Commas and transitional expressions

   MT Reference Style Guide  >  Medical Transcription Grammar, Usage and Style  >  Punctuation  >  The Comma  >  Commas and transitional expressions

Transitional phrases exist in the second of two related sentences and help in the transition from the expression in the first sentence to the expression in the second sentence. Look for transitional words such as however, therefore, on the other hand, subsequently, etc.Â

The patient was given a bolus of normal saline. Subsequently, she became more responsive.
or
The patient was given a bolus of normal saline; subsequently, she became more responsive.

The patient was given a bolus of normal saline. She became, subsequently, more responsive.
or
The patient was given a bolus of normal saline. She became more responsive, subsequently.

Use commas to set off transitional expressions when they interrupt the flow of the sentence. Do not set these elements off when they are used to emphasize the meaning; in such cases, the tone of the voice goes up.

Nonessential: We are determined, nevertheless, to obtain the necessary diagnostic studies.
Essential: We are nevertheless determined to obtain the necessary diagnostic studies.

Keep in mind that the presence of these words does not always signal a transition. The transitional expression however is frequently used and it is important to evaluate its position as being introductory, interrupting or terminating in the second of the two related sentences. Use of either a period or a semicolon to separate the sentences has any bearing on the role of the transitional word in the second sentence.

Interruptive: The patient was brought to the emergency room with extensive traumatic injuries. Despite exhaustive efforts, however, he expired.
Terminating: The patient was brought to the emergency room with extensive traumatic injuries. Despite exhaustive efforts, he expired, however.
Introductory: The patient was brought to the Emergency Room with extensive traumatic injuries; however, despite exhaustive efforts, he expired.

NOT: The patient was brought to the Emergency Room with extensive traumatic injuries, however, despite exhaustive efforts, he expired.
NOT: The patient was brought to the Emergency Room with extensive traumatic injuries, however despite exhaustive efforts, he expired.

Setting off the transitional word with commas implies that it is nonessential and can be removed.

Do not use transitional words as a conjunction, as they do not function in a linking role.