ED Note Template

Chief complaint: [text name="variable_1" default=""]
History of present illness: 
[textarea name="variable_2" default=""]

Review of systems:
General: [textarea name="variable_21" default="denies fever/chills, fatigue, malaise, weight changes"]
HEENT: [textarea name="variable_22" default="denies headaches, vision changes, rhinorrhea, sore throat"]
Cardiac: [textarea name="variable_23" default="denies chest pain, palpitations, peripheral edema"]
Pulmonary: [textarea name="variable_24" default="denies shortness of breath, dyspnea, cough, sputum production"]
GI: [textarea name="variable_25" default="denies nausea/vomiting, abdominal pain, diarrhea/constipation, melena/hematochezia"]
GU: [textarea name="variable_26" default="denies dysuria, hematuria"]
MSK: [textarea name="variable_27" default="denies myalgias, arthralgias, weakness, numbness/tingling"]
Dermatologic: [textarea name="variable_28" default="denies rashes"]
Neurologic: [textarea name="variable_29" default="denies seizures"]
Psychiatric: [textarea name="variable_30" default="denies depression, anxiety"]
Endocrine: [textarea name="variable_31" default="denies polyphagia, polydipsia, polyuria"]
Hematologic/lymphatic: [textarea name="variable_32" default="denies abnormal bleeding/bruising"]

Past medical/surgical history:
[textarea name="variable_3" default=""] 

Allergies: 
[textarea name="variable_4" default=""]

Pertinent medications:
[textarea name="variable_5" default=""]

Social history: 
Tobacco - [text name="variable_6" default=""]
Alcohol - [text name="variable_7" default=""]
Illicit drugs - [text name="variable_8" default=""]

Vital signs: 
BP – [text name="variable_9" default=""] mm Hg
T – [text name="variable_10" default=""] F
HR – [text name="variable_11" default=""] bpm
RR – [text name="variable_12" default=""] brpm
SaO2 - [text name="variable_13" default=""] %

Physical examination
General: [textarea name="variable_14" default="AAOx3, NAD"]
HEENT: [textarea name="variable_15" default="NC/AT, PERRLA, EOMI, mmm, no LAD"]
Cardiovascular: [textarea name="variable_16" default="RRR, +s1, +s2, no M/R/G"]
Pulmonary: [textarea name="variable_17" default="CTA b/l, no W/R/R"]
Abdominal: [textarea name="variable_18" default="soft, NT/ND, no hepatosplenomegaly, +bowel sounds"]
Neurological/MSK/Extremities: [textarea name="variable_19" default="CN 2-12 intact, normal motor strength, normal sensation, normal reflexes "]

Assessment & Plan
[textarea name="variable_20" default=""]