falan42/nurse_detection huggingface dataset:
Intercostal block - 1 

PREPROCEDURE DIAGNOSIS:,  Chest pain secondary to fractured ribs, unmanageable with narcotics.,POSTPROCEDURE DIAGNOSIS:,  Chest pain secondary to fractured ribs, unmanageable with narcotics.,PROCEDURE: , Intercostal block from fourth to tenth intercostal spaces, left.,INDICATIONS: , I was requested by Dr. X to do an intercostal block on this lady who fell and has fractured ribs, whose chest pain is paralyzing and not responding well to increasing doses of narcotics.,PROCEDURE DETAIL:,  After obtaining an informed consent with the patient on her bedside, she was placed in the right decubitus position with the left side up.  The posterior left chest wall was prepped and draped in the usual fashion and then a mixture of 1% Xylocaine 20 mL and Marcaine 0.25% 20 mL were mixed together and the intercostal spaces from the fourth to the tenth ribs were anesthetized.  A total of 30 mL worth of solution was used.  I also injected some local anesthetic subcutaneously into an area of contusion in the left lumbar area.,The patient tolerated the procedure well.  She had no respiratory distress.  Immediately, the patient felt some relief from the pain.  Chest x-ray was ordered for the following day.pain management, xylocaine, marcaine, intercostal spaces, intercostal block, fractured ribs, intercostal, fractured, narcotics, chest,
Kenalog Injection 

PROCEDURE:,  Left L5 transforaminal epidural steroid injection with 40 mg of Kenalog under fluoroscopic guidance.,INDICATIONS:  ,The patient is a 78-year-old female with back pain referring into the left side.  She has had a couple of epidurals in the past, both of which led to only short-term improvement with intralaminar and caudal placements.  Therefore, transforaminal approach was selected for today's procedure.,Risks and benefits were discussed with the patient.  She agreed to accept the risks and signed informed consent to proceed.,PROCEDURE DETAILS:,  The patient was placed prone on the table.  The skin was thoroughly cleansed with betadine swabs x3 and wiped off with a sterile gauze.  The subcutaneous intramuscular and interligamentous region was anesthetized with buffered 1% lidocaine.,A 5-inch, 22-gauge spinal needle was directed under intermittent fluoroscopic guidance using an oblique approach at the opening of the L5 nerve root.  Once bony contact was made, a lateral was obtained and showed the needle tip to be against the posterior spinal body in the anterior epidural space.  Then an AP view was obtained which showed the needle tip to be below the 6 o'clock position of the pedicle.,EPIDUROGRAM: , Omnipaque 300, 1 mL, was placed through the foraminal opening of the L5 nerve root on the left.  This did show dye spread pattern which was narrowed consistent with foraminal stenosis.  The dye did traverse the foraminal opening and was seen spreading around the pedicle into the anterior epidural space.  It was also spreading peripherally along the L5 nerve root.,The patient tolerated the procedure well.  She did feel that the needle tip was placed at the epicenter of her pain, and this was improved with the placement of the anesthetic.,I will see the patient back in the office in the next few weeks to monitor response of the injection.pain management, transforaminal approach, epidural steroid injection, nerve root, needle tip, kenalog, transforaminal, fluoroscopic, guidance, foraminal, injection
Knee Injection 

The patient was told that the injection may cause more pain for two to three days afterwards and if this occurred they would best be served by icing the area 15-20 minutes every 6 hours.  The patient was advised to protect the knee by limiting repetitive bending, squatting , kneeling and excessive heavy use for a week.  Also, they were asked to follow up in two weeks p.r.n.pain management, knee injection, hibistat, xylocaine, bending, epinephrine, knee joint, kneeling, needle, patella, squatting, superolateral approach, cleansed, kneeNOTE,: 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.
Hip Injection 

PROCEDURE: , Hip injection.,INFORMED CONSENT:  ,The risks, benefits and alternatives of the procedure were discussed with the patient.  The patient was given opportunity to ask questions regarding the procedure, its indications and the associated risks.,The risk of the procedure discussed include infection, bleeding, allergic reaction, dural puncture, headache, nerve injuries, spinal cord injury, and cardiovascular and CNS side effects with possible of vascular entry of medications.  I also informed the patient of potential side effects or reactions to the medications potentially used during the procedure including sedatives, narcotics, nonionic contrast agents, anesthetics, and corticosteroids.,The patient was informed both verbally and in writing.  The patient understood the informed consent and desired to have the procedure performed.,PROCEDURE:  ,Oxygen saturation and vital signs were monitored continuously throughout the procedure.  The patient remained awake throughout the procedure in order to interact and give feedback.  The X-ray technician was supervised and instructed to operate the fluoroscopy machine.,The patient was placed in the prone position on the treatment table.  The skin over and surrounding the treatment area was cleaned with Betadine.  The area was covered with sterile drapes, leaving a small window opening for needle placement.  Fluoroscopy was used to identify the boney landmarks of the hip and the planned needle approach.  The femoral artery was located by palpation of the pulse.  The skin, subcutaneous tissue, and muscle within the planned needle approach were anesthetized with 1% Lidocaine.  All injected medications were preservative free.  With fluoroscopy, a *** spinal needle was gently guided into the ***.  Multiple fluoroscopic views were used to ensure proper needle placement.  Approximately *** nonionic contrast agent was injected under direct real-time fluoroscopic observation.  Correct needle placement was confirmed by production of an appropriate arthrogram without concurrent vascular dye pattern.  Finally, the treatment solution, consisting of ***.  All injected medications were preservative free.  Sterile technique was used throughout the procedure,COMPLICATIONS: , None.  No complications.  The patient tolerated the procedure well and was sent to the recovery room in good condition.,DISCUSSION: , Post-procedure vital signs and oximetry were stable.  The patient was discharged with instructions to ice the injection site as needed for 15-20 minutes as frequently as twice per hour for the next day and to avoid aggressive activities for 1 day.  The patient was told to resume all medications.  The patient was told to be in relative rest for 1 day but then could resume all normal activities.,The patient was instructed to seek immediate medical attention for shortness of breath, chest pain, fever, chills, increased pain, weakness, sensory or motor changes, or changes in bowel or bladder function.,Follow up appointment was made in approximately 1 week.pain management, boney landmarks, fluoroscopy, femoral artery, planned needle approach, hip injection, injection, hip, needle
Hypogastric Plexus Block 

NAME OF PROCEDURE:,  Hypogastric plexus block.,ANESTHESIA:,  Local.,PROCEDURE: , The patient was in the operating room in the prone position with the back prepped and draped in sterile fashion.  Local anesthesia was used to make a skin wheal 8-10 cm lateral to the L4 spinous process bilaterally from the midline.  Starting from the left side, a 20-gauge 6-inch needle was placed to the left L5-S1 facet level under AP fluoroscopic view.  On lateral view, the tip of the needle was at the inferior one-third of the LS vertebral body, anterior aspect.  Next 5 cc of Omnipaque dye was injection showing a linear spread along the anterior portion of L5 down the sacral promontory.  After negative aspiration 18 cc of 0.25% Marcaine plus 40 mg of Depo-Medrol was injection.  There were no complications.  The above sequence was repeated for the right side.  There were no complications.  The patient was discharged back to outpatient recovery in stable condition.pain management, vertebral body, fluoroscopic view, omnipaque, hypogastric plexus blockNOTE
Epidural Steroid Injection - 2 

PROCEDURE:  ,Caudal epidural steroid injection without fluoroscopy.,ANESTHESIA:,  Local sedation.,VITAL SIGNS: , See nurse's records.,PROCEDURE DETAILS: , INT was placed.  The patient was in the prone position.  The back was prepped with Betadine.  Lidocaine 1.5% was used to make a skin wheal over the sacral hiatus.  A 18-gauge Tuohy needle was then placed into the epidural space.  There were no complications from this (no blood or CSF).  After negative aspiration was performed, a mixture of 10 cc preservative free normal saline plus 160 mg preservative free Depo-Medrol was injected.  Neosporin and band-aid were applied over the puncture site.  The patient was then placed in supine position.  The patient was discharged to outpatient recovery in stable condition.pain management, epidural space, epidural steroid injection, caudal epidural, caudal, fluoroscopy, steroid, epidural, injection
Intercostal Block 

PREOPERATIVE DIAGNOSIS: , Severe post thoracotomy pain.,POSTOPERATIVE DIAGNOSIS: , Severe post thoracotomy pain.,PROCEDURE: , Intercostal block, left.,PROCEDURE DETAIL: , With the patient in the ICU bed who was having a large amount of intravenous narcotic to control his thoracotomy pain, after obtaining informed consent, his left posterior chest was prepped and draped in the usual fashion and Marcaine 0.025% was injected in the spaces four to eight sequentially.  A total of 40 mL of Marcaine was used.,The patient tolerated the procedure well and experienced immediate benefit out of the procedure.pain management, thoracotomy pain, intercostal block, marcaine, thoracotomy, intercostal,
Epidural Steroid Injection - 3 

PROCEDURE NOTE:,  The patient was placed in a prone position.  The neck was sterilely prepped using a cervical prep set.  A lidocaine skin wheal was raised over the C5-6 interspace.  A 20-gauge Tuohy needle was used.  Loss of resistance was obtained using hanging drop technique.  This was followed by 2 mL of radiograph contrast material which showed spread of the dye into the epidural space.  A total of 5 mL containing 4 mL of 0.25% bupivacaine and 80 mg of methylprednisolone acetate were then infiltrated.  Following the infiltration, the patient noted warming of his arms and dramatic improvement of his symptoms.  He was observed for 30 minutes and discharged home in good condition.  There were no apparent complications to the procedure.pain management, methylprednisolone acetate, steroid, bupivacaine, methylprednisolone, acetate, epidural, injectionNOTE,: 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.,
Epidural Steroid Injection - 1 

PREOPERATIVE DIAGNOSIS:,  Herniated lumbar disk with intractable back pain.,POSTOPERATIVE DIAGNOSIS: , Herniated lumbar disk with intractable back pain.,OPERATION PERFORMED: , L3-L5 epidural steroid injection with epidural catheter under fluoroscopy.,ANESTHESIA: , Local/IV sedation.,COMPLICATIONS: , None.,SUMMARY:  ,The patient in the operating room in the prone position with the back prepped and draped in the sterile fashion.  The patient was given sedation and monitored.  Local anesthetic was used to insufflate the skin over sacral hiatus.  A 16-gauge RK needle was placed at the sacral hiatus into the caudal canal with no CSF or blood.  A Racz tunnel catheter was then placed to the needle and guided up to the L3-L4 level.  After negative aspiration 4 cc of 0.5% Marcaine and 80 mg of Depo-Medrol were injected.  The catheter was then repositioned at the L4-L5 level where after negative aspiration same local anesthetic steroid mixture was injected.  Needle and catheter were removed intact.  The patient was discharged in stable condition.pain management, epidural catheter, epidural steroid injection, lumbar disk, steroid injection, fluoroscopy, herniated, lumbar, needle, steroid, epidural, catheter, injection
Epidurogram 

PREOPERATIVE DIAGNOSES:  ,1.  Right lower extremity radiculopathy with history of post laminectomy pain.,2.  Epidural fibrosis with nerve root entrapment.,POSTOPERATIVE DIAGNOSES:  ,1.  Right lower extremity radiculopathy with history of post laminectomy pain.,2.  Epidural fibrosis with nerve root entrapment.,OPERATION PERFORMED: , Right L4, attempted L5, and S1 transforaminal epidurogram for neural mapping.,ANESTHESIA:,  Local/IV sedation.,COMPLICATIONS: , None.,SUMMARY: , The patient in the operating room in the prone position with the back prepped and draped in the sterile fashion.  The patient was given sedation and monitored.  Local anesthetic was used to insufflate the skin and paraspinal tissues and the L5 disk level on the right was noted to be completely collapsed with no way whatsoever to get a needle to the neural foramen of the L5 root.  The left side was quite open; however, that was not the side of her problem.  At this point using a oblique fluoroscopic projection and gun-barrel technique, a 22-gauge 3.5 inch spinal needle was placed at the superior articular process of L5 on the right, stepped off laterally and redirected medially into the intervertebral foramen to the L4 nerve root.  A second needle was taken and placed at the S1 nerve foramen using AP and lateral fluoroscopic views to confirm location.  After negative aspiration, 2 cc of Omnipaque 240 dye was injected through each needle.,There was a defect flowing in the medial epidural space at both sides.  There were no complications.pain management, laminectomy, radiculopathy, nerve root entrapment, epidural fibrosis, nerve root, epidurogram, neural, epidural, foramen, nerve, needle
Epidural Steroid Block 

DIAGNOSIS: , Left sciatica.,ANESTHESIA: , Intravenous sedation,NAME OF OPERATION:,1.  Left L5-S1 transforaminal epidural steroid block with fluoroscopy.,2.  Left L4-5 transforaminal epidural steroid block with fluoroscopy.,3.  Monitored intravenous Versed sedation.,PROCEDURE: , The patient was taken to the block room.  He was placed prone on the fluoroscopy table.  He was monitored appropriately.  He was administered Versed 2 mg IV.  His O2 saturation remained greater than 90%.  His back was prepped and draped.  The C-arm was brought in.  The endplates at L5-S1 were squared off.  The C-arm was rotated to the left.  The L5 pedicle, the superior articular process of the L5-S1 facet, and the "neck of the scotty dog" were all visualized.  After adequate local anesthesia, a 22-gauge, 3-1/2-inch spinal needle was inserted using down-the-barrel-of-the-needle technique.  The needle was advanced into the posterior aspect of the foramen and then advanced anteriorly toward the 6 o'clock position on the pedicle.  No paresthesias were noted.  One-half cc of contrast was injected and spread medially around the pedicle and into the epidural space, and the L5 nerve root was visualized.  Depo-Medrol 80 mg plus 1 cc of 4% preservative-free lidocaine was injected.  The needle was flushed and removed.,I then went up to the L4-5 level, and using a similar technique, injected the patient transforaminally at the L4-5 level.  Depo-Medrol 80 mg plus 1 cc of 4% preservative-free lidocaine was injected at the L4-5 level just as at the L5-S1 level.  The patient had pain down his left leg during the injection, primarily at the L5-S1 level similar to what he normally experiences.  He was awake and alert, and taken to the recovery room in good condition.  His left leg pain was relieved.pain management, c-arm, epidural steroid block with fluoroscopy, sciatica, transforaminal, steroid block with fluoroscopy, epidural steroid block, depo medrol, transforaminal epidural, steroid block, fluoroscopy, epidural, intravenous, steroid,
Epidural Steroid Injection 

PRE-OP DIAGNOSES:,  Low back pain - 724.2, Herniated disc - 722.10, Lumbosacral Facet, arthropathy - 724.4.,POST-OP DIAGNOSES: , Low back pain - 724.2, Herniated disc - 722.10, Lumbosacral Facet, arthropathy - 724.4.,INTERVAL HISTORY:,  Plans, risks and options were reviewed with the patient in detail.  The patient understands and agrees to proceed.,ANESTHESIA: , General Anesthesia,PROCEDURE PERFORMED:,  Epidural steroid injection, epidurogram, fluroscopy.,PROCEDURE:,  After informed consent, the patient was taken to the procedure room and placed in the prone position.  EKG, blood pressure and pulse oximetry were monitored and remained stable throughout the procedure.  The area was prepped and draped in the usual sterile fashion.  Local anesthetic was infiltrated at the appropriate level.  Fluoroscopic guidance was used to place a #20-gauge Tuohy epidural needle gently into the epidural space at L4-L5 using a paramedian approach.  No blood or CSF was obtained on aspiration.,RADIOLOGY: , Injection of 3 cc of OMNIPAQUE showed spread of the dye into the epidural space on AP and Lateral imaging.  The Needle was injected with Depo-Medrol 80 mg with Bupivacaine 1/16th , 8 cc total vol.  Patient tolerated procedure well and was transferred to recovery room.  Patient was discharged home with escort.  Discharge instructions were given.,POST-OP PLAN:,  I will see the patient back in my office in two weeks.  Continue p.r.n. medications as needed.pain management, back pain, herniated disc, lumbosacral facet, epidural needle, lumbosacral facet arthropathy, epidural steroid injection, facet arthropathy, epidural space, injection, epidurogram, fluroscopy, herniated, lumbosacral, steroid, arthropathy, epidural,
Cervical Selective Nerve Root Block 

CERVICAL SELECTIVE NERVE ROOT BLOCK,PREPROCEDURE PREPARATION:,  After being explained the risks and benefits of the procedure, the patient signed the standard informed consent form.  The patient was placed in the prone position and standard ASA monitors applied.  Intravenous access was established and IV sedation was used.  For further details of IV sedation and infusion, please refer to anesthesia notes.  The patient was able to respond appropriately throughout the procedure.  * Fluoroscopy was used to identify the appropriate anatomy.  The skin was prepped and draped in a sterile fashion and sterile technique was maintained throughout the procedure.,PROCEDURE DETAILS:,  The patient was laid supine.  Oblique placement was achieved by placing pillow below the shoulder and turning the head.  The C# neural foramina was identified by counting down from the C2-3 foramen.  The external carotid artery was marked off by palpation.  The neck was aseptically prepared.  1% lidocaine was used for local infiltration and subsequently a 25-gauge spinal needle was passed down to the C# neural foramen under fluoroscopic control.  The posterior inferior edge of the foramen bone was contacted.  The needle was then redirected and slowly walked off the bone into the foramen by a few millimeters.  Care was taken to remain in the posterior inferior edge of the foramen.  Positioning was checked by AP view, in which the needle tip extended no further medially than the midpoint of the adjacent pedicle.  1 mL of contrast was used to confirm position under fluoroscopy after aspiration.  Acceptable dye pattern was seen.  Subsequent 1 mL of 1% lidocaine was injected after aspiration and the patient was monitored.  No adverse affects with 1% lidocaine were noted and subsequently 1 mL of Celestone was injected.  Compression bandage was applied to the neck and no complications were noted.,POSTPROCEDURE EVALUATION:,  After a 30-minute recovery period, during which no complications were noted, the patient was discharged home.  Pulse oximetry was carried out on room air in recovery and all oxygen saturations were above 95% with no respiratory distress observed.pain management, nerve root block, 1% lidocaine, asa monitors, cervical selective nerve root block, fluoroscopy, iv sedation, nerve root, oblique, selective nerve root, carotid artery, foramen, neural foramina, edge of the foramen, selective nerve root block, cervical,
Coccygeal injection 

COCCYGEAL INJECTION,PROCEDURE:,:  Informed consent was obtained from the patient.  A gloved little finger was inserted into the anal region and the sacral/coccygeal joint was palpated and the coccyx was moved and it was confirmed that this reproduced pain.  After aseptic cleaning, a 25-gauge needle was inserted through the skin into the sacral/coccygeal joint.  It was confirmed that the needle was not entering the rectal cavity by finger placed in the rectum.  After aspiration, 1 mL of cortisone and 2 mL of 0.25% Marcaine were injected at the site.  Postprocedure, the needle was withdrawn.  A small pressure dressing was placed and no hematoma was observed to form.,POST PROCEDURE INSTRUCTIONS:, The patient has been asked to report to us any redness, swelling, inflammation, or fevers.  The patient has been asked to restrict the use of the * extremity for the next 24 hours.pain management, coccygeal injection, 0.25% marcaine, 1 ml of cortisone, coccygeal joint, coccyx, fevers, inflammation, redness, sacral, swelling, coccygeal, injectionNOTE,: 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.