REHAB ACRONYMS DEFINED  [ back to Recovering from a Brain injury ]
Providers of brain injury rehabilitation services, and the therapies they provide, are identified by acronyms. With respect to service providers, the acronyms may tell us about their education and training, license status, scope of practice, the professional organizations to which they belong or the position they hold in a hospital or clinic. Acronyms are used as a shorthand way to identify the condition of the patient requiring therapy, therapy types, therapy locations, therapy start and end dates, etc. This saves space in program brochures, medical records and medical reports. Below, I have compiled a list of many of the acronyms in common usage today in the brain injury rehabilitation field, which are listed alphabetically. Families of persons who are applying for, or already receiving, brain injury rehabilitation services may find the definitions useful in deciphering application forms or service provider reports.

AACBIS American Academy for the Certification of Brain Injury Specialists, created 1996 by the Brain Injury Association to recognize persons who have completed advanced studies in brain injury treatment, care and rehabilitation. Certificates are granted for 5 years at Levels I, II
and III. Certification means mastery of advanced training materials, but does not signify any particular level of actual work experience or clinical performance.

ABI Acquired brain injury. Refers to any brain injury acquired after birth by means of trauma, oxygen deprivation, toxic exposure, electrocution or otherwise.

ABN Abnormal

ABPDC American Board of Professional Disability Consultants

ABR Auditory Brainstem Response

ADA Americans with Disabilities Act

ADL Activities of Daily Living

AEP Auditory Evoked Potential

ALD Assistive Listening Device

AMA American Medical Association or Against Medical Advice

AOD Alcohol and Other Drug Programs

APA American Psychiatric Association or American Psychological Association

APTA American Physical Therapy Association

ARD Acute Respiratory Distress

A&W Alive and Well

ASHA American Speech-Language and Hearing Association

B Born, referring to date of or place of birth

BAER Brainstem Auditory Evoked Response

BBB Blood Brain Barrier, the fine mesh of arterioles and capillaries that supply the brain with oxygen but also block large and potentially toxic molecules from reaching the brain. Drugs that cannot penetrate the BBB cannot affect the brain. A severe brain injury with tearing of blood vessels can cause a breakdown in the BBB, leaving the brain open to infection and exposure to toxic substances.

BBT Basal Body Temperature

B&J Bone and Joint, referring to a type of injury or doctor

BL Baseline, Bleeding or Blood Loss

BN Brachial Neuritis, refers to inflammation of the nerves in the brachial plexus of the shoulder

BP Behavior Pattern, Blood Pressure or Bathroom Privileges in a Hospital

BS Blood Sugar

BT Bedtime, Body Temperature or Brain Tumor

Bx Biopsy

CA Chronologic Age

CAL Computer Assisted Learning

CARF Commission on Accreditation of Rehabilitation Facilities, an independent not for profit
organization that conducts an in depth review of the quality of services offered by rehabilitation service providers and grants or denies accreditation dependent on whether the provider meets national standards of consumer-focused, state of the art performance. Providers who seek CARF accreditation include Adult Day Services, Assisted Living, Behavioral Health, Mental Health, Substance Abuse and Rehabilitation Medicine. As of 2003 there were 38,000 organizations accredited by CARF in the US, Canada and Europe. To order the CARF catalogue call 520-325-1044 ext. 3 or access its website at www.carf.org

CBC Complete Blood Count

CBF Cerebral Blood Flow. Traumatic brain injury causes acute, short term changes in CBF, and may cause long term abnormalities in more severe cases. Increased flow is associated with high blood pressure. Decreased flow is associated with oxygen and glucose deprivation. SPECT imaging measures blood flow patterns in the brain

CC Current Complaint, Chief Complaint, Clinical Course or Critical Condition

CCC-SP Certificate of Clinical Competency in Speech Therapy

CD Convulsive Disorder

C/D Cigarettes Smoked per Day

CDD Certificate of Disability for Discharge

CHN Child Neurology

CIR Comprehensive In-Patient Rehabilitation

CIRS Certified Insurance Rehabilitation Specialist

CMA Certified Medical Assistant

CMT Certified Massage Therapist

CN Cranial Nerve. There are 12 pairs of cranial nerves coming off the brain that supply sensory inputs and motor outputs to the head, face, eyes, ears nd nose, mouth and throat.

CNA Certified Nurse's Aide (or Assistant)

CNS Central Nervous System, refers to the brain and spinal cord. The PNS or peripheral nervous system includes all motor and sensory nerves that leave from or return to the spinal cord.

CORF Comprehensive Outpatient Rehabilitation Facility

CPP Cerebral Perfusion Pressure equals MAP (mean arterial pressure) minus ICP (intracranial pressure). Low CPP following traumatic brain injury creates the risk of cerebral ischemia or oxygen deprivation. ICP and CPP are both monitored carefully in acute coma patients.

CRC Certified Rehabilitation Counselor

CRRN Certificate of Registered Rehabilitation Nurse

CSF Cerebrospinal Fluid, the nutrient rich fluid that cushions and bathes the brain and is circulated continuously through the brain's ventricular system. Skull fracture can cause a CSF leak through the nose or ears.

CVA Cerebrovascular Accident, refers to stroke, burst aneurysm or transient ischemic attack

D/A Date of Accident, Date of Admission to the Hospital or Discharge and Advise

DAI Diffuse Axonal Injury, refers to non-focal brain damage involving widespread disruption of axonal connections between brain cells. DAI is most obvious following a high speed head impact, when multiple lesions in the white matter of the brain can be seen on MRI. With high speed head impacts there is sufficient force to physically cut axons in half, leaving axonal stumps called axon retraction balls. However, DAI exists on a continuum of severity from lethal to mild and is believed to occur in mild TBI despite the inability of MRI to detect it. There is evidence that in mild TBI, the axons are not physically cut in two, but are strained, and consequent to strain injury the axons can undergo extensive physical degeneration over a period of days or weeks due in part to blockage of normal axonal transport of fluids and nutrients.

DAST Drug and Alcohol Screening Test

DB Date of Birth, Disability, Deep Breath or Data Base

DC Decrease, Diagnostic Code, Discontinue(d) or Discharge(d). Also Doctor of Chiropractic.

DCN Depressed but Cognitively Normal

DD Differential Diagnosis

DDD Degenerative Disc Disease

DDS Damaged Disk Syndrome or Doctor of Dental Science

DDx Differential Diagnosis

DE Diagnostic Error or Drug Evaluation

DES Dementia Rating Scale or Doctor's Emergency Service

DFG Direct Forward Gaze

DIB Difficulty in Breathing or Disability Insurance Benefits

DJD Degenerative Joint Disease

DL Developmental Level

DNR Dorsal Nerve Root (of the spinal cord)

DNS Deviated Nasal Septum or Did Not Show for Appointment

DNT Did Not Test (for a particular condition)

DO Doctor of Osteopathy, Doctor's Order or Drugs Only. Osteopaths must pass 4 years of rigorous training in medicine and osteopathy. They approach medical problems as manifestations of skeletal problems, e.g. severe headaches following head trauma as a consequence of mechanical narrowing of the space between skull bones with compression and flow restrictions of cerebro-spinal fluid.

DOE Date of Examination

DPI Daily Permissible Intake

DPM Doctor of Physical Medicine, Doctor of Podiatry or Discontinue Previous Medication

DPV Disabling Positional Vertigo

DSH Deliberate Self-Harm

DTC Day Treatment Center. Patients with TBI who need rehabilitation services on an outpatient basis, and who live at home with their spouse, parents or other care giver, may attend a DTC. They benefit from having the treatment while living in the community and having daily contact with a loved one.

DUR Drug Use Review

DVT Deep Vein Thrombosis, a harmful and potentially fatal complication of being hospitalized for TBI and having to lay still for long periods of time.

DW Daily Weight

Dx Diagnosis

DZ Diazepam (valium) or Dizziness

E/A Emergency Admission

EAC External Auditory Canal

ECF Extended Care Facility

EDH Epidural Hematoma, a rapidly expanding blood clot between the outer dural membrane of the brain and the inside of the skull. The source is generally a torn artery such as the middle meningeal artery. EDH is usually associated with skull fracture, especially in the temporal bone. EDH can be lethal if not detected and surgically evacuated rapidly following the traumatic event. When EDH is suspected clinically, hospitals will do a CT scan.

EEG Electro-encephalogram, a test for measuring brain waves that can assist in diagnosis of brain injury, seizure disorder, sleep disorders and other medical conditions. A completely flat EEG is used as a confirmatory test for the diagnosis of "brain death" in a totally non-responsive patient, who has met all clinical indicators of that condition.

ENG Electronystagnagram, a test for the presence of brain stem malfunction used for people with balance problems from whiplash, tumor or other medical causes. ENT A medical doctor specializing in disorders of the Ear, Nose and Throat, also called an otolaryngologist. Persons with brain injury may consult an ENT for problems like vertigo, tinnitus (ringing in the ears) or hearing loss.

EOD Every Other Day

FCOVD Fellow in College of Vision Development

FIM Functional Independence Measure, a test for rating level of self-sufficiency in activities of daily living

FNP Family Nurse Practitioner

GCS Glasgow Coma Scale, devised in 1972 by Drs. Teasdale and Jennett in Glasgow, Scotland, has become the most used yardstick of level of consciousness in the world. It is a somewhat crude but useful measure of gross brain function (arousal, alertness, orientation) that can be applied within minutes at an accident scene, in an ambulance or at a hospital. It rates eye opening, best motor response and best verbal response on a 15 point scale with 3-8 corresponding to severe brain injury, 9-12 to moderate and 13-15 to mild. Rehab providers often refer to GCS scores taken during the acute phase of injury, which are correlated in the medical literature with amenability to certain types of rehab and ultimate clinical outcomes (measured by the GOS or Glasgow Outcome Scale).

HEENT Head, Ears, Eyes, Nose and Throat. Physical examination of a trauma victim always
includes reference to this cluster of body parts.

HID Headache, Insomnia, Depression Syndrome; Herniated Intervertebral Disc; or Hyperkinetic Impulse Disorder

HMO Health maintenance organization. IPOs require primary care physician referral for specialty services. PPOs allow self-referral directly to a specialist. The National Committee on Quality Assurance is an independent not for profit organization that assesses and reports on quality of HMOs for the public. It can be reached at 202-955-3500.

HNS Head and Neck Surgery

ICF Intermediate Care Facility

ICP Intracranial Pressure, the pressure on the brain which can be elevated to dangerous, even fatal levels by brain swelling following head injury. Normal ICP is between 0-10 mm Hg. ICP is deemed elevated when it exceeds 20 mm Hg. Sustained episodes of ICP of 25 mm Hg is associated with death or poor outcome. ICP is measured by means of a sensor on a catheter inserted through the skull by burr hole. Use of ICP measuring device imperative after severe brain injury to avoid complications including herniation of the brain through the foramen magnum (spinal cord outlet) and oxygen deprivation injury due to compression of arteries or arterioles.

ICU Intensive Care Unit is the part of a hospital for persons (such as those who have suffered an acute brain injury) who are at risk of dying in the absence of "intensive" monitoring of and care of basic life processes such as metabolism, fluid and electrolyte levels, respiration, heart rate, pulse, blood pressure, intra-cranial pressure and the like. Rehabilitation begins after discharge from the ICU with very few exceptions.

JCAHO Joint Commission on Accreditation of Healthcare Organizations,
a private, not for profit organization that develops quality standards and inspects for compliance with such standards with respect to hospitals, long term care facilities, ambulatory health care organizations and organizations offering psychiatric services and home care agencies.

LAc Licensed Accupuncturist

LCSW Licensed Clinical Social Worker

LPN Licensed Practical Nurse

LVN Licensed Vocational Nurse

MD Doctor of Medicine. Must pass 4 years of accredited medical school. A license to practice medicine can only be issued by a department, board or agency acting with the authority of a State government.

MRC Master in Rehabilitation Counseling

MT Movement Therapist

NAD No Acute Distress, referring to absence of obvious distress in a patient submitting to a medical examination

OD Optimal Dose, Overdose or Doctor of Optometry. Optometrists test for traumatic injury to or diseases of the eyes, test for visual acuity and write prescriptions for corrective lenses. Some get advanced training in neuro-optometry or functional optometry and can help brain injured persons with blurred or double vision consequent to head trauma.

OMR Outpatient Medical Rehabilitation

OT Occupational Therapist, provides instruction to persons prior or subsequent to discharge from a hospital as to matters of self-care and activities of daily living with the goal of promoting self-sufficiency. OTs help patients re-learn or re-master a great variety of activities including meal preparation, eating, use of the toilet, basic personal hygiene, typing, using tools, organizing and processing mail, paying bills and driving.

PET A form of neuro-imaging called positron emission tomography, which requires the subject to absorb a mildly radioactive glucose solution, and which uses a gamma camera to generate a color coded map of brain metabolism during mental tasks. It is useful in assessing what parts of the traumatized brain have returned to normal levels of function and which remain non-functional or in a state of impaired function, based on the known correlation between levels of brain function and glucose metabolism.PhD A Doctorate of Philosophy awarded by a graduate school, represents the highest level of formal academic training in a given subject. To become licensed in psychology, a person must be awarded a PhD from an APA approved program in psychology. Neuro-psychologists are clinical psychologists who test and/or treat people with brain injuries. The most competent among them have taken advanced coursework in neuro-anatomy and neuro-physiology and have been trained at hospitals in brain injury rehabilitation.

PICU Pediatric Intensive Care Unit

PMH Past Medical History, refers to illnesses, injuries or surgeries previous to a hospital admission.

PsyD Doctor of Psychology

PT Physical Therapist, provides hands-on training and instruction in stretching and exercise to ease pain, restore strength and flexibility and increase range of motion. A registered physical therapist is called an RPT.

PTA Physical Therapy Aide

PTA Post Traumatic Amnesia, refers to the period just before, during or after a brain injury which cannot be recalled by the victim due to physiologic disruption of normal brain function. Retrograde specifically refers to amnesia for a period of time before the brain injury, while anterograde specifically refers to amnesia for events after the brain injury. The length of PTA (in seconds, minutes, hours, days or weeks) is an important measure of the severity of a brain injury and an important predictor of ultimate clinical outcome following rehabilitation.

RN Registered Nurse

RT Respiratory Therapist

Rx Prescription by a physician for medication, medical appliances or devices or therapy services

SDH Subdural Hematoma, a blood clot between the membranes that surround the brain (the meninges) and the brain itself, caused by lower velocity head injury with tearing of a vein that bridges the meninges. Generally non-fatal. Slow bleeding into the subdural space can go undetected and cause a chronic SDH that weeks later manifests by headaches or other symptoms.

SLP Speech-Language Pathologist