Friday, January 3, 2014

Dictation error

One thing our transcription service does is expand abbreviations for us. So for example, if I said, "The patient had a CVA," the dictation would read, "The patient had a cerebrovascular accident."

That's all fine and good. Unless the transcription gets it totally wrong.

What I said: "Following her CVA, the decision was made to give the patient TPA."

From the transcription: "Following her cerebrovascular accident, the decision was made to give the patient total parenteral alimentation."

Really? That's the abbreviation that gets put in for a transcription service used by a stroke service? I've never even heard that abbreviation before.


  1. Maybe the transcriptionist thought the patient wasn't able to swallow after her stroke?

  2. Does that service make disctintion betwen capital letters and not capital? I usually write it t-PA. But even then, that is some serious mistake...

  3. Or perhaps the transcriptionist was thinking from an internal medicine standpoint rather than an emergency room standpoint... the sentence makes total sense in scenario a) the patient was intubated in the ICU, as well as scenario b) presenting acutely to the ED within 4.5 hours of having a stroke.

  4. This is, to put it mildly, terrifying. You should do little tests---perhaps diagnose someone with TBD, and see what happens.

  5. The scenario makes no sense because he term is TPN - total parenteral nutrition - not "alimentation" (unless you speak French...) and stroke patients with dysphagia get NG feeds. Never TPN

  6. The transcription service at my hospital once typed "lever" instead of "liver" (for a hepatology dictation), so there's no way I'd ever trust it to expand abbreviations.