory quotient Respiratory/respiration rate Right rotation Renal replacement therapy Right sacro-anterior Reflex sympathetic dystrophy Right side flexion Repetitive strain injury Right side lying

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abbreviation RSO RSP RSV RT RTA RTI RTS RTW RuJ RuQ Rv. RV RVDV RVF RVH RVOT RVOTO RVSP RVSV Rx. RZF S abbreviation s SA SAD SAH SaO2 SARS SB SBA SBBE SBE SBFT SBR

Definition Right salpingo-oophorectomy Right sacro-posterior Respiratory syncytial virus Radiotherapy Road traffic accident Respiratory tract infection Raised toilet seat Returned to ward Radio-ulnar joint Right upper quadrant Review Right ventricle Right ventricle diastolic volume Right ventricular failure Right ventricular hypertrophy Right ventricular outflow tract Right ventricular outflow tract obstruction Right ventricular systolic pressure Right ventricle systolic volume Treatment Rollator zimmer frame

Definition Second Spinal anaesthetic Seasonal affective disorder Sub arachnoid haemorrhage Oxygen saturation Severe acute respiratory syndrome Seen by Stand-by assistance Small bowel barium enema Subacute bacterial endocarditis Small bowel follow through Serum bilirubin rate

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abbreviation SC SCBu SCC SCD SCIDS SCJ SCL cancer SCM muscle Se SF6 SFA SFD SgA SHO SHx. SIC SIDS SIJ SIMV Sitt. SL SLE SLR SLT SM SMD SMR SN SNAg Snr. SOAP SOB SOBAR

Definition Subcutaneous Special Care Baby unit Spinal cord compression Sickle cell disease Severe combined immune deficiency syndrome Sterno-clavicular joint Small cell lung cancer Sterno-cleido-mastoid muscle Selenium Sulphurhexaflouride Saturated fatty acids Small for dates Small for gestational age Senior House Officer Social history Self-intermittent catheterisation Sudden infant death syndrome Sacroiliac joint Synchronised intermittent mandatory ventilation Sitting Sublingually Systemic lupus erythematosus Straight leg raise Speech and Language Therapy/Therapist Staff Midwife Sub-mucosal diathermy Sub-mucosal resection Staff Nurse Sustained natural apophyseal glide Senior Subjective Objective Assessment Plan Shortness of breath Shortness of breath at rest

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abbreviation SOBOE Soc. Hx. SOP S&P SP SpR SR SRF SROM SSD SSg SSM SSN SSPE ST STAH STAR STAT Stats. Std.M Std.N Std.PHN STEMI STI STJ STM STNR STR SuI Sup. Su.R Surg. SV SVC SVCO

Definition Shortness of breath on exertion Social history Standard operating procedure Syringing and probing Supra pubic Specialist Registrar Sinus rhythm Sub retinal fluid Spontaneous rupture of membranes Source to skin distance Split skin graft Senior Staff Midwife Senior Staff Nurse Subacute sclerosing panencephalitis Sinus tachycardia Subtotal abdominal hysterectomy Scandinavian total ankle replacement At once/Immediately Statistics Student Midwife Student Nurse Student Public Health Nurse ST elevation myocardial infarction Sexually transmitted infection Sub-talor joint Short term memory Symmetric tonic neck reflex Soft tissue release Stress urinary incontinence Superior Suburethral repair Surgical Self-ventilating Superior vena cava Superior vena cava obstruction

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abbreviation SVD SVRA SVT SW SWD SWETZ T abbreviation TA TAH TAPVD TAPVR TAR TB TBC TBI TBg TBL TBW Tc.D TCI TCM TCOM TCPO2 TCRE T1DM T2DM t.d.s./t.i.d. TEDs TEE Temp.

Definition Spontaneous vaginal delivery Self-ventilating on room air Supra ventricular tachycardia Social Worker Shortwave diathermy Short wire excision of transformation zone

Definition Tendon of achilles Total abdominal hysterectomy Total anomalous pulmonary venous drainage Total anomalous pulmonary venous return Total ankle replacement Tuberculosis Tuberculin bacillus culture Traumatic brain injury True blood glucose Total blood loss Tension band wiring Transcerebral diameter To come in Transcutaneous monitor Transcutaneous oxygen monitoring Transcutaneous Oxygen Pressure Transcervical resection of endometrium Type 1 diabetes mellitus Type 2 diabetes mellitus Three Times Daily Thrombo-embolic deterrent stockings Total energy expenditure Temperature

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abbreviation TENS TEP TER TES TF TFA TFTs TFVT Tg. TgA THR TIA TIBC Tib. & Fib. TICH Tidal PD TITs TkR TL TM TMD TMJ TMP TOE TOF TOP TORCH

TPHA TPN TPR

Definition Transcutaneous electrical nerve stimulation Tracheoesophageal puncture Total elbow replacement Therapeutic endoscopic sialalendoscopy Transfer Trans fatty acids Thyroid Function Tests Tension free vaginal tape Triglycerides Transposition of the great arteries Total Hip Replacement Transient ischaemic attack Total iron binding capacity Tibia & Fibula Traumatic intracranial haemorrhage Tidal peritoneal dialysis Trimming of Inferior Turbinates Total knee Replacement Tubal ligation Tympanic membranes Thyromental distance Tempero-mandibular joint Transmembrane pressure Trans oesophageal echocardiogram Tracheoesophageal fistula Termination of pregnancy Toxoplasmosis Other Rubella Cytomegalovirus Herpes Teponema pallidum haemagglutination Total parenteral nutrition Temperature, pulse and respiration

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abbreviation TR TRACHY TRH Trigs Ts. & As. TSH TSpine TSR TTN TTWB TuAg TuRBT TuRP TV TVI TVS u abbreviation uA uAC uBW uC uD u&E uL uLTT uO uPPP uRTI uS/uSS uST uTI uVC

Definition Tricuspid regurgitation Tracheostomy Thyrotrophin releasing hormone Triglycerides Tonsillectomy & Adenoidectomy Thyroid stimulating hormone Thoracic spine Total shoulder replacement Transient tachypnoea of the newborn Toe touch weight bearing Timed up and go test Transurethral resection of bladder tumour Transurethral resection of prostate Tricuspid valve Tissue velocity imaging Transvaginal scan

Definition urinalysis umbilical arterial catheter usual body weight urinary catheter ulnar deviation urea and electrolytes upper limb upper limb tension test urinary output uvulopalatopharyngoplasty upper respiratory tract infection ultrasound/ultrasound scan ultrasound therapy urinary tract infection umbilical venous catheter

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abbreviation uVJ uWSD V abbreviation VA VAS VBAC VBg VC VCJD VDRL VE Veg. VEPs V. Fib. VFu VHI Via VIN Vits. VL VLCD VMA VML VMO Vol. VQ VR VRE VS VSB VSD VT VVF

Definition uretero-vesical junction underwater seal drain

Definition Visual acuity Visual analogue scale Vaginal birth after caesarean section Venous blood gas Volume control Variant Crutzfeldt Jakob Disease Venereal disease research laboratory test Ventricular ectopics Vegetables Visual evoked potentials Ventricular fibrillation Videofluoroscopy Voluntary Health Insurance By way of Vulval intraepithelial neoplasia Vitamins Vision left Very low calorie diet Vanillylmandelic acid Vastus medialis longus Vastus medialis oblique Volume Ventilation perfusion quotient Vision right Vancomycin resistant enteroccocus Volume support Videostroboscopy Ventricular septal defect Ventricular tachycardia Vesico vaginal fistula

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abbreviation VVs Vx. VZIg W abbreviation WB WBC WC WCC W.chair W.end WFD WFL WL WNL WPWS WR Wt. WZF x abbreviation x-match Y abbreviation YO Z abbreviation ZF Zn ZN Stain

Definition Varicose Veins Vertex Varicella zoster immune globulin

Definition Weight bear/bearing Whole blood count Water Closet/Toilet White cell count Wheelchair Weekend Word finding difficulties Within functional limits Waiting list Within normal limits Wolff-Parkinson-White Syndrome Ward round Weight Wheeled zimmer frame

Definition Crossmatch

Definition Year old

Definition Zimmer frame Zinc Ziehl Neelsen stain

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Others abbreviation & @ / Dx FVIII FIx Fx FxI FxIII # 1 /2 Sitt. 1/7 1/52 1/12 1:1 x/7 x/52 x/24 x/12 1o ? 2 x2
o o

Definition And At Diagnosis Factor eight Factor nine Factor ten Factor eleven Factor thirteen Fracture Half sitting One day One week One month One to one Where x = number of days Where x = number of weeks Where x = number of hours Where x = number of months Primary Query (e.g. Query Multiple Sclerosis) Secondary to Twice Degrees only permitted for measuring angles Temperature in degrees Celsius Lumbar vertebrae Sacral vertebrae With

C L1-L5 S1-S5 C

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4. notatIon foR mobILISatIonS anD manIPULatIonS

Central posteroanterior pressures (PAs)

Central anteroposterior pressures (APs)

Unilateral PAs on left

Unilateral PAs on right

Unilateral APs on the left

Unilateral APs on the right

Transverse pressure towards left Transverse pressure towards right

Rotation of head, thorax or pelvis towards left

Rotation of head, thorax or pelvis towards right

Lateral flexion towards left

Lateral flexion towards right

Longitudinal movement (state cephalad or caudad)

GRADING OF MOBILISATIONS

GRADE I: GRADE II: GRADE III: GRADE IV: GRADE V:

small amplitude movement at beginning of range of movement large amplitude movement well into the range of movement (not into resistance or stiffness ) large amplitude movement into resistance small amplitude movement into resistance high velocity thrusting movement beyond end range of motion

Reference: G D Maitland. (1994 5th edition) Vertebral Manipulation. Butterworth Heinemann.

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