falan42/nurse_detection huggingface dataset:
Closed Reduction - 2 

PREOPERATIVE DIAGNOSIS: , Left distal both-bone forearm fracture.,POSTOPERATIVE DIAGNOSIS: , Left distal both-bone forearm fracture.,PROCEDURE:,  Closed reduction with splint application with use of image intensifier.,INDICATIONS: , Mr. ABC is an 11-year-old boy who sustained a fall on 07/26/2008.  Evaluation in the emergency department revealed both-bone forearm fracture.  Considering the amount of angulation, it was determined that we should proceed with conscious sedation and closed reduction.  After discussion with parents, verbal and written consent was obtained.,DESCRIPTION OF PROCEDURE:  ,The patient was induced with propofol for conscious sedation via the emergency department staff.  After it was confirmed that appropriate sedation had been reached, a longitudinal traction in conjunction with re-creation of the injury maneuver was applied reducing the fracture.  Subsequently, this was confirmed with image intensification, a sugar-tong splint was applied and again reduction was confirmed with image intensifier.  The patient was aroused from anesthesia and tolerated the procedure well.  Post-reduction plain films revealed some anterior displacement of the distal fragment.  At this time, it was determined this fracture proved to be unstable.,DISPOSITION: , After review of the reduction films, it appears that there is some element of fracture causing displacement.  We will proceed to the operating room for open reduction and internal fixation versus closed reduction and percutaneous pinning as our operative schedule allows.,surgery, closed reduction, reduction with splint application, distal both bone forearm, distal both bone, splint application, emergency department, conscious sedation, image intensifier, bone forearm, forearm fracture, reduction, emergency, department, conscious, displacement, splint, sedation, tong, distal, bone, image, intensifier, forearm, fracture
Closed Reduction - Mandible Fracture 

PREOPERATIVE DIAGNOSIS: , Bilateral open mandible fracture, open left angle and open symphysis fracture.,POSTOPERATIVE DIAGNOSIS: , Bilateral open mandible fracture, open left angle and open symphysis fracture.,PROCEDURE:  ,Closed reduction of mandible fracture with MMF.,ANESTHESIA: , General anesthesia via nasal endotracheal intubation.,FLUIDS: , 2 L of crystalloid.,ESTIMATED BLOOD LOSS: , Minimal.,HARDWARE: , None.,SPECIMENS: , None.,COMPLICATIONS: , None.,CONDITION:  ,The patient was extubated to PACU in good condition.,INDICATIONS FOR PROCEDURE: , The patient is a 17-year-old female who is 2 days status post an altercation in which she sustained multiple blows to the face.  She was worked up on Friday night, 2 days earlier at Hospital, was given palliative treatment and discharged and instructed to follow up as an outpatient with an oral surgeon and given a phone number to call.  The patient was worked up initially.  On initial exam, it was noted that the patient had a left V3 paresthesia.  She had a gross malocclusion.  On the facial CT and panoramic x-ray, it was noted to be a displaced left angle fracture and nondisplaced symphysis fracture.  Alternatives were discussed with the patient and it was determined she would benefit from being taken to the operating room under general anesthesia to have a closed reduction of her fractures.  Risks, benefits, and alternatives of treatment were thoroughly discussed with the patient and informed consent was obtained with the patient's mother.,DESCRIPTION OF PROCEDURE:, The patient was taken to the operating room #4 at Hospital and laid in a supine position on the operating room table.  Monitor was attached and general anesthesia was induced with IV anesthetics and maintained with nasal endotracheal intubation and inhalation anesthetics.  The patient was prepped and draped in the usual oromaxillofacial surgery fashion.,Surgeon approached the operating table in a sterile fashion.  Approximately 10 mL of 2% lidocaine with 1:100,000 epinephrine was injected into the oral vestibule in a nerve block fashion.  A moistened Ray-Tec sponge was placed in the posterior oropharynx and the mouth was prepped with Peridex mouthrinse, scrubbed with a toothbrush.  The Peridex was evacuated with Yankauer suction.  Erich arch bars were adapted to the maxilla from the first molar to the contralateral first molar and secured with 24-gauge surgical steel wire on the posterior teeth and 26-gauge surgical steel wire on the anterior teeth.  Same was done on the mandible.  The patient was then manipulated up in the maximum intercuspation and noted to be reproducible.  The throat pack was then removed.,The patient was remanipulated up to the maximum intercuspation and secured with interdental elastics.  At this point in time, the procedure was then determined to be over.,The patient was extubated and transferred to the PACU in good condition.surgery, open symphysis fracture, closed reduction, mmf, endotracheal, pacu, bilateral open mandible fracture, symphysis fracture, mandible fracture, fracture, intubation, angle, mandible,
Circumcision - Newborn  

PROCEDURE: , Newborn circumcision.,INDICATIONS: , Parental preference.,ANESTHESIA:,  Dorsal penile nerve block.,DESCRIPTION OF PROCEDURE:,  The baby was prepared and draped in a sterile manner.  Lidocaine 1% 4 mL without epinephrine was instilled into the base of the penis at 2 o'clock and 10 o'clock.  The penile foreskin was removed using a XXX Gomco.  Hemostasis was achieved with minimal blood loss.  There was no sign of infection.  The baby tolerated the procedure well.  Vaseline was applied to the penis, and the baby was diapered by nursing staff.surgery, nerve block, newborn circumcision, foreskin, gomco, penis, circumcision, newborn, penile
Cleft Repair - Soft Palate 

PREOPERATIVE DIAGNOSIS: , Cleft soft palate.,POSTOPERATIVE DIAGNOSIS: , Cleft soft palate.,PROCEDURES:,1.  Repair of cleft soft palate, CPT 42200.,2.  Excise accessory ear tag, right ear.,ANESTHESIA: , General.,DESCRIPTION OF PROCEDURE: , The patient was placed supine on the operating room table.  After anesthesia was administered, time out was taken to ensure correct patient, procedure, and site.  The face was prepped and draped in a sterile fashion.  The right ear tag was examined first.  This was a small piece of skin and cartilaginous material protruding just from the tragus.  The lesion was excised and injected with 0.25% bupivacaine with epinephrine and then excised using an elliptical-style incision.  Dissection was carried down the subcutaneous tissue to remove any cartilaginous attachment to the tragus.  After this was done, the wound was cauterized and then closed using interrupted 5-0 Monocryl.  Attention was then turned towards the palate.  The Dingman mouthgag was inserted and the palate was injected with 0.25% bupivacaine with epinephrine.  After giving this 5 minutes to take effect, the palate was incised along its margins.  The anterior oral mucosa was lifted off and held demonstrating the underlying levator muscle.  Muscle was freed up from its attachments at the junction of the hard palate and swept down so that it will be approximated across the midline.  The Z-plasties were then designed, so there would be opposing Z-plasties from the nasal mucosa compared to the oral mucosa.  The nasal mucosa was sutured first using interrupted 4-0 Vicryl.  Next, the muscle was reapproximated using interrupted 4-0 Vicryl with an attempt to overlap the muscle in the midline.  In addition, the remnant of the uvula tissue was found and was sutured in such a place that it would add some extra bulk to the nasal surface of the palate.  Following this, the oral layer of mucosa was repaired using an opposing Z-plasty compared to the nasal layer.  This was also sutured in place using interrupted 4-0 Vicryl.  The anterior and posterior open edges of the palatal were sewn together.  The patient tolerated the procedure well.  Suction of blood and mucus performed at the end of the case.  The patient tolerated the procedure well.,IMMEDIATE COMPLICATIONS: , None.,DISPOSITION:,  In satisfactory condition to recovery.surgery, repair, tragus, oral mucosa, nasal mucosa, ear tag, soft palate, palate, cleft, soft
Circumcision & Chordee Release 

PREOPERATIVE DIAGNOSES: , Phimosis and adhesions.,POSTOPERATIVE DIAGNOSES:  ,Phimosis and adhesions.,PROCEDURES PERFORMED: , Circumcision and release of ventral chordee.,ANESTHESIA:  ,Local MAC.,ESTIMATED BLOOD LOSS: , Minimal.,FLUIDS: , Crystalloid.  The patient was given antibiotics preop.,BRIEF HISTORY: , This is a 43-year-old male who presented to us with significant phimosis, difficulty retracting the foreskin.  The patient had buried penis with significant obesity issues in the suprapubic area.  Options such as watchful waiting, continuation of slowly retracting the skin, applying betamethasone cream, and circumcision were discussed.  Risk of anesthesia, bleeding, infection, pain, MI, DVT, PE, and CVA risks were discussed.  The patient had discussed this issue with Dr Khan and had been approved to get off of the Plavix.  Consent had been obtained.  Risk of scarring, decrease in penile sensation, and unexpected complications were discussed.  The patient was told about removing the dressing tomorrow morning, okay to shower after 48 hours, etc.  Consent was obtained.,DESCRIPTION OF PROCEDURE:  ,The patient was brought to the OR.  Anesthesia was applied.  The patient was placed in supine position.  The patient was prepped and draped in usual sterile fashion.  Local MAC anesthesia was applied.  After draping, 17 mL of mixture of 0.25% Marcaine and 1% lidocaine plain were applied around the dorsal aspect of the penis for dorsal block.  The patient had significant phimosis and slight ventral chordee.  Using marking pen, the excess foreskin was marked off.  Using a knife, the ventral chordee was released.  The urethra was intact.  The excess foreskin was removed.  Hemostasis was obtained using electrocautery.  A 5-0 Monocryl stitches were used for 4 interrupted stitches and horizontal mattresses were done.  The patient tolerated the procedure well.  There was excellent hemostasis.  The penis was straight.  Vaseline gauze and Kerlix were applied.  The patient was brought to the recovery in stable condition.  Plan was for removal of the dressing tomorrow.  Okay to shower after 48 hours.surgery, phimosis, adhesions, release of ventral chordee, ventral chordee, circumcision, penis, chordee, foreskin,
Circumcision - 7 

PROCEDURE:,  Circumcision.,ANESTHESIA: , EMLA.,FINDINGS: , Normal penis.  The foreskin was normal in appearance and measured 1.6 cm.  There was no bleeding at the circumcision site.,PROCEDURE:,  Patient was placed on the circumcision restraint board.  EMLA had been applied approximately 90 minutes before.  A time-out was completed satisfactorily per protocol.  The area was prepped with Betadine.  The foreskin was grasped with sterile clamps and was dissected away from the corona and the glans penis with blunt dissection.  A Mogen clamp was applied to the cervix.  The excess foreskin was excised with the scalpel.  The clamp was removed.  At this point, the procedure was terminated.  Sterile Vaseline and gauze was applied to the glans penis.  There were no complications.  There was minimal blood loss.surgery, mogen clamp, glans penis, emla, penis, foreskin, circumcision
Circumcision - Infant 

PROCEDURE: , Circumcision.,PRE-PROCEDURE DIAGNOSIS: , Normal male phallus.,POST-PROCEDURE DIAGNOSIS: , Normal male phallus.,ANESTHESIA:  ,1% lidocaine without epinephrine.,INDICATIONS: , The risks and benefits of the procedure were discussed with the parents.  The risks are infection, hemorrhage, and meatal stenosis.  The benefits are ease of care and cleanliness and fewer urinary tract infections.  The parents understand this and have signed a permit.,FINDINGS: , The infant is without evidence of hypospadias or chordee prior to the procedure.,TECHNIQUE:  ,The infant was given a dorsal penile block with 1% lidocaine without epinephrine using a tuberculin syringe and 0.5 cc of lidocaine was delivered subcutaneously at 10:30 and at 1:30 o'clock at the dorsal base of the penis.,The infant was prepped then with Betadine and draped with a sterile towel in the usual manner.  Clamps were placed at 10 o'clock and 2 o'clock and the adhesions between the glans and mucosa were instrumentally lysed.  Dorsal hemostasis was established and a dorsal slit was made.  The foreskin was fully retracted and remaining adhesions between the glans and mucosa were manually lysed.  The infant was fitted with a XX-cm Plastibell.  The foreskin was retracted around the Plastibell and circumferential hemostasis was established.  The excess foreskin was removed with scissors and the infant tolerated the procedure well with a minimum amount of blood loss.  Instructions for continuing care are to watch for any evidence of hemorrhage or urination and the parents are instructed in the care of the circumcised penis.surgery, dorsal slit, hypospadias, chordee, epinephrine, hemorrhage, penis, adhesions, circumcision, phallus, lidocaine, foreskin, infant
Circumcision - 6 

PROCEDURE: , Circumcision.,Signed informed consent was obtained and the procedure explained.,DETAILS OF PROCEDURE: ,The child was placed in a Circumstraint board and restrained in the usual fashion.  The area of the penis and scrotum were prepared with povidone iodine solution.  The area was draped with sterile drapes, and the remainder of the procedure was done with sterile procedure.  A dorsal penile block was done using 2 injections of 0.3 cc each, 1% plain lidocaine.  A dorsal slit was made, and the prepuce was dissected away from the glans penis.  A Gomco clamp was properly placed for 5 minutes.  During this time, the foreskin was sharply excised using a #10 blade.  With removal of the clamp, there was a good cosmetic outcome and no bleeding.  The child appeared to tolerate the procedure well.  Care instructions were given to the parents.surgery, gomco clamp, dorsal slit, glans penis, slit, circumcision, penisNOTE,: Thesetranscribed medical transcription sample reports and examples are provided by various users andare for reference purpose only. MTHelpLine does not certify accuracy and quality of sample reports.These transcribed medical transcription sample reports may include some uncommon or unusual formats;this would be due to the preference of the dictating physician. All names and dates have beenchanged (or removed) to keep confidentiality. Any resemblance of any type of name or date orplace or anything else to real world is purely incidental.
Circumcision - 5 

PROCEDURES:,1.  Release of ventral chordee.,2.  Circumcision.,3.  Repair of partial duplication of urethral meatus.,INDICATIONS: , The patient is an 11-month-old baby boy who presented for evaluation of a duplicated urethral meatus as well as ventral chordee and dorsal prepuce hooding.  He is here electively for surgical correction.,DESCRIPTION OF PROCEDURE: , The patient was brought back into operating room 35.  After successful induction of general endotracheal anesthetic, giving the patient, preoperative antibiotics and after completing a preoperative time out, the patient was prepped and draped in the usual sterile fashion.,A holding stitch was placed in the glans penis.  At this point, we probed both urethral meatus.  Using the Crede maneuver, we could see urine clearly coming out of the lower, the more ventral meatus.  At this point, we cannulated this with a 6-French hypospadias catheter.  We attempted to cannulate the dorsal opening, however, we were unsuccessful.  We then attempted to place lacrimal probes and were also unsuccessful indicating this was incomplete duplication.  At this point, we identified the band connecting both the urethral meatus and incised it with tenotomy scissors.  We sutured both meatus together such that there was one meatus at the normal position at the tip of the glans.,At this point, we made a circumcising incision around the penis and degloved the penis in its entirety relieving all chordee.  Once all the chordee had been adequately released, we turned our attention to the circumcision.  Excessive dorsal foreskin was removed from the skin and glans.  Mucosal cuts were reapproximated with interrupted 5-0 chromic suture.  Dermabond was placed over this and bacitracin was placed on this once dry.  This ended the procedure.  ,DRAINS:,  None.,ESTIMATED BLOOD LOSS: , Minimal.,URINE OUTPUT:  ,Unrecorded.,COMPLICATIONS: , None apparent.,DISPOSITION:  ,The patient will now go under the care of Dr. XYZ, Plastic Surgery, for excision of scalp hemangioma.surgery, release of ventral chordee, repair of partial duplication, partial duplication, ventral chordee, urethral meatus, glans, penis, circumcision, ventral, chordee, urethral, meatus,
Circumcision - 3 

CIRCUMCISION,After informed consent was obtained the baby was placed on the circumcision tray.  He was prepped in a sterile fashion times 3 with Betadine and then draped in a sterile fashion.  Then 0.2 mL of 1% lidocaine was injected at 10 and 2 o'clock.  A ring block was also done using another 0.3 mL of lidocaine.  Glucose water is also used for anesthesia.  After several minutes the curved clamp was attached at 9 o'clock with care being taken to avoid the meatus.  The blunt probe was then introduced again with care taken to avoid the meatus.  After initial adhesions were taken down the straight clamp was introduced to break down further adhesions.  Care was taken to avoid the frenulum.  The clamps where then repositioned at 12 and 6 o'clock.  The Mogen clamp was then applied with a dorsal tilt.  After the clamp was applied for 1 minute the foreskin was trimmed.  After an additional minute the clamp was removed and the final adhesions were taken down.  Patient tolerated the procedure well with minimal bleeding noted.  Patient to remain for 20 minutes after procedure to insure no further bleeding is noted.,Routine care discussed with the family.  Need to clean the area with just water initially and later with soap and water or diaper wipes once healed.surgery, circumcision, 1% lidocaine, betadine, glucose water, adhesions, circumcision tray, diaper wipes, foreskin, frenulum, meatus, straight clamp, sterile fashion, clampNOTE,: Thesetranscribed medical transcription sample reports and examples are provided by various users andare for reference purpose only. MTHelpLine does not certify accuracy and quality of sample reports.These transcribed medical transcription sample reports may include some uncommon or unusual formats;this would be due to the preference of the dictating physician. All names and dates have beenchanged (or removed) to keep confidentiality. Any resemblance of any type of name or date orplace or anything else to real world is purely incidental.
Circumcision - 1 

CIRCUMCISION - OLDER PERSON,OPERATIVE NOTE:,  The patient was taken to the operating room and placed in the supine position on the operating table.  General endotracheal anesthesia was administered.  The patient was prepped and draped in the usual sterile fashion.  A 4-0 silk suture is used as a stay-stitch of the glans penis.  Next, incision line was marked circumferentially on the outer skin 3 mm below the corona.  The incision was then carried through the skin and subcutaneous tissues down to within a layer of * fascia.  Next, the foreskin was retracted.  Another circumferential incision was made 3 mm proximal to the corona.  The intervening foreskin was excised.  Meticulous hemostasis was obtained with electrocautery.  Next, the skin was reapproximated at the frenulum with a U stitch of 5-0 chromic followed by stitches at 12, 3, and 9 o'clock.  The stitches were placed equal distance among these to reapproximate all the skin edges.  Next, good cosmetic result was noted with no bleeding at the end of the procedure.  Vaseline gauze, Telfa, and Elastoplast dressing was applied.  The stay-stitch was removed and pressure held until bleeding stopped.  The patient tolerated the procedure well and was returned to the recovery room in stable condition.surgery, circumcision, elastoplast, meticulous hemostasis, telfa, vaseline gauze, circumferential incision, corona, cosmetic result, endotracheal anesthesia, foreskin, glans penis, hemostasis, stay stitch, circumferentially, stitchNOTE,: Thesetranscribed medical transcription sample reports and examples are provided by various users andare for reference purpose only. MTHelpLine does not certify accuracy and quality of sample reports.These transcribed medical transcription sample reports may include some uncommon or unusual formats;this would be due to the preference of the dictating physician. All names and dates have beenchanged (or removed) to keep confidentiality. Any resemblance of any type of name or date orplace or anything else to real world is purely incidental.
Circumcision - 4 

The patient tolerated the procedure well and was sent to the Recovery Room in stable condition.surgery, circumcision, circumferential proximal incisions, hemostasis, vaseline soaked gauze, catgut, foreskin, needlepoint bovie, pain block, shaft of the penis, supine position, penisNOTE,: Thesetranscribed medical transcription sample reports and examples are provided by various users andare for reference purpose only. MTHelpLine does not certify accuracy and quality of sample reports.These transcribed medical transcription sample reports may include some uncommon or unusual formats;this would be due to the preference of the dictating physician. All names and dates have beenchanged (or removed) to keep confidentiality. Any resemblance of any type of name or date orplace or anything else to real world is purely incidental.
Circumcision - Child  

PROCEDURE: , Circumcision.,Signed informed consent was obtained and the procedure explained.,The child was placed in a Circumstraint board and restrained in the usual fashion.  The area of the penis and scrotum were prepared with povidone iodine solution.  The area was draped with sterile drapes, and the remainder of the procedure was done with sterile procedure.  A dorsal penile block was done using 2 injections of 0.3 cc each, 1% plain lidocaine.  A dorsal slit was made, and the prepuce was dissected away from the glans penis.  A ** Gomco clamp was properly placed for 5 minutes.  During this time, the foreskin was sharply excised using a #10 blade.  With removal of the clamp, there was a good cosmetic outcome and no bleeding.  The child appeared to tolerate the procedure well.  Care instructions were given to the parents.surgery, circumstraint, dorsal slit, gomco clamp, circumcision, childNOTE,: Thesetranscribed medical transcription sample reports and examples are provided by various users andare for reference purpose only. MTHelpLine does not certify accuracy and quality of sample reports.These transcribed medical transcription sample reports may include some uncommon or unusual formats;this would be due to the preference of the dictating physician. All names and dates have beenchanged (or removed) to keep confidentiality. Any resemblance of any type of name or date orplace or anything else to real world is purely incidental.,