The acronym “LOL” is universally recognized as internet slang for “Laugh Out Loud.” While this shorthand is not part of any official, standardized dictionary of medical abbreviations, its appearance in clinical notes is a rare, highly problematic occurrence. This article defines the specific technical concepts this acronym is sometimes used to represent, highlighting why its non-standard use is discouraged in healthcare documentation. The confusion surrounding this abbreviation serves as an important case study for the wider risks associated with medical shorthand.
The Primary Meaning of LOL in Clinical Settings
The most frequent, albeit informal, technical interpretations of “LOL” in a clinical environment relate to organ function, specifically “Low Output Liver” or “Low Output Left Ventricle.” Neither phrase is a formal medical diagnosis, but they describe a state where an organ is failing to perform its function adequately. “Low Output Liver” refers to a reduced level of hepatic function, often indicated by blood tests showing insufficient protein synthesis or poor clearance of waste products like bilirubin. When the liver’s output is low, the body struggles to manage clotting factors and toxins, a condition often seen in advanced liver disease.
Similarly, “Low Output Left Ventricle” describes a compromised heart function where the left ventricle cannot eject blood effectively. This condition is a form of heart failure, characterized by a low cardiac output, meaning the heart pumps a reduced volume of blood per minute. The measurement of Left Ventricular Ejection Fraction (LVEF) quantifies this, with a low percentage indicating the heart muscle is too weak. While the formal term is often “Low Cardiac Output Syndrome” (LCOS), the non-standard “LOL” is occasionally used as quick, ambiguous shorthand by clinicians.
Contextual Use and Documentation Ambiguity
The occasional appearance of non-standard abbreviations like “LOL” stems from the fast-paced nature of clinical documentation. Healthcare professionals frequently rely on shorthand to quickly record observations in patient charts, especially in handwritten notes or older electronic systems. This drive for speed clashes with the need for absolute clarity, particularly when the abbreviation overlaps with common cultural language. The non-medical meaning of “LOL” introduces ambiguity, creating a communication breakdown when a non-specialist views the record.
The ambiguity is further compounded because “LOL” has been used informally, and unprofessionally, to stand for “Little Old Lady.” This derogatory phrase belittles and inappropriately characterizes a patient, violating professional standards and compromising the dignity of care. The overlap between this slang and the potential technical meanings illustrates the inherent risk of using any non-standard abbreviation. This forces the reader to guess the intended context, which can lead to miscommunication among the care team.
The Broader Problem of Confusing Medical Shorthand
The confusion surrounding the non-standard use of “LOL” is one example of a broader, systemic issue in healthcare documentation. The use of abbreviations, while efficient, is a significant source of medical error that can lead to patient harm. Organizations like The Joint Commission (TJC) maintain a list of discouraged abbreviations, symbols, and dose designations that pose a high risk for misinterpretation.
The TJC “Do Not Use” list includes several high-risk abbreviations:
- The abbreviation “U” for “unit” can easily be mistaken for a “0” or a “4” if handwritten poorly.
- Using “QD” for “once daily” or “QOD” for “every other day” are frequently confused, potentially resulting in a patient receiving medication on the wrong schedule.
- Common abbreviations like “Pt” can be ambiguous, sometimes standing for “patient” and other times for “physical therapy” or a specific lab test.
The widespread reliance on shorthand forces healthcare facilities to constantly educate staff and implement electronic systems to prevent these communication errors.