Followup versus Follow up

FOLLOWUP/FOLLOW UP

The most common dilemmas in transcription world that I have faced is the confusion regarding Follow Up and Followup.

First of all, "followup" is a noun, whereas "follow up" is verb, but it is confusing as to where to use followup and follow up.

THUMBRULE

Noun:
If you can place "a/an" in front of followup, then it will be one word.
eg. The patient presents for a followup evaluation.

Even if the dictator does not say "a/an" and if you can place "a" in front of followup and it does not alter the meaning of the sentence, then it would be one word.

Dictated:  The patient presents for followup appointment
Transcribed:  The patient presents for (a) followup appointment - "a" does not alter the meaning of the sentence - in this case it would be one word.

Dictated:  The patient is to see Oncology for followup
Transcribed:  The patient is to see Oncology for (a) followup  -- making sense - one word.

Variation:
Dictated: The patient is to have cardiology followup in 2 weeks

Transcribed:  The patient is to have (a) cardiology followup in 2 weeks - here "cardiology followup" is acting like one word and putting "a" before "cardiology followup" does not change the meaing, so it will be one word.

Dictated: Followup appoinment has been scheduled
Transcribed: (A) followup appoinment has been scheduled - making sense, not changing meaning - followup will be one word.

Verb:
On the other hand, if adding "a/an" in front of follow up does not make sense -- then it will be 2 words.
eg.

Dictated:  The patient is to follow up in one month.
Transcribed:  The patient is to (a) follow up in one month  -- adding "a" is not making sense, then this will be two words.

Dictated:  Follow up in the clinic in 1 month
Transcribed:  (A) Follow up in the clinic in 1 month  -  this is not making any sense, as the dictator wants to say "the patient is to follow up in the clinic in 1 month", where "a" cannot be placed in front of "follow up" -- here it will be 2 words as it is being used as a verb in a commanding way.
 

BOTTOM LINE

1. If "a/an" can be placed in front of "followup" it will be 1 word, if cannot or does not make any sense, it will be 2 words.
2. Account specification.  I have been through accounts where irrespective of noun, verb, or adjective, follow up should be always hyphenated, eg., follow-up.  So, it also depends upon account instruction and specification, otherwise the general rule applies.

Nitrate versus Nitrite

NITRATE/NITRITE

Another confusion regarding using nitrate versus nitrite that comes to my notice.  I will just try to explain, hope this will help you.

NITRATE is a salt of nitric acid.  Nitrate generally refers to a class of drugs, in the form of isosorbide mononitrate and isosorbide dinitrate, given for angina pectoris, chest pain.  It is never to be written in Urinalysis or any lab test concerning urinary tract infection.

NITRITE is a salt of nitrous acid, which is a laboratory data for determining urinary tract infection or UTI.  A positive nitrite test indicates that bacteria may be present in significant numbers in urine.  This is always meant and said in urinalysis portion of the laboratory test.

BOTTOM LINE

1.      Nitrite -- the “i” corresponds with UTI.  So, for UTI and urinalysis, it is always nitrite.

2.      Nitrate -- a drug for angina pectoris.where "a" corresponds to angina.

ACE Versus Ace

ACE CONFUSION

I have come across some files where there were confusions regarding Ace and ACE.  I will try to explain the basic difference between the two, as it could lead to medical error.

ACE:  This actually is an abbreviation of angiotensin-converting enzyme (inhibitor).  The doctor generally refers to the ACE inhibitor drugs which are used to treat hypertension, for example, lisinopril, fosinopril, captopril, etc.  It is generally given for hypertension and acts by blocking the angiotensin converting enzyme.  It has a very common side effect of dry cough.

Ace:  This is actually a brand name of a bandage, Ace wrap or Ace adherent bandage.  It is generally applied to the extremities.

BOTTOM LINE

1.      In orthopedic/surgery file or where there is a possibility of applying a bandage or a compression dressing, use Ace wrap.

2.      In files where there is a mention of hypertension, use ACE, as a medication, acronym.

Orthostatic Hypotension/Hypertension

ORTHOSTATIC HYPOTENSION/ORTHOSTATIC HYPERTENSION

This is again a very common mistake that I have come across.  First of all, we need to know what are orthostatic hypotension and orthostatic hypertension and where to use them appropriately.

ORTHOSTATIC HYPOTENSION:  This is a form of low blood pressure that occurs in a standing position, i.e., whenever the patient suddenly changes his/her position from sitting to standing, or lying to sitting, the blood pressure drops, which can cause blackout.

At times, doctor even dictates in the vital signs, where he would dictate a series of blood pressure and pulse readings of the patient in sitting, lying, and standing positions.

This is a very common problem that occurs with the patients and 99% of the time dictated by the doctor.

ORTHOSTATIC HYPERTENSION:  This is on the other hand increase of blood pressure due to patient’s sudden position change.  This is very rarely dictated.  I have got only one file in my entire career where the doctor dictated orthostatic hypertension.

BOTTOM LINE

Orthostatic Hypotension is what the doctor dictates in 99% of the files.

Orthostatic Hypertension is rarely used.