Download Grammar Basics - Med-Star Paramedic Ambulance, Inc Brandon

Grammar Basics
101
Grammar
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In any spoken or written language, grammar is considered a set of
structural rules that govern the composition, or the make up, of clauses,
phrases, and words.
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Grammar consists of many parts. However, for EMS reporting purposes
we will focus on the following:
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Fragments and Run-Ons
Comma Splicing
Coordinating and Subordinating Conjunctions
Subject-Verb Agreement
Verb Tense
Pronouns
Capitalization
Punctuation
Spelling
Fragments
• Sentences missing a subject and/or verb
are considered fragments.
– Fragments
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Neck – trachea midline.
Secured patient to car seat.
Skin warm dry.
No other recent trauma.
[no verb]
[no subject]
[no verb]
[no subject/verb]
Fragments Continued…
• Complete sentences have at least one
subject and one verb.
– Fragments Corrected
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Neck and trachea are midline.
Patient was secured in a car seat.
Patient’s skin was warm and dry.
Patient confirmed he had no other recent trauma.
Run-On Sentences
• A run-on sentence occurs when two or more
simple sentences are combined without
correct punctuation.
• Simple sentences contain a subject, verb, and
a complete thought.
– Run-On Sentence
o Nurse states patient came into the ER this morning
patient complains of not breathing well.
Run-On Sentences Continued…
• Few ways exist to correct run-on sentences.
• The writer should consider revising a run-on
sentence in one of three ways.
– Breaking the run-on sentence into two sentences.
– Correctly adding a coordinating conjunction and a comma.
– Correctly adding a subordinating conjunction and a
comma.
Run-On Sentences Continued…
• Corrected Run-On Sentence – three ways presented
– The nurse states the patient came into the ER this morning. She
informs us that the patient complains of not breathing well.
– The nurse states the patient came into the ER this morning, and
he complains of not breathing well.
– The nurse stated that because the patient complained of not
breathing well, he came into the ER.
o This third example reads a somewhat confusing. Though it is written correctly,
revision of this statement would be recommended for readability and clarification.
Comma Splicing
• Comma splices incorrectly connect simple sentences.
– Comma Splice
o Airway – patent, Breathing – spontaneous and regular, Circulation –
normal and regular.
– Corrected Comma Splice
o Airway is patent. Breathing is spontaneous and regular. Circulation is
normal and regular.
– Coordinating and subordinating conjunctions used correctly
with commas can be utilized to correct comma splices.
– For EMS reporting purposes it would be easier and simpler to
make small, complete sentences when describing the
assessment.
Coordinating Conjunctions
• Coordinating conjunctions join independent
clauses to make compound sentences.
• Coordinating Conjunctions
ü And
ü But
ü For
ü Nor
ü Or
ü So
ü Yet
Coordinating Conjunctions
Continued…
• Coordinating conjunctions can be used to revise
run-on sentences and comma splices.
• Coordinating conjunctions can make the writing
process less choppy by joining simple sentences.
– Independent Clauses
• The patient complained of shortness of breath. He did not
complain of chest pain.
– Joined Independent Clauses
• The patient complained of shortness of breath and not chest
pain.
Subordinating Conjunctions
• Subordinating conjunctions join independent clauses to make
complex sentences.
• Subordinating Conjunctions
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After
Although
As
As if
Because
Before
Even if
Even though
If
If only
Rather than
Since
Subordinating Conjunctions
Continued…
• Subordinating Conjunctions Continued…
ü That
ü Though
ü Unless
ü Until
ü When
ü Where
ü Whereas
ü Wherever
ü Whether
ü Which
ü While
Subordinating Conjunctions
Continued…
• Like Coordinating Conjunctions, subordinating
conjunctions can be used to correct run-on
sentences and comma splices.
• They can also be used to make the writing process
less choppy.
– Though the patient complained of shortness of breath, he did not
complain of chest pain.
– The patient came to the emergency room because he had shortness of
breath.
Subject – Verb Agreement
• All sentences must have a subject and a verb
that agree.
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The patient says.
The family states.
He complains.
She notes.
I observe.
• See handouts for further explanation.
Verb Tense
• Seven Basic Verb Tenses (or time)– ThirdPerson Plural Noun
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Simple Present: They talk.
Present Perfect: They have talked.
Present Progressive: They are talking.
Simple Past: They talked.
Past Perfect: They had talked.
Future: They will talk.
Future Perfect: They will have talked.
Verb Tense Continued…
• Verb Tenses – Third-Person Singular Noun
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Simple Present: She talks.
Present Perfect: She has talked.
Present Progressive: She is talking.
Simple Past: She talked.
Past Perfect: She had talked.
Future: She will talk.
Future Perfect: She will have talked.
Verb Tense Continued…
• Verb tense lets the reader know if an event has happened,
is happening, or will happen.
• Careful attention must be given to all sentences in a report
to ensure verb tense is consistent.
• See handouts for more information about verbs and their
importance in sentence structure and meaning.
• Verb inconsistency in the EMS report can cause confusion.
Therefore, it can make billing challenging.
– Employees may be asked to revise their report depending on the
nature of the error (& Tracy). J
– Please remember, if the EMS report cannot be understood or read
with clarity, it may not be able to be billed.
Pronouns
• A pronoun replaces a noun.
• Subject Pronouns replace subjects.
– I, you, he or she, it , we, they
o Shaleen took the patient’s vital signs. She noted the vital signs in
the patient’s chart.
• Object Pronouns replace objects.
– Me, you, him, her, it, us, them
o Shaleen took the patient’s vital signs. She noted them in the
patient’s chart.
Pronouns Continued…
• Possessive Pronouns replace possessive nouns
and show ownership.
– My, mine, your, yours, his, her, hers, its, ours,
their, theirs
o The patient’s belongings were left in the truck. His belongings,
once found, were given to the nurse.
o Jay needs to attach his keys to his hip.
o Dana needs to bring her own water bottle to work. She is always
taking mine.
Capitalization
• Always capitalize the names of people.
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Judi Zimmerman
Dean
Professor Joe/Prof. Joe
Doctor Vaska/Dr. Vaska
• Capitalize family relationships only when they are used as part of a
person’s title.
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Aunt Crystal
Granny Smith
• Capitalize names of political, national, racial, civic, and athletic groups.
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The American Heart Association
The American Association of Retired Persons
The Tennessee Volunteers
The Sensory Processing Disorder Foundation
The American Academy of Professional Coders
The Republican Party
The House of Representatives
Capitalization Continued…
• Capitalize the names of specific places.
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Brandon, South Dakota
Mount Rushmore
The Roman Coliseum
Sanford Hospital
Splitrock Blvd.
The University of South Dakota
Avera McKennan Emergency Department
Capitalization Continued…
• Capitalize words that derive from other names of places.
– Italian
– French
– Spanish
• Capitalize dates and events.
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October
Friday
Christmas
Memorial Day
• Capitalize historic events.
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World War II
The Reformation
The Boston Tea Party
re-enactment of the Civil War
Capitalization Continued…
• Capitalize titles of specific types of media and works
– books, movies, songs, magazines, journals,
television shows, articles, etc.
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The Argus Leader [newspaper]
FireEMS
[professional journal]
Essentials of Paramedic Care
[book]
Pre-Hospital Care Report Manual
[instruction manual]
Life Under the Lights
[website]
Capitalization Continued…
• Capitalize the brand names of specific products.
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Terumo 3cc Syringe
Kendall Alcohol Preps
Convenience Bag
Baxter Normal Saline
MedSource Nasal Cannula
Amsino I.V. Administration Set
One Touch Ultra Strips
Dr. Pepper
Dodge Durango
Hy-Vee Spring Water
Punctuation: Comma Usage
• Use a comma:
– To separate city name from state name.
o Brandon, South Dakota
– To separate day and year.
o October 21, 2011
– After a transitional world or phrase.
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For example, this is how you use a comma.
First, I will write the transitional word.
Next, I will place the comma.
Finally, show me what you have learned.
Punctuation: Comma Usage
Continued…
• Between adjectives that independently describe the
same noun.
– Our medics swiftly, safely, and accurately drove the ambulance.
• Before a conjunction to join two independent clauses –
and, but, for, nor, or, so, and yet.
– Kris wanted to drive the truck, and Tracy wanted to administer
patient care.
– Dean decided to buy the black shirt, but Shaleen thought it best
to buy the green one.
– Jay said to practice courtesy with all patients, so the employees
agreed to follow his direction.
Punctuation: Comma Usage
Continued…
• After an introductory clause and after a subordinate
clause at the beginning of a sentence.
– Though the patient denies any loss of consciousness, she
did complain of dizziness.
– Upon arrival at the patient’s home address, we found the
patient lying on the living-room couch.
– To find the patient, we had to enter through the pool gate,
go through the sliding back door, and walk up the stairs to
the second floor bedroom.
Punctuation: Comma Usage
Continued…
• To separate items in a list.
– The patient’s skin was dry, pale, and warm.
– The patient complains of headache, nausea, and vomiting.
– The patient presents with chest pain, dizziness, shortness
of breath, and abdominal pain.
– The patient states she has had a mastectomy, a
hysterectomy, and two knee surgeries in the past.
Punctuation: Comma Usage
Continued…
• To isolate information not essential to the
meaning of the sentence.
– The patient’s sister, who was visiting from Utah,
waited outside for the ambulance to arrive.
Punctuation: Semi-Colons
• Semi-Colons are used to separate two independent clauses
that are related.
– The patient complains of light-headedness; she also complains
of nausea.
– During the assessment, I noted the patient’s skin was dry and
pale; his skin was also hot to touch.
• Semi-Colons are used to join multiple listings that already
contain commas.
– The patient was returning from visits to Minneapolis,
Minnesota; Watertown, South Dakota; and Estherville, Iowa,
when she started noticing symptoms of possible influenza.
Punctuation: Colons
• Colons are used after introducing an independent clause followed
by a list.
– The patient complains of the following: headache, nausea, vomiting,
diarrhea, abdominal pain, and fever.
• Colons are used after an independent clause when introducing a
quotation.
– The patient made it very clear how she felt: “I feel like an elephant is sitting on my
chest.”
• Colons are used between two independent clauses when emphasis
on the second clause is desired.
– The patient’s lung sounds are diminished: they are full of crackles and wheezes.
Punctuation: Quotation Marks
• Quotation marks are used around direct
quotes.
– The patient stated, “I feel like I have been hit by a bus!”
• Quotations are also used around short stories,
chapter titles, speeches, episodes of T.V. or
radio shows, essays, magazines or newspaper
articles, short poems, and song titles.
Spelling: Contractions
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Contractions are words created by combining two words and omitting
some of the letters and replacing them with an apostrophe.
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Common contractions spoken every day:
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Have not – haven’t;
Are not – aren’t;
Do not – don’t;
They are – they’re;
We are – we’re;
We will – we’ll;
He will – he’ll;
They will – they’ll;
I am – I’m;
She is – she’s.
Spelling: Contractions Continued…
• Contractions can sometimes sound like possessives.
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You’re/your – your are/your
It’s/its – it is/its
They’re/their – they are/their
Who’s/whose – who is/whose
• Care needs to be taken not to confuse the use of these
words – clarity can be skewed.
• Remember to ask yourself, “What is the reader trying
to communicate to the audience?”
Spelling: Possessives
• A possessive singular noun is created by adding an apostrophe s.
– Patient’s skin
– Patient’s vitals
• A possessive plural noun already ending in s, add an apostrophe.
– The twins’ mother appeared exhausted after giving birth.
• No apostrophes are necessary for possessive pronouns.
– His, Hers, Ours, Yours, Whose, Theirs, Its
• Pronouns preceding a noun are already possessive – they do not
need an s.
– His, Her, Our, Your, Whose, Their
o Her doctor instructed us to go to Sanford’s Emergency Room.
Spelling: Homonyms
• Homonyms are words that sound the same but are spelled
differently and have different meanings.
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There/their
Red/read
Affect/effect
Whole/hole
Wear/where
Hear/here
Rails/Rales (medical term commonly misspelled)
Do/Due
Weak/Week
• See attachment for a list of commonly misused homonyms.
Reference
• Purdue OWL, (1995-2011). The Writing Lab,
The OWL at Purdue, the English
Department, and Purdue University.
• http://owl.english.purdue.edu
Proofread, Proofread, Proofread!!!
• Take five minutes to scan your final document.
• Read it backward for spelling errors.
• Compare your narrative with the
documentation from other facilities.
– Check spelling of name
– Address, phone number, social, birth date
– Check for transposed numbers
– Transportation reason - consistency