text before? after? context? type of report? help us help you... nm
Posted By: flybye on 2006-02-03
In Reply to: s/l prayer mere flu was noted. - ???
Subject: text before? after? context? type of report? help us help you... nm
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Trac...most likely tendinopathy, but consider the entire context of report.
Subject: Trac...most likely tendinopathy, but consider the entire context of report.
what type of report is it?
Subject: what type of report is it?
is this an op report or H&P or what?
More context, please? Where in anatomy, type of procedure, etc?
Subject: More context, please? Where in anatomy, type of procedure, etc?
x
for what type of pain? what is the report about?
Subject: for what type of pain? what is the report about?
.
Usually depends on the type of report
Subject: Usually depends on the type of report
While account specifics vary from hospital to hospital, I don't think I've had a hospital with an H&P that didn't require that you separate out the headings; discharge summaries, on the other hand, are usually allowed to be in paragraph form, and consults are a toss-up. Clinic/office notes are totally a matter of account specifics. When you get into specialty clinics, they sometimes break it down even further; i.e., an ENT doctor may separate out HEAD: EYES: EARS:, etc., and a neurologist may do MENTAL STATUS: CRANIAL NERVES: STRENGTH: REFLEXES, etc. However, in most cases, if the doctor uses headings in an exam for some of the systems/body parts, you usually are to use the appropriate ones for all; as noted, though, that is dependent on account specifics.
Got a body part? Report type? Something before and after this???nm
Subject: Got a body part? Report type? Something before and after this???nm
s
a type of fracture on a radiology report
Subject: a type of fracture on a radiology report
(Am new to radiology) Pertaining to right elbow fracture: S/L "desalergeeze" fracture. I have been trying to hear "distal ........ fracture" but it sounds like the above. Thanks so much.
What comes before or after this? Where in the dictation is this located? Type of report? nm
Subject: What comes before or after this? Where in the dictation is this located? Type of report? nm
s
How would I type a math equation in a report?
Subject: How would I type a math equation in a report?
Dictator said client answer 100 minus 7 as 93 after much calculation. Should I use the minus and equal signs? Thanks in advance....
I am not sure what type of report you are doing, but could it be amantadine and Zetia for the 2 meds
Subject: I am not sure what type of report you are doing, but could it be amantadine and Zetia for the 2 meds ?
More text
Subject: More text
I have explained to him that it is experimental therapy. There is no guarantee of success. The turbacent toxicities are substantial and these were discussed with the patient.
Need to know how it was used in the text.
Subject: Need to know how it was used in the text.
xx
Sorry, misunderstood the text.
Subject: Sorry, misunderstood the text.
More text would be helpful. sm
Subject: More text would be helpful. sm
If this is ortho, the second term probably should be Brudzinski sign.
a little more info/text might help
Subject: a little more info/text might help
. . of what you are transcriting - is patient pre- or perioperative . . parative not a medical word that I can find . . . a derivative of "parous" possibly?
May be PERIORAL but need more text to be sure...
Subject: May be PERIORAL but need more text to be sure...
Is in on the face (around the mouth in particular)?
aortogram cath see text
Subject: aortogram cath see text
During (Seldinger technique)approach to the infrarenal aorta..."to get full approach for the "UnaFlush or UniFlush" catheter. At first I tried to hear "Omniflush" but at the end of the report, it sounded much more like "UnaFlush or UniFlush." Any clues?
Not enough text to go on, but suspect you're sm
Subject: Not enough text to go on, but suspect you're sm
missing something here. Buccal is an adjective, so if that is indeed the correct term, you need a noun to go with it. What kind of surgery is this?
More text, is it a cancer note, what are we looking at?
Subject: More text, is it a cancer note, what are we looking at?
Full text as dictated (sm)
Subject: Full text as dictated (sm)
Here's the full text as dictated without any edit.
Would appreciate any opinions. Thanks!
"Recently, he went to a massage parlor that was given by a woman and he said he had more than just a massage. He said that she performed a hand job on them. Basically, that was pretty much about it. She masturbated him with her hand and after that, he started to have some discomfort. He denies having any oral, vaginal, or anal sex with this person. He said that after all that, he said he started to get this discomfort."
If you post more text, we can probably figure it out.
Subject: If you post more text, we can probably figure it out.
x
hmmm... what's the text book way?
Subject: hmmm... what's the text book way?
I really don't know. It's a school assigned transcript looking for a I guess "Text Book" way of transcribing it. But all she dictates is
Pyscho was consulted. for her 'Hospital Course.' ... So I was confused at to whether leave it or expand.. but as I see what your saying.. because when I expand it those ways.. doesn't really make sense.. maybe they are wanting me to realized that and not expand but "" the report.
s/l jump to the PDA...see text inside.
Subject: s/l jump to the PDA...see text inside.
It was noted that the radial artery graft to the circumflex and s/l jump to the PDA was totally occluded
hm...any more info? before or after text? is this urine, blood, or? nm
Subject: hm...any more info? before or after text? is this urine, blood, or? nm
without any context, maybe concha bullosa? next time give context. thanks!
Subject: without any context, maybe concha bullosa? next time give context. thanks!
Context, context, context. There is a lott
Subject: Context, context, context. There is a lott
of help out here but what is this?
same here. Type out numbers at beginning of sentences. Otherwise type numeral if in sentence itself.
Subject: same here. Type out numbers at beginning of sentences. Otherwise type numeral if in sentence itself.
nm
Patient with type 2 diabetes prescribed a s/l glutisone type drug. nm
Subject: Patient with type 2 diabetes prescribed a s/l glutisone type drug. nm
which is preferred ~ diabetes mellitus type II or type 2?
Subject: which is preferred ~ diabetes mellitus type II or type 2?
I get confused, how do you type out grade, class, type SM
Subject: I get confused, how do you type out grade, class, type SM
I forget which ones use Roman and which do not. TIA
When doctor says tib-fib, do you type it like that or do you type tibiofibular? Thanks
.
Siewart type I or Siewert type I
Subject: Siewart type I or Siewert type I
When I google it, I'm finding both. Cannot locate it in a Stedman's book. Doctor spells with "a" but you can't always go by the spellings!
How do I type this particular type of dialysis bath? sm
Subject: How do I type this particular type of dialysis bath? sm
Doc is an ESL and unclear, but it s/l he is saying "...using a 3 K 21/2 bath." I have never had this in a report and after googling, am still as clueless as I was. I cannot find it in AAMT, either. Any help would be appreciated. Thank you!
acromion process - type 2 or type II
Subject: acromion process - type 2 or type II
Could it be hollowing-type or hollow-end-type? - nm
Subject: Could it be hollowing-type or hollow-end-type? - nm
xx
how to type out Type I Aortic aneurysm
Subject: how to type out Type I Aortic aneurysm
Would you use a roman numeral for Type I Aortic aneurysm or use Type one or type 1 ... I am thinking it is Type I but I am unsure. I am new to this all. Thanks for any help.
I would type it under PLAN and type what is dictated.
Subject: I would type it under PLAN and type what is dictated.
I have had that happen to me before, and I was told by QA to not move things around in the report, maybe that is the same for you, but if I were typing this report, I would type it in the order as is dictated, even if that means typing it under the heading PLAN. Also, his vitals were probably taken at the end of the exam as they were repeated, so it would make sense to type them again under that heading. Hope that helps!
Maybe this? What context is it used?
PPP syndrome could refer to MEN (multiple endocrine neoplasia), which "typically involves the pituitary, parathyroid, and pancreas glands (recall it as the PPP syndrome)."
http://www.utmem.edu/endocrinology/Endocrine%20pathophysioloy/Chap%2014.htm
I also saw pustulosis palmoplantaris syndrome and pretty picture protectiveness syndrome.
A little context would help. SM
Subject: A little context would help. SM
What kind of surgery is it? Where is the incision being made?
Can you please supply this information. Thanks
we need context!! please
Subject: we need context!! please
x
More context please? nm
Subject: More context please? nm
nm
More context would help us help you. What is the sm
Subject: More context would help us help you. What is the sm
sentence before, the sentence with the s/l, and the sentence after? Thanks.
How about some context? nm
Subject: How about some context? nm
x
Say WHAT??!!!?? Need context. nm
Subject: Say WHAT??!!!?? Need context. nm
nm
any context to go with your s/l? nm
Subject: any context to go with your s/l? nm
x
How about some context? nm
Subject: How about some context? nm
x
context please?
Subject: context please?
more context before this? nm
Subject: more context before this? nm
Context!?! nm
Subject: Context!?! nm
x
What's the context?
Subject: What's the context?
.
in what context?
Subject: in what context?
x
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