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Jul 15 12:35
• FINDINGS: Right anterior and right posterior grade 2 hemorrhoids ____ ...
+ wav
Sat Jul 22 03:50:14 2017 wav
FINDINGS: Right anterior and right posterior grade 2 hemorrhoids _____ posterior midline fissure.
** • got it. thanks. healing - guy
Sat Jul 22 03:56:43 2017 guy


• Using a 50:50 Marcaine to lidocaine with epinephrine mixture, a perian ...
+ wav
Sat Jul 22 03:06:40 2017 wav
Using a 50:50 Marcaine to lidocaine with epinephrine mixture, a perianal block was performed with 10 cc of local anesthesia injected on each side. A pudendal nerve block using the same local anesthetic mixture was then performed. External exam was significant for an anterolateral anal fistula _____ left. A digital rectal exam was then performed and significant for anal stenosis.
** • nevermind. Thanks to anyone who tried. - guy
Sat Jul 22 03:50:32 2017 guy


• Several samples were also spent for cultures including aerobic, anaero ...
+ wav
Sat Jul 22 01:28:08 2017 wav
Several samples were also spent for cultures including aerobic, anaerobic, and fungal. All of the tissue was debrided within the bony cavity until all bony margins were visualized. At that point in time, tooth #31 was extracted by a simple elevator and forceps technique. The tooth was noted to have four roots which was an anatomic _____ as mandibular molars typically only have two roots.
** • NOTE: You have a typo....sent for cultures (not spent) - Q
Sat Jul 22 01:30:14 2017 Q

**** • Thanks for the correction. he does say spent so my fingers typed as is. wav posted. - guy
Sat Jul 22 01:33:14 2017 guy

****** • WAV does not cover that portion...Even if he said spent, that would be wrong; it s/b sent. - Q
Sat Jul 22 01:35:07 2017 Q

******** • Thanks. i agree. - guy
Sat Jul 22 01:37:49 2017 guy

** • variant - Questyr
Sat Jul 22 01:29:43 2017 Questyr

**** • Thanks a lot. - guy
Sat Jul 22 01:30:56 2017 guy


• Excess cement was removed after proper occlusion of the crowns were ve ...
+ wav
Sat Jul 22 00:56:46 2017 wav
Excess cement was removed after proper occlusion of the crowns were verified. Extractions were completed using dental elevators and forceps. Fibrillar ____ was used to achieve hemostasis. All the restorations and extractions wee completed, the throat pack was removed and the patient was turned over to Anesthesia for extubation.
** • ??bulking?? - Questyr
Sat Jul 22 00:58:44 2017 Questyr

**** • Thanks a lot. - guy
Sat Jul 22 01:00:52 2017 guy


• Preoperative Diagnosis: EARLY CHILDHOOD CARIES. Procedure: ...
+ wav
Sat Jul 22 00:44:54 2017 wav
Preoperative Diagnosis:
EARLY CHILDHOOD CARIES.

Procedure:
RESTORATIONS AND EXTRACTIONS OF TEETH.

The patient is a 7-year-9-month-old male with history of seizure disorder, epilepsy, _____, taking Keppra and Risperdal, that has multiple carious primary and permanent teeth.
** • ????daily ____ seizures??? - Questyr
Sat Jul 22 00:47:58 2017 Questyr

** • NOTE: No hyphen between year and 9. - Questyr
Sat Jul 22 00:46:58 2017 Questyr

**** • Thanks a lot. Thanks for the correction. - guy
Sat Jul 22 00:52:26 2017 guy


• saying **ten twelve** umbilical trocar. how to write it?
+ guy
Fri Jul 21 23:43:07 2017 guy
At this point, we examined the mesenteric defects of her bypass. Petersens defect appeared close as did the jejunojejunal anastomosis. At this point, secondary trocars were removed under direct vision. The fascia of the **10-12** umbilical trocar was closed with a figure-of-eight #0 Vicryl suture using a suture passer.
** • 10/12 (see link) + Questyr
Fri Jul 21 23:47:47 2017 Questyr
link
**** • Thanks a lot. - guy
Fri Jul 21 23:48:37 2017 guy


• We then incised the peritoneum overlying the infundibulum and the cyst ...
+ mp3
Fri Jul 21 23:32:52 2017 mp3
We then incised the peritoneum overlying the infundibulum and the cystic duct and cystic artery were identified and circumferentially dissected. A clip was placed and we obtained the critical view of safety _____ two tubular structures entering the gallbladder with the _____ gallbladder taken off of the liver.
** • 2. bottom surface? of the - poi
Sat Jul 22 00:02:11 2017 poi

**** • I thought I heard that too..or bottom side..but when I checked + Q
Sat Jul 22 00:05:26 2017 Q
image of the anatomy it is the top surface of the gallbladder that meets the liver....unless the patient is face down maybe
****** • that really makes no sense to me at all as the entire gallbladder lies + link-poi
Sat Jul 22 00:29:08 2017 link-poi
in the liver, particularly if patient is supine..but as you say, not worth arguing about.
******** • reposting link + poi
Sat Jul 22 00:35:53 2017 poi
link
********** • that didn't work either, doesn't matter. - poi
Sat Jul 22 00:36:53 2017 poi

************ • That's okay...it put in your parameters to see the images..and as U say, doesn't matter - Q
Sat Jul 22 00:38:37 2017 Q

******** • Your link did not show any images. Here are the images I looked at. - Q
Sat Jul 22 00:31:32 2017 Q

********** • oops + Q
Sat Jul 22 00:31:55 2017 Q
link
****** • Thanks a lot everybody - guy-wag
Sat Jul 22 00:09:26 2017 guy-wag

** • #1 by seeing #2 ?? - Questyr
Fri Jul 21 23:46:59 2017 Questyr

**** • Thanks a lot. flagging #2. - guy
Fri Jul 21 23:54:00 2017 guy


• After all material risks, benefits, and alternatives to the procedure ...
+ wav
Fri Jul 21 23:21:56 2017 wav
After all material risks, benefits, and alternatives to the procedure were explained to the patient, written informed consent was obtained. The patient was brought to the operating room and placed supine on the operating table. SCDs were placed. Anesthesia was then administered and the endotracheal tube was placed. The surgical field was then prepped and draped in the standard sterile fashion. Prior to incision, a time-out was completed verifying correct patient, procedure site, laterality, and positioning. Given _____ abdominal wall, we decided to obtain access to the abdomen using the Optiview technique in the left upper quadrant.
** • ???her slack??? - Questyr
Fri Jul 21 23:42:28 2017 Questyr

**** • Thanks a lot. - guy
Fri Jul 21 23:43:25 2017 guy


• right ventricular free wall diastolic s/l madge-eh-nation suggestive of increased TIA
+ card/echo?
Fri Jul 21 20:51:32 2017 card/echo?
There is right ventricular free wall diastolic ___ suggestive of increased intrathoracic pressure.
** • can you post a sound file? - nm
Fri Jul 21 21:20:08 2017 nm

**** • Unfortunately, no. - OP
Fri Jul 21 21:24:16 2017 OP

****** • how about another s/l ? all I see is "imagination" - nm
Fri Jul 21 21:28:17 2017 nm

******** • That's all I heard too. Thanks for trying. Need to flag and send on. - OP
Fri Jul 21 23:59:41 2017 OP


• The patient is a 39-year-old female with a history of left patella fra ...
+ wav
Fri Jul 21 19:09:20 2017 wav
The patient is a 39-year-old female with a history of left patella fracture, status post open reduction and internal fixation complicated by a wound. Wound was conservatively managed for sometime with VAC changes followed by Integra placement approximately five weeks ago. At that time, she was noted to have approximately 1-cm area of exposed bone underlying granulation tissue and it was felt that this _____ to be covered adequately with Integra rather than a local flap and so a decision was made to place Integra
** • sometime should be "some time" - Questyr
Fri Jul 21 20:34:29 2017 Questyr

**** • If it helps...sometime is an adjective or adverb, but in + Questyr
Fri Jul 21 20:40:50 2017 Questyr
your context "for" is a preposition and it needs an object noun (in your case "time")....and "some" is a determiner (see link)
****** • Thanks for the correction. - guy
Fri Jul 21 23:23:12 2017 guy

** • this wound could be covered. - billybob
Fri Jul 21 19:16:24 2017 billybob

**** • Thanks a lot. - guy
Fri Jul 21 19:18:00 2017 guy


• Preoperative Diagnosis: LEFT EYEBROW MASS. Procedure: LEF ...
+ wav
Fri Jul 21 18:47:15 2017 wav
Preoperative Diagnosis:
LEFT EYEBROW MASS.

Procedure:
LEFT EYEBROW MASS EXCISION.

The patient is a 10-year-old healthy male who presented with a mildly enlarging left eyebrow medial mass. The mass was most likely consistent with _____ cyst. The patients mother and the patient wished to have the mass excised and so after discussing the risks and benefits, they agreed to undergo elective excision of the left eyebrow mass. Informed consent was obtained.
** • an epidermal inclusion - Questyr
Fri Jul 21 18:57:02 2017 Questyr

**** • Thanks a lot. - guy
Fri Jul 21 19:02:44 2017 guy

** • epidermal inclusion cyst - mn
Fri Jul 21 18:56:54 2017 mn

**** • Thanks a lot. - guy
Fri Jul 21 19:02:32 2017 guy


• s/l sebreety ESL help !
+ mt
Fri Jul 21 15:42:27 2017 mt
The differential diagnosis includes littoral cell angioma, sarcoidosis, and lymphoma. She has no fevers or chills or drenching night sweats. No weight loss. We will obtain a CT of the neck and chest to rule out lymphadenopathy. We will repeat an MRI of the abdomen and pelvis in three to six months to evaluate the s/l sebreety of the splenic lesions.
** • could be it - thanks! - mt
Fri Jul 21 16:01:07 2017 mt

** • severity? - taco
Fri Jul 21 15:49:20 2017 taco


• She fell on the ground with a _____ s/l "fushed" (like the "few" in fuchsia) arm
+ tia
Fri Jul 21 13:09:25 2017 tia
She fell on the ground with a _____ s/l "fushed" (like the "few" in fuchsia) arm and has had pain in her shoulder ever since.
** • Maybe talking about a FOOSH injury = Fall On Out-Stretched Hand + an oldie
Fri Jul 21 19:57:32 2017 an oldie
It's an old acronym but some of my ER docs still use it.

Just a thought, though.
**** • Oooh, I like that! - Q
Fri Jul 21 20:41:54 2017 Q

** • Actually taco's makes sense where "a fushed"= outstretch..She fell on + Questyr
Fri Jul 21 13:43:12 2017 Questyr
the ground with outstretched arm (IMO)
**** • typo..."a fushed"= outstretched - Q
Fri Jul 21 13:43:45 2017 Q

****** • thanks for trying! :) I ended up flagging it. - tia
Fri Jul 21 16:58:46 2017 tia

** • all I can think of is "outstretched" but nothing like your s/l - taco
Fri Jul 21 13:26:33 2017 taco


• Pt with ventricular tachycardia with *SC* at age 14
+ CO MT
Fri Jul 21 12:50:29 2017 CO MT
Not mentioned elsewhere in report. Thanks
** • more context - what is pt's problem? any hx of surgery? what section of report is this? + taco (sm)
Fri Jul 21 13:01:18 2017 taco (sm)
SC can stand for succinylcholine (used as a general anesthesia for things like intubation) and it can cause VT.

But I'm not sure I would go with that unless I had some other evidence, like if we were discussing doing a procedure under anesthesia or if this was dictated in allergy section.


**** • I've sent the report, thanks - CO MT
Fri Jul 21 13:03:03 2017 CO MT

** • Maybe spontaneous conversion, I'm thinking - CO MT
Fri Jul 21 12:59:00 2017 CO MT


• omega 36 oil
+ tlh
Fri Jul 21 11:40:01 2017 tlh
Dictated is "omega 36 oil", but is this "omega 3-6", "omega 3/6", etc.? Has anyone transcribed something similar? Thanks!
** • I am familiar with omega-3 but not omega "36" oil, which is what he dictates. Help? - d p f m j i
Fri Jul 21 11:44:07 2017 d p f m j i

**** • listen for "fish" instead of "6" -- If you can't hear "fish", I have no idea. - taco
Fri Jul 21 11:51:35 2017 taco

****** • I'm going with omega-3&6 - tlh
Fri Jul 21 11:55:42 2017 tlh

****** • Thanks! He actually corrects himself from omega-3 to omega-36. - tlh
Fri Jul 21 11:53:44 2017 tlh

** • omega-3 fish oil - taco
Fri Jul 21 11:41:43 2017 taco


• Guy...please check your re-place/replace thread below.
- Questyr
Fri Jul 21 10:26:40 2017 Questyr

** • Thanks for the correction. - guy
Fri Jul 21 10:37:22 2017 guy


• The patient is a 74-year-old gentleman who was brought in by EMS after ...
+ wav
Fri Jul 21 10:00:54 2017 wav
The patient is a 74-year-old gentleman who was brought in by EMS after having been assaulted by five individuals. The patient could _____ recall the events leading up to the assault, but does report some loss of consciousness as well as subjective malocclusion. The patient underwent a CT of the face that revealed a right parasymphyseal fracture and right angle/ramus fracture that extends into the posterior base of the coronoid.
** • he corrects from "could" to "states that he could" - taco
Fri Jul 21 10:03:52 2017 taco

**** • Thanks a lot. - guy
Fri Jul 21 10:08:09 2017 guy


• Preoperative Diagnosis: CATARACT, LEFT EYE. Procedure: LE ...
+ wav
Fri Jul 21 09:37:30 2017 wav
Preoperative Diagnosis:
CATARACT, LEFT EYE.

Procedure:
LEFT EYE CATARACT EXTRACTION WITH PHACOEMULSIFICATION AND INTRAOCULAR LENS PLACEMENT.

Next, a cystotome was placed in the Viscoat cannula and a continuous curvilinear capsulorrhexis was completed using both a cystotome and Utrata forceps. BSS hydrodissection was used to ensure free rotation of the lens nucleus. At this point, _____ was noted. So, great care was taken to phacoemulsify the cataract using a divide-and-conquer technique.
** • phacodonesis - taco
Fri Jul 21 09:43:30 2017 taco

**** • Thanks a lot. - guy
Fri Jul 21 09:47:07 2017 guy


• Preoperative Diagnosis: LEFT SMALL FINGER METACARPOPHALANGEAL JOINT ...
+ wav
Fri Jul 21 09:13:18 2017 wav
Preoperative Diagnosis:
LEFT SMALL FINGER METACARPOPHALANGEAL JOINT INSTABILITY.

Procedure:
REPAIR OF LEFT SMALL FINGER PALMAR INTEROSSEOUS TENDON.

To confirm this, a midlateral incision was made over the radial proximal phalanx and taken down with tenotomy scissors. The palmar interosseous muscle tendon was identified _____. Upon manipulation of the muscle, the identification of the distal stump of the injured tendon was confirmed _____ over the first webspace.
** • at its volar attachment to the flexor systems...within the wound over the fourth - billybob
Fri Jul 21 09:14:53 2017 billybob

**** • Thanks a lot. Thanks for the correction. - guy
Fri Jul 21 09:18:29 2017 guy


• A discrete stenotic area was noted in the popliteal artery below the k ...
+ mp3
Fri Jul 21 08:30:45 2017 mp3
A discrete stenotic area was noted in the popliteal artery below the knee, and we elected to treat that using a 4 x 80 mm balloon. This started very well and resulted in much larger lumen with more brisk flow distally _____. We then completed our _____ of the left lower extremity and noted diffuse disease in the anterior tibial distribution with reconstitution down in the foot. We selected the anterior tibial artery using a glidewire and we were able to pass that down to the level of the ankle. We were now able to advance Glide catheter most of the way, but met significant resistance near the bottom. We then exchanged this for CSI catheter and we were able to advance the wire down to the level of the ankle.
** • noted afterward. 2 is arteriogram - k p e c i h
Fri Jul 21 08:45:45 2017 k p e c i h

** • #1 noted afterwards. #2 arteriogram - taco
Fri Jul 21 08:45:08 2017 taco

**** • Thanks a lot everybody - guy
Fri Jul 21 08:46:29 2017 guy


• The patient is a 65-year-old gentleman followed by podiatry and referr ...
+ mp3
Fri Jul 21 08:16:21 2017 mp3
The patient is a 65-year-old gentleman followed by podiatry and referred to vascular surgery for evaluation of dry gangrene of the left second and third toes. ABIs were consistent with occlusive disease _____ for arteriography and possible intervention.
** • at some level in the leg, and he is taken - taco
Fri Jul 21 08:29:27 2017 taco

**** • Thanks a lot. - guy
Fri Jul 21 08:30:13 2017 guy


• The Veress needle was removed and a size #11 trocar was attempted to b ...
+ mp3
Fri Jul 21 06:48:33 2017 mp3
The Veress needle was removed and a size #11 trocar was attempted to be placed under direct visualization. Due to the _____ fascia, the trocar was unable to be inserted and decision was made to proceed with an open entry.
** • Due to the tensity of the fascia, .... - mn
Fri Jul 21 08:14:19 2017 mn

**** • Thanks a lot. - guy
Fri Jul 21 08:15:42 2017 guy


• The Veress needle was then inserted again with free flow of the saline ...
+ wav
Fri Jul 21 06:45:29 2017 wav
The Veress needle was then inserted again with free flow of the saline to confirm intraabdominal placement. CO2 gas was then connected and the abdomen was insufflated and deemed to _____ with a normal opening pressure. Once distention was adequate, the CO2 gas was disconnected. The Veress needle was removed and a size #11 trocar was attempted to be placed under direct visualization.
** • deemed/seemed to flow freely? - k p e c i h
Fri Jul 21 08:47:28 2017 k p e c i h

**** • Thanks a lot. - guy
Fri Jul 21 08:47:40 2017 guy


• She reportedly has a bowel movement every other day that is anywhere from a type 1-3
+ 1-3 ok here?
Fri Jul 21 04:32:21 2017 1-3 ok here?
She reportedly has a bowel movement every other day that is anywhere from a type 1-3 on the Bristol scale.

Is type 1-3 okay here or should it be type 1 to 3 because of the "from" preceding it?
** • I personally would use to. - :)
Fri Jul 21 05:48:01 2017 :)

**** • ... - thanks
Fri Jul 21 06:18:43 2017 thanks


• She was seen by Deena Beck, physician assistant. Cap physician assistant?
- cap?
Fri Jul 21 02:35:14 2017 cap?

** • no - :)
Fri Jul 21 02:39:19 2017 :)

**** • ... - thanks a lot
Fri Jul 21 02:49:53 2017 thanks a lot


• s/l Jasper Emergency Room. Should be in Indiana area
- hospital name
Fri Jul 21 02:31:25 2017 hospital name

** • There is a Jasper Memorial Hospital in Jasper, Indiana - :)
Fri Jul 21 02:40:35 2017 :)

**** • Thanks. I found a Jasper County Hospital in Rensselaer, IN. - op
Fri Jul 21 02:49:46 2017 op


• re-placed hyphenated here?
+ guy
Fri Jul 21 02:16:42 2017 guy
The placenta was delivered via Crede and taken off the field. The uterus was then exteriorized, wrapped in a moist towel, and cleared of all clots and debris. The hysterotomy was closed in a single locked layer using 1-0 Vicryl suture with excellent hemostasis noted. The uterus was **re-placed** and the gutters were cleared of all clots and debris.
** • The answer you were given was incorrect: s/b re-placed as + Questyr
Fri Jul 21 10:25:09 2017 Questyr
re-placed means the same thing that was taken out was placed back in. Replaced (without the hyphen) means that one thing was substituted for another. (here is the AAMT link in the archives from 6/22)
**** • Thanks for the correction. - guy
Fri Jul 21 10:37:11 2017 guy

** • no hyphen - :)
Fri Jul 21 02:25:09 2017 :)

**** • Thanks a lot. - guy
Fri Jul 21 02:28:35 2017 guy


• FINDINGS: Dense adhesions in the subcutaneous layer in lower uterine ...
+ mp3
Fri Jul 21 02:01:12 2017 mp3
FINDINGS: Dense adhesions in the subcutaneous layer in lower uterine segment. Baby girl _____ at 1053, birthweight 2760 g, Apgars 9 and 9, clear amniotic fluid. Normal tubes and ovaries bilaterally.
** • in ___ position - wag
Fri Jul 21 03:06:53 2017 wag

**** • Thanks a lot. - guy
Fri Jul 21 06:46:12 2017 guy


• 27-year-old with ___ diagnosis of metastic colon cancer ____ sm
+ wav :)
Fri Jul 21 01:43:10 2017 wav :)
and currently on palliative chemotherapy.
** • Sorry, I can't get them. - Questyr
Fri Jul 21 01:44:52 2017 Questyr


• 27-year-old with ___ diagnosis of metastic colon cancer.
- wav :)
Fri Jul 21 01:41:17 2017 wav :)

** • reposting above as i have another blank with it. - :)
Fri Jul 21 01:42:41 2017 :)


• The patients bladder was then emptied and a 20-French Foley catheter ...
+ wav
Fri Jul 21 01:03:52 2017 wav
The patients bladder was then emptied and a 20-French Foley catheter was placed and the patients bladder was irrigated with 500 cc of saline with no brisk bleeding noted. The patient was then undraped _____ in dorsal lithotomy position, and placed in a supine position. She was awoken from general anesthesia and brought to the recovery room in stable condition.
** • undraped, taken out of the dorsal etc - Q
Fri Jul 21 01:13:00 2017 Q

**** • Thanks a lot. - guy
Fri Jul 21 01:13:11 2017 guy

** • and taken out of the dorsal - poi
Fri Jul 21 01:12:14 2017 poi

**** • Thanks a lot. - guy
Fri Jul 21 01:13:00 2017 guy

** • There is no WAV - Questyr
Fri Jul 21 01:10:05 2017 Questyr


• I infiltrated the periurethral tissues with Marcaine with epinephrine ...
+ TYIA=)
Fri Jul 21 00:55:10 2017 TYIA=)
I infiltrated the periurethral tissues with Marcaine with epinephrine and then made a midline incision from near the urethral meatus up toward the bladder neck. Using a Lonestar Retractor, S/L*savus cunner traction I dissected toward the perineal membrane back to the right of the urethra.
** • I'd like to hear it - Questyr
Fri Jul 21 00:56:46 2017 Questyr

**** • I'm not sure I know how to upload - e a n a o l
Fri Jul 21 01:06:12 2017 e a n a o l


• We were unable to initially visualize the right UO. The left UO was v ...
+ mp3
Fri Jul 21 00:53:15 2017 mp3
We were unable to initially visualize the right UO. The left UO was visualized in orthotopic position and uninvolved _____ bladder tumor. We then use the resectoscope loop to extensively resect the areas of the bladder involved in the tumor. This tumor was sent off as right trigone bladder tumor
** • We then USED (not use...tho it sounds like he says that...because + Q
Fri Jul 21 00:55:47 2017 Q
he using the past tense in the report.)
** • by - Questyr
Fri Jul 21 00:54:27 2017 Questyr

**** • Thanks a lot. Thanks for the correction. - guy
Fri Jul 21 00:57:14 2017 guy


• The visual obturator was then removed and the resectoscope was placed ...
+ wav
Fri Jul 21 00:50:18 2017 wav
The visual obturator was then removed and the resectoscope was placed within the sheath and a pancystoscopy was performed. There was an approximately 3 cm papillary _____ tumor covering the right trigone extending from the right lateral wall to the middle of the bladder, proximally to the bladder neck, as well as _____ posterior aspect of the bladder.
** • #1 ???grape-appearing??? - Q
Fri Jul 21 00:53:02 2017 Q

**** • see link for support...they say grape-like and grape clusters + Q
Fri Jul 21 00:53:57 2017 Q
link
** • #2 to kind of the - Questyr
Fri Jul 21 00:51:27 2017 Questyr

**** • Thanks a lot. - guy
Fri Jul 21 00:53:48 2017 guy


• IMPLANTS: No. SPECIMENS: There were five specimens. There wa ...
+ wav
Fri Jul 21 00:27:58 2017 wav
IMPLANTS: No.

SPECIMENS: There were five specimens. There was a bladder urine for cytology, right bladder _____ tumor, bladder tumor deep #1 right ureteral orifice and a bladder tumor deep #2.

DRAINS: There was a 20-French two-way Foley left at the end of the case.

** • Since he says 5 specimens I think comma after #1 and comma after orifice - Q
Fri Jul 21 00:30:05 2017 Q

** • trigone - Questyr
Fri Jul 21 00:28:35 2017 Questyr

**** • Thanks a lot. Thanks for the correction. - guy
Fri Jul 21 00:32:23 2017 guy


• The common femoral artery was identified, dissected, and controlled, the sm
+ :)
Fri Jul 21 00:08:40 2017 :)
femoral artery was dissected and controlled, and the profunda femoral artery did start bleeding before full control heparin was given and a finger was held over for hemostasis until the heparin was circulated for at least a minute.

need punctuation help on this please.
** • See message FMO + Questyr
Fri Jul 21 00:26:39 2017 Questyr
The common femoral artery was identified, dissected, and controlled. The profunda femoral artery did start bleeding before full control. Heparin was given and a finger was held over for hemostasis until the heparin was circulated for at least a minute.
**** • Oops...bleeding. Before full control, heparin etc - Q
Fri Jul 21 00:27:28 2017 Q

** • I would start new sentence with "The profunda..." comma after given? - poi
Fri Jul 21 00:14:33 2017 poi

**** • Thanks. - :)
Fri Jul 21 00:27:15 2017 :)


• The ___ was then occluded with a VesseLoop and the common femoral with a ____ clamp.
- :) wav
Fri Jul 21 00:07:34 2017 :) wav

** • 1. SFA - poi
Fri Jul 21 00:10:02 2017 poi

**** • can't get #2. ____ mesh or mush clamp??? (WAG) - poi
Fri Jul 21 00:15:42 2017 poi

****** • thanks. He sounds like he has a mouthful of mush. LOL - :)
Fri Jul 21 00:26:44 2017 :)

******** • Poi. It is a Fogarty Mush clamp. - :)
Fri Jul 21 00:31:47 2017 :)

********** • oh yea! thanks for letting me know - poi
Fri Jul 21 00:37:02 2017 poi

************ • On googling I found a Atlas of Endovascascular surgery that + Questyr
Fri Jul 21 00:46:38 2017 Questyr
shows Fogarty Mush and Fogarty mush...so I check The Surgical Word Book by Tessier and it shows mush clamp...so in your context I think it s/b Fogarty mush clamp.
************** • and please excuse my other typos - Q
Fri Jul 21 00:47:11 2017 Q


• This was taken down obliquely to the subcutaneous tissue and small ____ sm
+ wav :)
Thu Jul 20 23:58:38 2017 wav :)
vessels were ligated.
** • branch?? - poi
Fri Jul 21 00:00:12 2017 poi

**** • Thanks again! - :)
Fri Jul 21 00:05:02 2017 :)


• pseudoaneurysm of the proximal profunda femoral artery. There was sm
+ wav :)
Thu Jul 20 23:39:39 2017 wav :)
excellent _______ superficial femoral artery ____ all of which vessels were soft without disease.
** • femoral pulse, ...pulse - poi
Thu Jul 20 23:51:53 2017 poi

**** • Thanks poi. I thought that was what it should be but was not sure as I could not make sm + :)
Thu Jul 20 23:54:46 2017 :)
it out that clear.


• FINDINGS: Products of conception _____ suction, all fetal parts ident ...
+ wav
Thu Jul 20 23:27:13 2017 wav
FINDINGS: Products of conception _____ suction, all fetal parts identified, hemostatic at the end of the case. Fundus firm.
** • removed via suction - MTmom
Thu Jul 20 23:29:10 2017 MTmom

** • removed via - poi
Thu Jul 20 23:29:00 2017 poi

**** • Thanks a lot everybody - guy
Thu Jul 20 23:33:43 2017 guy


• So, a full-thickness skin graft was placed just medial to the skin pad ...
+ mp3
Thu Jul 20 22:52:15 2017 mp3
So, a full-thickness skin graft was placed just medial to the skin paddle overlying a portion of the anastomosis. The rest of the wound that was exposed where the anterior tibial vessel was previously dissected, we placed Integra to cover the anastomosis and the rest of the wound. This was ____ with running 4-0 chromic suture.
** • inset - Questyr
Thu Jul 20 22:53:17 2017 Questyr

**** • Thanks a lot. - guy
Thu Jul 20 22:58:07 2017 guy


• The tympanomeatal flap was inset into the wound using a 3-0 Monocryl a ...
+ wav
Thu Jul 20 22:47:34 2017 wav
The tympanomeatal flap was inset into the wound using a 3-0 Monocryl and 5-0 nylon interrupted sutures. There was a portion of the wound medially overlying the anastomosis where previous existing wound was incised to allow _____ anastomosis to lie.
** • ???for a tunnel for the??? - Questyr
Thu Jul 20 22:52:09 2017 Questyr

**** • Thanks a lot. - guy
Thu Jul 20 22:58:02 2017 guy


• At this point, the flap was brought down to the left lower extremity w ...
+ wav
Thu Jul 20 22:26:17 2017 wav
At this point, the flap was brought down to the left lower extremity wound and loosely inset into the wound. Using operating microscope magnification, the flap vessels and the recipient vessels were prepared _____ irrigation. Non-crushing Rizzuti clamps were placed
** • and they were filled with _____ - poi
Thu Jul 20 22:40:49 2017 poi

**** • hyper_____ - poi
Thu Jul 20 22:43:52 2017 poi

****** • ???heparinized??? - Q
Thu Jul 20 22:44:56 2017 Q

******** • that sounds good - poi
Thu Jul 20 22:47:12 2017 poi

** • Uncle :{ - Questyr
Thu Jul 20 22:32:53 2017 Questyr

**** • Thanks a lot everybody - guy
Thu Jul 20 22:45:31 2017 guy


• At this point, we made the lateral incision of the flap and dissection ...
+ wav
Thu Jul 20 22:10:55 2017 wav
At this point, we made the lateral incision of the flap and dissection was once again carried towards the perforator that we had previously identified to fully free the flap and the perforator from the surrounding tissue. Once this was complete, we once again listened to the signal on the skin paddle and there was noted to be a ____Doppler signal.



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