Otitis Management

Assessment
[select value="side|Left|Right|Bilateral"] [select value="diagnosis|otitis media|eustachian tube dysfunction|otalgia- etiology unclear|serous otitis media|myringitis"]
Plan
Analgesia  [select value="Advil and Tylenol as needed for pain|A/B Otic drops with oral over-the-counter analgesics as needed for pain|A/B Otic drops as needed for pain"]
Antibiotics  [select value="none are indicated|Amoxicillin 80-90 mg/kg divided three times daily for 7 days|Amoxicillin 250 mg twice daily for 5 days|Amoxicillin 500 mg twice daily for 5 days|Amoxicillin 1 gm bid for 5 days|Amoxicillin 200 mg twice daily for 10 days|Amoxicillin 250 mg twice daily x 10 days|Amoxicillin 400 mg twice daily for 10 days|Amoxicillin 500 mg twice daily for 10 days|Amoxicillin 1 gm twice daily for 10 days|Amoxicillin 125 mg three times daily x 10 days|Amoxicillin 250 mg three times daily x 10 days|Amoxicillin 500 mg three times daily x 10 days|Augmentin 500 mg bid x 10 days|Augmentin 875 mg bid x 10 days|Augmentin 400 mg bid x 10 days|Augmentin 200 mg bid x 10 days|Bactrim suspension (peds > 2 months) 8-10 mg/kg/d divided bid x 10 days|Bactrim DS 1 bid x 10 days|Biaxin (peds > 6 months) 15 mg/kg divided bid x 10 days|Biaxin 500 mg bid x 10 days|Vantin (peds > 2 months) 10 mg/kg divided bid x 10 days|Vantin 200 mg bid x 10 days|Zithromax 500 mg now then 250 mg qd x 4 days|Zithromax (peds > 6 months) 10 mg/kg now then 5 mg/kg qd x 4 days"]
Follow up  If not improving or if worsening instructed patient to [select value="call office|return to clinic|call or return to clinic"]
Education  [checkbox value="symptomatic measures|medication side effects|natural course"]
Assessment

Plan
Analgesia
Antibiotics
Follow up If not improving or if worsening instructed patient to
Education

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 1, 6 form elements, 16 boilerplate words, 1 checkboxes, 5 drop downs, 8 total clicks
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