Introduction to Health Records Abbreviations
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| CCU | Coronary Care Unit
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| ECU | Emergency Care Unit
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| ER | Emergency Room
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| ED | Emergency Department
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| ICU | Intensive Care Unit
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| PICU | Pediatric Intensive Care Unit
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| NICU | Neonatal Intensive Care Unit
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| SICU | Surgical Intensive Care Unit
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| PACU | Post-Anesthesia Care Unit
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| L & D | Labor & Delivery
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| OR | Operating Room
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| Post-Op | after surgery
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| Pre-Op | before surgery
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| VS | Vital Signs
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| T | Temperature
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| BP | Blood Pressure
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| HR | Heart Rate
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| RR | Respiratory Rate
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| Ht | Height
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| Wt | Weight
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| BMI | Body Mass Index
(measurement of body fat based on height and weight)
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| I/O | Intake/Output
[the amount of fluids a patient has taken in (by IV or mouth) and the produced (usually just urine output)]
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| Dx | Diagnosis
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| DDx | Differential Diagnosis
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| Tx | Treatment
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| Rx | Prescription
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| H & P | History & Physical
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| Hx | history
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| CC | Chief Complaint
(the main reason for the visit)
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| HPI | History of Present Illness
(the story of the symptoms)
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| ROS | Review Of Symptoms (anything else not directly related to the chief complaint)
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| PMHx | Past Medical History
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| FHx | Family History
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| PE | Physical Exam
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| Pt | Patient
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| y/o | Years Old
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| h/o | History Of
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| PCP | Primary Care Provider
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| f/u | Follow Up
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| SOB | Shortness Of Breath
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| PERRLA | Pupils are Equal, Round, and Reactive to Light and Accommodation
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| NAD | No Acute Distress
(the patient does not display any intense symptoms)
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| RRR | Regular Rate and Rhythm
(description of a normal heart on exam)
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| CTA | Clear To Auscultation
(description of normal sounding lungs)
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| WDWN | Well Developed, Well Nourished
(the patient is grown or has grown appropriately and does not appear to be malnourished)
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| A & O | Alert & Oriented
(the patient can answer questions and is aware of what is going on)
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| WNL | Within Normal Limits
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| NOS | Not Otherwise Specified
(catch-all for diagnoses that don't quite fit any specific cause)
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| NEC | Not Elsewhere Classified
(catch-all for diagnoses that don't quite fit any specific cause)
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| PO | Per Os (by mouth)
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| NPO | Nil Per Os (nothing by mouth)
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| PR | Per Rectum (anal)
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| IM | IntraMuscular
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| SC | SubCutaneous (under the skin)
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| IV | IntraVenous
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| CVL | Central Venous Line
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| PICC | Peripherally Inserted Centeral Catheter
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| Sig | instructions short for "signa" from Latin for LABEL
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| ad lib | as desired
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| BID | twice daily
(Latin: two in a day)
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| TID | three times daily
(Latin: three in a day)
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| QD | daily (Latin: each day)
(now prohibited in many healthcare settings)
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| QID | four times daily (Latin: four in a day)
(now prohibited in many healthcare settings)
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| QHS | at night
(Latin: each night at the hour of sleep)
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| AC | before meals
(Latin: before food)
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| PC | after meals
(Latin: after food)
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| prn | as needed
(Latin: as the need arises)
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Created by:
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