Abbreviations are not the transcribers' friend, so avoid them. Unless and only when the abbreviation is part of a title, transcribe the words as spoken.
For instance, Dr. Fleming, John Trindle, Jr., or Gen. Fitzgibbons remain as abbreviations. Otherwise, the words would be transcribed as spoken. For example:
On the other hand, there are professions--such as medicine--in which acronyms, initials, and abbreviations are the common speech. Experience and reference books will help transcriptionists up front. But, they will need to memorize the sounds and meanings in such fields where abbreviations are an integral part.
You can usually resolve any differences when you edit, but you do need to develop habits that save time while assuring accuracy.
Tip 1: Determine how the client facility wants the transcription to read. You can record the abbreviation verbatim because the abbreviation is the language of record. But, because abbreviations can obscure meaning, many clients prefer a translation of the abbreviations as they occur in diagnosis.
Tip 2: Acronyms are not abbreviations. Once they become household words, they should be transcribed as such, e.g., MRSA or HIV/AIDS.
Tip 3: You can cover several bases by placing the clarification in parentheses after the acronym, as in OBS (organic brain syndrome) or GALT (gut-associated lymphoid tissue).
Tip 4: Be careful in the use of periods and of upper and lower case letters. Some abbreviations are written in all lower case letters followed by periods, like q.a.d. for every other day or s.o.s for if there is a need. Periods are not used when the abbreviation/acronym consists of all upper case letters.
A period can be used in I.V or I.M. to differentiate them from Roman Numerals. IV or IM is also acceptable as long as the transcriptionist is consistent throughout.
Tip 5: You pluralize an abbreviation with an "s" at the end. If the abbreviation ends in a period, use the "s" after an apostrophe.
Confer with your resource books while editing and shoot for consistency.