abridged note

[Age and Gender] [***] pmhx of [***] comes to ED w/ [***]. [Narrative]. Their pain/symptom is [*/10], located in [***], constant, non mediating with [***], associated with [checkbox name="variable_16" value="trauma|falls|fever|headache|AMS|dizziness|syncope|shortness of breath|cough|rhinorrhea|congestion|chest pain|palpitations|abdominal pain|nausea|vomiting|diarrhea|constipation|melena|hematochezia|dysuria|hematuria|urinary frequency|flank pain|skin changes|p.o. issues|issues urinating|issues stooling|issues with ambulation|back pain"]. Started [select name="variable_17" value="randomly| "]. Denies [checkbox name="variable_18" value="trauma|falls|fever|headache|AMS|dizziness|syncope|shortness of breath|cough|rhinorrhea|congestion|chest pain|palpitations|abdominal pain|nausea|vomiting|diarrhea|constipation|melena|hematochezia|dysuria|hematuria|urinary frequency|flank pain|skin changes|p.o. issues|issues urinating|issues stooling|issues with ambulation|back pain"].

PCP: [textarea name="variable_19" default="sample text"]
Specialist: [textarea name="variable_20" default="sample text"]
Pharmacy: [textarea name="variable_21" default="sample text"]

As per HPI

[General: non-toxic, NAD
HEENT: NCAT, PERRL
Cardiac: RRR, no murmurs, 2+ peripheral pulses
Chest: CTA
Abdomen: soft, non-distended, bowel sounds present, no ttp, no rebound or guarding
Extremities: no peripheral edema, calf tenderness, or leg size discrepancies
Skin: no rashes
Neuro: AAOx4, 5+motor, sensory grossly intact
Psych: mood and affect appropriate]

Impression: [Age and Gender] pmhx of [***] comes to ED w/ [***]. Their symptoms and exam findings of [***] in the setting of [***] are concerning for [***].

Ordered [labs, imaging, medications] for diagnosis, management, and treatment.
[Age and Gender] [***] pmhx of [***] comes to ED w/ [***]. [Narrative]. Their pain/symptom is [*/10], located in [***], constant, non mediating with [***], associated with . Started . Denies .

PCP:

Specialist:

Pharmacy:


As per HPI

[General: non-toxic, NAD
HEENT: NCAT, PERRL
Cardiac: RRR, no murmurs, 2+ peripheral pulses
Chest: CTA
Abdomen: soft, non-distended, bowel sounds present, no ttp, no rebound or guarding
Extremities: no peripheral edema, calf tenderness, or leg size discrepancies
Skin: no rashes
Neuro: AAOx4, 5+motor, sensory grossly intact
Psych: mood and affect appropriate]

Impression: [Age and Gender] pmhx of [***] comes to ED w/ [***]. Their symptoms and exam findings of [***] in the setting of [***] are concerning for [***].

Ordered [labs, imaging, medications] for diagnosis, management, and treatment.

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.5, 6 form elements, 112 boilerplate words, 3 text areas, 2 checkboxes, 1 drop downs, 64 total clicks
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