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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.

Wednesday 1 August 2012

Removal of spinal cord stimulator epidural array Removal of spinal cord stimulator generator Thoracic laminectomy for epidural abscess Deep spinal infection incision and drainage and debridement and layered complex closure of postoperative wound infection


PREOPERATIVE DIAGNOSES:
1.  Status post spinal cord stimulator, epidural array implantations.
2.  Spinal cord stimulator generator implantation.
3.  History of previous infection about the spinal cord stimulator, epidural array with recurrent infection and epidural abscess at the site of the spinal cord stimulator, epidural array.

POSTOPERATIVE DIAGNOSES:
1.  Status post spinal cord stimulator, epidural array implantations.
2.  Spinal cord stimulator generator implantation.
3.  History of previous infection about the spinal cord stimulator, epidural array with recurrent infection and epidural abscess at the site of the spinal cord stimulator, epidural array.
OPERATION PERFORMED:
1.  Removal of spinal cord stimulator, epidural array.
2.  Removal of spinal cord stimulator generator.
3.  Thoracic laminectomy for epidural abscess.
4.  Deep spinal infection incision and drainage and debridement.
5.  _____ layered complex closure of postoperative wound infection.

ANESTHESIA:  General.

INDICATIONS:  The patient is a 77-year-old woman.  Refer to my previously dictated clinical note at which point, I discussed indications of procedures, risks, benefits, and expected outcomes.  The dictation number for that is #2683505.

PROCEDURE IN DETAIL:  After obtaining informed consent, the patient was taken to the operating room.  After induction of general endotracheal anesthesia, the patient was positioned prone on the Jackson table.  All pressure points were carefully padded.  The back was prepped and draped in the usual sterile fashion.  The incision of the spinal cord stimulator generator was opened up sharply with #10 scalpel.  The incision had been drained copious amounts of fluid.  The generator was easily explanted.  There was a significant amount of grungy-appearing tissue, which was bluntly and sharply dissected.  The skin edges were sharply resected with #11 scalpel.

I opened up the midline thoracic incision approximately 5 inches of the cranial most portion of the incision with a #10 scalpel, carried down with electrocautery to the fascia.  We identified the spinal cord stimulator electrode extension.  These were followed cranially to the laminotomy site.

With meticulous dissection, I was able to gently tease the scar at the laminotomy site off of the dura.  There was egress of significant amount of epidural pus.  The epidural array was easily removed.  Next, I extended the laminotomy cranially with Kerrison rongeurs with an elevator was used to probe the epidural space to ensure there is no evidence for any residual epidural abscess both cranially and caudally.  There is no evidence for any residual epidural pus.  Next, I irrigated out the epidural space with antibiotic-impregnated saline.  Meticulous hemostasis was obtained.  Next, I irrigated the thoracic incision copiously with antibiotic-impregnated saline with pulse lavage.  Meticulous hemostasis was obtained with cautery.  Hemovac drain placed in epidural space, brought by separate stab incision.  Next, a meticulous multiple layer closure was performed with 0 PDS suture for the fascia and muscle, subcutaneous tissues in layers 2-0 PDS suture, and skins were approximated with 3-0 nylon in interrupted mattress fashion.  Next, I previously debrided the pocked from the spinal cord stimulator generator. I placed the drain into the depths of the incision.  I closed the dead space with 0 PDS sutures, subcutaneous tissues in layers with 2-0 PDS suture, and interrupted stitch of 3-0 nylon in mattress fashion for the skin.  Sterile dressing were applied followed by an Ioban drape dressing.

The patient was next carefully transferred to a hospital stretcher and awoken from anesthesia, extubated and taken to the recovery room in stable condition.

Estimated blood loss was approximately 50 mL.  Specimen was cultures from the epidural space as well as from the spinal cord stimulator generator pocket as well as spinal cord stimulator generator and epidural array.  No complications.  No change in baseline evoked potentials.  The patient tolerated the procedure well.

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1 comment:

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