When shortcuts fall short: The hidden danger of abbreviations in critical care

Effective critical care communication is vital for patient safety, yet the risks of ambiguous abbreviations and acronyms or initialisms in clinical communication remain understudied. This narrative review aims to identify potentially ambiguous abbreviations and acronyms in critical care and evaluate their potential implications for clinical safety and communication quality. From this, educational interventions and standardized protocols could be devised to optimize communication. PubMed and Embase databases were used to identify studies and reports on the use of abbreviations and acronyms in medical care and references of identified publications were screened. Additionally, the large language model "Chat Generative Pre-Trained Transformer-4omni" was used to generate a list of ambiguous terms used in critical care. We identified 52 ambiguous acronyms and initialisms, and 24 abbreviations used in critical care with multiple meanings, risking critical errors during communication and ward transfers. These ambiguities stem from specialty, context, or institutional differences. The literature discusses optimization of communication in critical care during hand-offs or more complex solutions including auto-expansion software or protocols. Only few studies discussed the dangers of medication errors or misunderstandings due to abbreviation use. Abbreviations contribute to as much as 13 % of medication errors. Strategies are proposed to reduce abbreviation-related errors including spelling out terms initially, using closed-loop communication, standardized unit-approved lists, regular education, and avoiding jargon. Ambiguous abbreviations and acronyms pose a significant threat to safe and effective communication in critical care. Standardized terminology, education, and clear documentation practices are urgently needed to mitigate these risks and improve patient safety.