# ER/OR jargon - any ER nurses or doctors here?



## PaperbackWriter (Apr 23, 2016)

Hello,
I thought this topic might have been asked already since it seems like it would be a common one but I didn't see anything in the threads list.

I need just a couple lines/orders that might be spoken between doctors and nurses as a patient is about to die on the operating table after being brought into the emergency room. If it helps, the patient has been shot, but I don't specify where.

Unfortunately, my experience in this area is limited to the movies where they mostly say things like "get the crash cart" and "we're losing her/him".

What would they really say if she is about to die? I want to suggest that the patient dies instead of _telling _the reader that she dies.

Thanks!


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## RhythmOvPain (Apr 23, 2016)

YouTube.

Scrubs.

The serious parts.


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## PaperbackWriter (Apr 23, 2016)

Hm, can you narrow it down for me?


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## PrinzeCharming (Apr 23, 2016)

I found this to be really interesting. 

*Communication between doctors and nurses in the emergency department*




PaperbackWriter said:


> Hm, can you narrow it down for me?



*ER: 
*
I would suggest watching videos from Untold Stories of the ER. 


_[Content Warning] 
_
[video=youtube;gCxFvg3Fhps]https://www.youtube.com/watch?v=gCxFvg3Fhps[/video]

*Post-ER: 
*
8 Things to Say When Your Patient Dies


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## Sonata (Apr 24, 2016)

Apologies.  Incorrect posting


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## RhythmOvPain (Apr 24, 2016)

Arg, it's actually harder to find a good video detailing a scene where the patient is about to die, a lot of these are the after effects.

There's so much realism in Scrubs (more than any other hospital show), but it's carpeted over with absurd comedy.


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## PaperbackWriter (Apr 24, 2016)

Thanks for taking the time to help. The video reinforced the term "BP's dropping" statement I've heard so many times before. I'm going to use that but I need just one more.

I didn't see any examples of the wording of specific orders between doctors and nurses in the *Communication between doctors and nurses in the emergency department *article. It seems to be more about communication in general. The post ER (8 things...) being after the fact doesn't give me any specific wording either.

Do you have any idea if they still say (or have ever said) "Get the crash cart."?

The story is through the perspective of the patient and I want her to hear something very specific just before she loses consciousness that would suggest to the readers that she dies without actually telling them she dies.


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## PaperbackWriter (Apr 24, 2016)

I found this helpful just now:

http://www.dvxuser.com/V6/archive/index.php/t-185644.html


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## PrinzeCharming (Apr 24, 2016)

PaperbackWriter said:


> I didn't see any examples of the wording of specific orders between doctors and nurses in the *Communication between doctors and nurses in the emergency department *article. It seems to be more about communication in general. The post ER (8 things...) being after the fact doesn't give me any specific wording either.



Oh, I know it wasn't helpful. I am sorry I didn't clarify that it was just "interesting to know" ... I studied Linguistics. I am all about the language. 

Try this ... link.


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## Sonata (Apr 24, 2016)

PaperbackWriter said:


> The story is through the perspective of the patient and I want her to hear something very specific just before she loses consciousness that would suggest to the readers that she dies without actually telling them she dies.


A patient on the point of death would not be aware of the fact that she or he was dying.

Having worked in an ER, although many years ago now, I never heard any of those comments supposedly made by ER doctors or nurses.

They are pure television chat.  Not reality.


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## Schrody (Apr 24, 2016)

PaperbackWriter said:


> Hello,
> I thought this topic might have been asked already since it seems like it would be a common one but I didn't see anything in the threads list.
> 
> I need just a couple lines/orders that might be spoken between doctors and nurses as a patient is about to die on the operating table after being brought into the emergency room. If it helps, the patient has been shot, but I don't specify where.
> ...


 
And how do they know he will die? They might know some probability of dying, but they can't be certain of an hour or day of death :scratch:


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## Jack of all trades (Apr 24, 2016)

The TV show ER is rather old, but it wasn't comedy. I'm not sure how dated the jargon is, though.

I'm assuming the victim was shot in the chest. An arm or leg would be less likely to cause death. A major artery or vein would have to be hit in a limb to cause death. Chest wound seems more likely. Unless there was delay in being brought to the emergency room.

A crash cart, to shock the heart, I believe, is not likely to be used for a gunshot victim. You should talk with someone who works in an ER.

A gunshot victim would have much blood loss. Therefore falling blood pressure (BP) is likely. A saline IV would be administered immediately for the purpose of getting volume back into the blood system so there's something for the heart to pump as well as ease for administering meds. The patient's blood type would have to be identified so the correct blood type can be given. While Type O is the universal donor, the rh factor is still a consideration. I believe, and do not take this as fact, that rh positive blood can be given to a negative person, but not the other way around. They might give O-positive blood to try to keep the patient alive, but getting the proper blood type would be a priority. The patient is likely to go into shock. Then there's other possibilities. The pulse would probably be faint and might be 'thready', though I'm not sure that's still said. The patient would have to be sent to OR for surgery, and the surgeon notified. 

I think the main thing would be to convey multiple people all bustling about, assuming this is in the ER, only snippets of conversation would be heard, as they would likely be talking with each other, and talking over others who are not part of that exchange. One doc would be in charge and directing the others, but nurses and maybe an intern would be part of the team.


Edited to add : If the victim was shot in the head, the victim would probably be put on life support so that the organs could be harvested for donation. That might be best to convey death is a given. The parent(s), spouse or some other next of kin would have to be consulted about organ donation. The driver's license might be checked to see if the victim wanted to be an organ donor.


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## Jack of all trades (Apr 24, 2016)

I've been searching my mind for a particular phrase and I think "cross match" is it. It has to do with either blood type or organ donation.

My local hospital has a bus stop right in front and many workers take the bus. If you have a similar set up, you could strike up a conversation at the bus stop and get your question answered.


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## Schrody (Apr 24, 2016)

Jack of all trades said:


> The patient's blood type would have to be identified so the correct blood type can be given. While Type O is the universal donor, the rh factor is still a consideration. I believe, and do not take this as fact, that rh positive blood can be given to a negative person, but not the other way around. They might give O-positive blood to try to keep the patient alive, but getting the proper blood type would be a priority.



It is a fact - I'm O+ and I can give to anyone, but receive only my blood type. Also, a positive Rh could be given to a person with the Rh -, but if the other way around, the person receiving a Rh- when that same person is Rh+ would need to receive an "Anti D" shot (like many mothers Rh- when giving birth). Also, like I already mentioned, I can give blood to A, B, or AB blood type, but it's recommended only in a highly emergent situations when there isn't enough of stack of your blood type.


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## Jack of all trades (Apr 25, 2016)

Schrody said:


> It is a fact - I'm O+ and I can give to anyone, but receive only my blood type. Also, a positive Rh could be given to a person with the Rh -, but if the other way around, the person receiving a Rh- when that same person is Rh+ would need to receive an "Anti D" shot (like many mothers Rh- when giving birth). Also, like I already mentioned, I can give blood to A, B, or AB blood type, but it's recommended only in a highly emergent situations when there isn't enough of stack of your blood type.



Thanks for the confirmation. I knew it is harmful for a positive person to get negative blood but wasn't sure about the opposite way around.

I hope the OP got enough info to write a good scene.


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## PaperbackWriter (May 1, 2016)

Sonata said:


> Having worked in an ER, although many years ago now, I never heard any of those comments supposedly made by ER doctors or nurses.
> 
> They are pure television chat.  Not reality.




Yes, but can I say anything that would make the readers think she is about to die? I'm shooting for something not entirely unrealistic, yet serious enough for the readers to draw a conclusion.

This is my challenge.


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## Sonata (May 1, 2016)

PaperbackWriter said:


> Yes, but can I say anything that would make the readers think she is about to die? I'm shooting for something not entirely unrealistic, yet serious enough for the readers to draw a conclusion.
> 
> This is my challenge.



The patient would have been taken straight into resuss when brought into the hospital, where very little is actually said as all the ER doctors and nurses know exactly what to do.  It is highly unlikely that the patient would be conscious at that stage as the ER staff would be working on him or her.  I have seen people die in those circumstances and even if they are still semi-conscious, if they are dying they just go.  The only thing then that would be said is "are we all agreed" - and then the clock would be checked for time of death to be announced.


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## PaperbackWriter (May 1, 2016)

Jack of all trades said:


> I've been searching my mind for a particular phrase and I think "cross match" is it. It has to do with either blood type or organ donation.
> 
> My local hospital has a bus stop right in front and many workers take the bus. If you have a similar set up, you could strike up a conversation at the bus stop and get your question answered.




I just called the biggest hospital in the area and they have a media/information center, which isn't open yet. I don't know why I hadn't thought of that before. I'll be calling them back in a couple hours.


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## Jack of all trades (May 1, 2016)

PaperbackWriter said:


> I just called the biggest hospital in the area and they have a media/information center, which isn't open yet. I don't know why I hadn't thought of that before. I'll be calling them back in a couple hours.



Glad my suggestion triggered an idea for you. Hope you get great stuff!


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## Sonata (May 1, 2016)

PaperbackWriter said:


> I just called the biggest hospital in the area and they have a media/information center, which isn't open yet. I don't know why I hadn't thought of that before. I'll be calling them back in a couple hours.



I do not know if things are done/said differently in the US - my knowledge is from a UK hospital.


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## PSFoster (Jan 19, 2020)

"call a code" or "code blue" the patient is in cardiac arrest, staff knows to fetch the crash cart.  "O2 sat is dropping" oxygen saturation is dropping to below normal levels. "we need to intubate" patient is having trouble breathing.  Just a few that I remember.


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## Amnesiac (Jan 19, 2020)

My degree is in Surgical Technology. I worked in Army and civilian OR's for a number of years. If I can help with anything, especially how things are done now, in the United States, I'll be happy to help.


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