MEDICAL TRANSCRIPTION SAMPLE REPORTS: common bile duct stone noted and removed with the endoscopic retrograde cholangiopancreatography

Medical Transcription

Medical transcription is one of the fastest-growing profession in the country today.

Medical transcription offers excellent opportunity to housewives, ex-servicemen, graduate fresh or experienced, especially the newly passed ones. It is also a high income career for the graduates. You can even sit at your home and earn money from home feasibly through medical transcription career, and one can organize his/her own work timings and avoid travel to the works for and thus earn more than the usual office goers.

Nature of job, doctors will dictates the patients’ information, which we will receive in wave format through voice mail or dictaphone which consists of medical datas, which we have to type.

Transcription process is conversion of voice to electronic text form. As this process deals medical data documentation, so this is called medical transcription. The person who deals with medical data process is called Medical Transcriptionist.

Any person can do home based medical transcription program, those who are interested to learn, who able to grasp accents’ of dictators’ voice, who able to understand English, who able to form sentences grammatically and finally, who wants to earn money shortly from home or office.

There are many institutions that providing free home based medical transcription training through internet with their own “terms and condition” and time limits, duration. To avail home based medical transcription training you should computer laptop or desktop with UPS, phone and internet connection for communications. They would design the program accordingly where one can learn medical transcription from home.

Home based Medical transcription Training program duration may be 2 to 4 months.

After successful completion of home medical transcription training from institute based on your quality and quantity, you will be offered a home based job medical transcription immediately, and you are supposed to sign an agreement and can start medical transcription job from home and can start earning from home. Companies will provide you files through internet which has to be transcribed.

Based on your quality and quantity, remuneration will be fixed with incentives per month and remuneration will be gradually increased as your experience increases. One can start earn initially low, but gradually can increase with incentives as experience increases.

Quality - the document should be without error and should not commit error beyond the limit. Files should be submitted with minimum 90% accuracy to company by the medical transcriptionist and to the client, 99.5% accuracy after QC/QA. Quantity - a transcriptionist should be able to transcribe minimum of 350 lines per day, initially after successful training.

Main advantage of taking home based medical transcription work, one can organize their own work timings. They can reduce your traveling time 2 to 4 hours, so that can spend more time in working to earn more.

Thursday, 26 July 2012

common bile duct stone noted and removed with the endoscopic retrograde cholangiopancreatography

INDICATIONS: Abdominal pain with the common bile duct stone seen on CT imaging with abnormal liver enzymes. Symptoms compatible with common bile duct stones.

POSTPROCEDURE DIAGNOSES: 1. Single common bile duct stone noted and removed with the endoscopic retrograde cholangiopancreatography, sphincterotomy, and stone extraction.

2. Possible gallstones. This is pending review by the radiologist.

PROCEDURE IN DETAIL: The risks of perforation, bleeding, infection, sedation, and pancreatitis were outlined in detail, and also delineated in the history and physical and consult. Anesthesia facilitated intubation and sedation in the prone position. Once in this position and sedated and intubated, the scope easily advanced to the second portion of the duodenum where the major ampulla is identified. Initial cannulation resulted in pancreatic cannulation. Manipulation with the wire resulted in subsequent easy biliary cannulation, which identified a small stone in the distal bile duct. There was also possible filling defects within the gallbladder itself. This will be reviewed with the radiologist. The sphincterotomy was then undertaken with 9- to 12-mm balloon, sweeping out the stone. This was seen within the duodenum and photographed. Further extraction cholangiography revealed no other filling defects in the common bile duct or intrahepatic biliary tree beside from bubbles. Free drainage was noted with postprocedure imaging, identifying good biliary drainage. The patient will be observed, placed on liquids. Surgical discretion at the timing of cholecystectomy, morning labs to be followed up. She did receive antibiotics earlier today.

MEDICAL TRANSCRIPTION SAMPLE REPORTS

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