MEDICAL TRANSCRIPTION SAMPLE REPORTS: Exploratory laparotomy and total abdominal hysterectomy

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.

Friday, 27 July 2012

Exploratory laparotomy and total abdominal hysterectomy

PREOPERATIVE DIAGNOSIS: Symptomatic fibroids.

POSTOPERATIVE DIAGNOSIS: Symptomatic fibroids.

OPERATION PERFORMED: Exploratory laparotomy and total abdominal hysterectomy.

ANESTHESIA: General endotracheal anesthesia.

ESTIMATED BLOOD LOSS: 250 mL.

URINE OUTPUT: 400 mL.

IV FLUIDS: 2600 mL.

FINDINGS: Approximately 16-week size uterus, normal bilateral tubes and ovaries.

SPECIMENS: Uterus and cervix.

PROCEDURE IN DETAIL: The patient was taken to the operating room where general anesthesia was found to be adequate. She was then prepped and draped in normal sterile fashion in the supine position. A transverse skin incision was then made with the scalpel and carried through the underlying layer of fascia. Fascia was incised in the midline. The incision was extended laterally. The muscles were separated in the midline and peritoneum was entered bluntly. The uterus was then delivered through the incision and the patient’s left round ligament was clamped, transected and tied. Hemostasis was noted in a similar fashion. The patient’s right round ligament was clamped, transected, and tied. Both were tagged. The left utero-ovarian ligament was then in a similar fashion clamped, transected, and suture ligated bilaterally. Bilateral ureter ends were skeletonized and bladder flap was created. With sharp dissection, the bladder was dissected off of the cervix. A curved Heaney clamp was then used to clamp the uterine bilaterally, which were clamped, transected, and ligated. Bilateral parametria were taken down to the level of the cervicovaginal junction. The cervix and uterus were then transected from the vagina and the vagina was closed with interrupted figure-of-eight using #1 Vicryl. Hemostasis was again noted. Irrigation was performed and all pedicles were visualized and noted to be hemostatic. Bilateral ureters were visualized and noted to be peristalsing. The fascia was then reapproximated using #1 Vicryl in a running fashion. Skin was closed with 4-0 Monocryl in a subcuticular fashion. The patient tolerated the procedure well. Sponge, lap, and needle count were correct x2. The patient was taken to recovery room in stable condition.

MEDICAL TRANSCRIPTION SAMPLE REPORTS

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