{
    "section": "plan",
    "templateSet": "Knee Pain",
    "templates": [
        {
            "text": "Labs",
            "template": "{children}",
            "children": [
                {
                    "text": "Blood tests",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Uric acid, serum",
                            "template": "Uric acid, serum"
                        },
                        {
                            "text": "Lyme (Borrelia burgdorferi) IgG+IgM antibodies, serum",
                            "template": "Lyme (Borrelia burgdorferi) IgG+IgM antibodies, serum"
                        },
                        {
                            "text": "CBC w\/ auto diff",
                            "template": "CBC w\/ auto diff"
                        },
                        {
                            "text": "Culture, blood, bacterial x2",
                            "template": "Culture, blood, bacterial x2"
                        },
                        {
                            "text": "Antinuclear antibodies (ANA), serum",
                            "template": "Antinuclear antibodies (ANA), serum"
                        },
                        {
                            "text": "Cyclic citrullinated peptide (CCP) antibody, IgG, serum",
                            "template": "Cyclic citrullinated peptide (CCP) antibody, IgG, serum"
                        },
                        {
                            "text": "Rheumatoid factor (RF), serum",
                            "template": "Rheumatoid factor (RF), serum"
                        },
                        {
                            "text": "C-reactive protein (CRP), serum",
                            "template": "C-reactive protein (CRP), serum"
                        },
                        {
                            "text": "Erythrocyte sedimentation rate (ESR)",
                            "template": "Erythrocyte sedimentation rate (ESR)"
                        }
                    ]
                },
                {
                    "text": "Synovial fluid labs",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Cell count and differential, synovial fluid",
                            "template": "Cell count and differential, synovial fluid"
                        },
                        {
                            "text": "Gram stain, synovial fluid",
                            "template": "Gram stain, synovial fluid"
                        },
                        {
                            "text": "Culture, synovial fluid, bacterial",
                            "template": "Culture, synovial fluid, bacterial"
                        },
                        {
                            "text": "Crystals, synovial fluid",
                            "template": "Crystals, synovial fluid"
                        }
                    ]
                },
                {
                    "text": "Gonococcal cultures (throat, GU Cx)",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Culture, Neisseria gonorrhoeae (GC)",
                            "template": "Culture, Neisseria gonorrhoeae (GC)"
                        }
                    ]
                },
                {
                    "text": "Labs to monitor analgesics use",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CBC",
                            "template": "CBC"
                        },
                        {
                            "text": "Metabolic panel, basic (BMP), serum",
                            "template": "Metabolic panel, basic (BMP), serum"
                        },
                        {
                            "text": "Metabolic panel, comprehensive (CMP), serum",
                            "template": "Metabolic panel, comprehensive (CMP), serum"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Imaging",
            "template": "{children}",
            "children": [
                {
                    "text": "Plain films",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "X-ray knee right, AP and lateral and Merchant",
                            "template": "X-ray knee right, AP and lateral and Merchant"
                        },
                        {
                            "text": "X-ray knee left, AP and lateral and Merchant",
                            "template": "X-ray knee left, AP and lateral and Merchant"
                        },
                        {
                            "text": "X-ray knee right, sunrise",
                            "template": "X-ray knee right, sunrise"
                        },
                        {
                            "text": "X-ray knee left, sunrise",
                            "template": "X-ray knee left, sunrise"
                        },
                        {
                            "text": "X-ray knee right, tunnel",
                            "template": "X-ray knee right, tunnel"
                        },
                        {
                            "text": "X-ray knee left, tunnel",
                            "template": "X-ray knee left, tunnel"
                        }
                    ]
                },
                {
                    "text": "MRI knee",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "MRI knee right",
                            "template": "MRI knee right"
                        },
                        {
                            "text": "MRI knee left",
                            "template": "MRI knee left"
                        }
                    ]
                },
                {
                    "text": "CT knee",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CT knee right",
                            "template": "CT knee right"
                        },
                        {
                            "text": "CT knee left",
                            "template": "CT knee left"
                        }
                    ]
                },
                {
                    "text": "Angiography, knee",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Angiography lower extremity right",
                            "template": "Angiography lower extremity right"
                        },
                        {
                            "text": "Angiography lower extremity left",
                            "template": "Angiography lower extremity left"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Procedures",
            "template": "{children}",
            "children": [
                {
                    "text": "Arthrocentesis, knee, diagnostic",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Arthrocentesis, knee, diagnostic",
                            "template": "Arthrocentesis, knee, diagnostic"
                        }
                    ]
                },
                {
                    "text": "Aspiration, knee, therapeutic",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Aspiration, knee, therapeutic",
                            "template": "Aspiration, knee, therapeutic"
                        }
                    ]
                },
                {
                    "text": "Injection, knee, corticosteroid",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Injection, knee, intra-articular, corticosteroid",
                            "template": "Injection, knee, intra-articular, corticosteroid"
                        }
                    ]
                },
                {
                    "text": "Injection, Iliotibial band, corticosteroid",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Injection, iliotibial band, corticosteroid",
                            "template": "Injection, iliotibial band, corticosteroid"
                        }
                    ]
                },
                {
                    "text": "Aspiration, bursa, diagnostic",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Aspiration, bursa, diagnostic",
                            "template": "Aspiration, bursa, diagnostic"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Analgesics",
            "template": "{children}",
            "children": [
                {
                    "text": "OTC pain relievers",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Take OTC acetaminophen prn",
                            "template": "Take OTC acetaminophen prn"
                        },
                        {
                            "text": "Apply OTC capsaicin cream daily prn",
                            "template": "Apply OTC capsaicin cream daily prn"
                        },
                        {
                            "text": "Take OTC ibuprofen prn",
                            "template": "Take OTC ibuprofen prn"
                        },
                        {
                            "text": "Take OTC naproxen prn",
                            "template": "Take OTC naproxen prn"
                        },
                        {
                            "text": "Take OTC pain relievers prn",
                            "template": "Take OTC pain relievers prn"
                        }
                    ]
                },
                {
                    "text": "Acetaminophen: prescriptions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "acetaminophen 500 mg tab",
                            "template": "acetaminophen 500 mg tab"
                        },
                        {
                            "text": "hydrocodone\/acetaminophen 5 mg\/500 mg cap",
                            "template": "hydrocodone\/acetaminophen 5 mg\/500 mg cap"
                        },
                        {
                            "text": "oxycodone\/acetaminophen 5 mg\/325 mg tab",
                            "template": "oxycodone\/acetaminophen 5 mg\/325 mg tab"
                        }
                    ]
                },
                {
                    "text": "NSAIDs: Oral prescriptions for acute pain",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "ibuprofen 800 mg tab",
                            "template": "ibuprofen 800 mg tab"
                        },
                        {
                            "text": "ibuprofen 600 mg tab",
                            "template": "ibuprofen 600 mg tab"
                        },
                        {
                            "text": "ibuprofen 400 mg tab",
                            "template": "ibuprofen 400 mg tab"
                        },
                        {
                            "text": "hydrocodone\/ibuprofen 7.5 mg\/200 mg tab",
                            "template": "hydrocodone\/ibuprofen 7.5 mg\/200 mg tab"
                        },
                        {
                            "text": "naproxen 500 mg tab",
                            "template": "naproxen 500 mg tab"
                        },
                        {
                            "text": "Celebrex 100 mg cap",
                            "template": "Celebrex 100 mg cap"
                        }
                    ]
                },
                {
                    "text": "Topical analgesics: Prescription, OTC",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Take OTC acetaminophen prn",
                            "template": "Take OTC acetaminophen prn"
                        },
                        {
                            "text": "capsaicin topical 0.08% cream",
                            "template": "capsaicin topical 0.08% cream"
                        },
                        {
                            "text": "Flector 1.3% patch",
                            "template": "Flector 1.3% patch"
                        },
                        {
                            "text": "Voltaren Gel 1% gel",
                            "template": "Voltaren Gel 1% gel"
                        }
                    ]
                },
                {
                    "text": "Opioids",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "hydrocodone\/acetaminophen 5 mg\/500 mg tab",
                            "template": "hydrocodone\/acetaminophen 5 mg\/500 mg tab"
                        },
                        {
                            "text": "hydrocodone\/ibuprofen 7.5 mg\/200 mg tab",
                            "template": "hydrocodone\/ibuprofen 7.5 mg\/200 mg tab"
                        },
                        {
                            "text": "oxycodone\/acetaminophen 5 mg\/325 mg tab",
                            "template": "oxycodone\/acetaminophen 5 mg\/325 mg tab"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Supplies, Equipment",
            "template": "{children}",
            "children": [
                {
                    "text": "Supplies: Immobilizers, splint, crutches",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Knee immobilizer",
                            "template": "Knee immobilizer"
                        },
                        {
                            "text": "Splint",
                            "template": "Splint"
                        },
                        {
                            "text": "Crutches",
                            "template": "Crutches"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Patient instructions",
            "template": "{children}",
            "children": [
                {
                    "text": "Patient instructions given",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Call if no improvement in 48-72 hours or if new sx arise",
                            "template": "Call if no improvement in 48-72 hours or if new sx arise"
                        },
                        {
                            "text": "Wrap knee in ACE bandage",
                            "template": "Wrap knee in ACE bandage"
                        },
                        {
                            "text": "Wear OTC arch support in shoes",
                            "template": "Wear OTC arch support in shoes"
                        },
                        {
                            "text": "Cast use and care instructions given",
                            "template": "Cast use and care instructions given"
                        },
                        {
                            "text": "Splint use and care instructions given",
                            "template": "Splint use and care instructions given"
                        },
                        {
                            "text": "Use knee immobilizer as instructed",
                            "template": "Use knee immobilizer as instructed"
                        },
                        {
                            "text": "Use crutches as instructed",
                            "template": "Use crutches as instructed"
                        },
                        {
                            "text": "Knee pain instructions given",
                            "template": "Knee pain instructions given"
                        }
                    ]
                },
                {
                    "text": "OTC pain relievers",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Take OTC pain relievers prn",
                            "template": "Take OTC pain relievers prn"
                        },
                        {
                            "text": "Take OTC acetaminophen prn",
                            "template": "Take OTC acetaminophen prn"
                        },
                        {
                            "text": "Take OTC naproxen prn",
                            "template": "Take OTC naproxen prn"
                        },
                        {
                            "text": "Take OTC ibuprofen prn",
                            "template": "Take OTC ibuprofen prn"
                        },
                        {
                            "text": "Apply OTC capsaicin cream daily prn",
                            "template": "Apply OTC capsaicin cream daily prn"
                        }
                    ]
                },
                {
                    "text": "R.I.C.E. instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "R.I.C.E. instructions given",
                            "template": "R.I.C.E. instructions given"
                        }
                    ]
                },
                {
                    "text": "Weight-bearing instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Weight-bearing as tolerated",
                            "template": "Weight-bearing as tolerated"
                        },
                        {
                            "text": "No weight bearing x3 days",
                            "template": "No weight bearing x3 days"
                        },
                        {
                            "text": "No weight bearing x5 days",
                            "template": "No weight bearing x5 days"
                        },
                        {
                            "text": "No weight bearing x7 days",
                            "template": "No weight bearing x7 days"
                        },
                        {
                            "text": "No weight bearing x2 weeks",
                            "template": "No weight bearing x2 weeks"
                        },
                        {
                            "text": "No weight bearing x3 weeks",
                            "template": "No weight bearing x3 weeks"
                        },
                        {
                            "text": "No weight bearing x4 weeks",
                            "template": "No weight bearing x4 weeks"
                        }
                    ]
                },
                {
                    "text": "Activity instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Activity as tolerated",
                            "template": "Activity as tolerated"
                        },
                        {
                            "text": "Gentle exercise as tolerated",
                            "template": "Gentle exercise as tolerated"
                        },
                        {
                            "text": "Return to normal activity as tolerated",
                            "template": "Return to normal activity as tolerated"
                        },
                        {
                            "text": "OK to resume usual activities as tolerated",
                            "template": "OK to resume usual activities as tolerated"
                        },
                        {
                            "text": "Avoid jumping, squatting, pressure to knee",
                            "template": "Avoid jumping, squatting, pressure to knee"
                        }
                    ]
                },
                {
                    "text": "Return to work instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Arthritis w\/o surgery, OK to return to work immediately",
                            "template": "Arthritis w\/o surgery, OK to return to work immediately"
                        },
                        {
                            "text": "Arthritis post viscosupplement injury, return to work in 7 days",
                            "template": "Arthritis post viscosupplement injury, return to work in 7 days"
                        },
                        {
                            "text": "Arthritis post-op, return to work in 28-110 days",
                            "template": "Arthritis post-op, return to work in 28-110 days"
                        },
                        {
                            "text": "ACL repair\/severe tear Grade III, return to sedentary\/modified work in 35 days\n                            ",
                            "template": "ACL repair\/severe tear Grade III, return to sedentary\/modified work in 35 days\n                            "
                        },
                        {
                            "text": "ACL repair\/severe tear Grade III, return to manual\/standing work in 180 days",
                            "template": "ACL repair\/severe tear Grade III, return to manual\/standing work in 180 days"
                        },
                        {
                            "text": "Meniscus tear w\/o surgery, return to clerical\/modified work in 0-2 days",
                            "template": "Meniscus tear w\/o surgery, return to clerical\/modified work in 0-2 days"
                        },
                        {
                            "text": "Meniscus tear w\/o surgery, return to manual\/standing work in 21 days",
                            "template": "Meniscus tear w\/o surgery, return to manual\/standing work in 21 days"
                        },
                        {
                            "text": "PFS w\/ arthroscopy, return to clerical\/modified work in 7-10 days",
                            "template": "PFS w\/ arthroscopy, return to clerical\/modified work in 7-10 days"
                        },
                        {
                            "text": "PFS w\/ arthroscopy, return to manual work in 28 days",
                            "template": "PFS w\/ arthroscopy, return to manual work in 28 days"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Follow-up, Referrals",
            "template": "{children}",
            "children": [
                {
                    "text": "Return visits",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Return visit as needed",
                            "template": "Return visit as needed"
                        },
                        {
                            "text": "Return visit in 3-5 days",
                            "template": "Return visit in 3-5 days"
                        },
                        {
                            "text": "Return visit in 5-7 days",
                            "template": "Return visit in 5-7 days"
                        },
                        {
                            "text": "Return visit in 7-10 days",
                            "template": "Return visit in 7-10 days"
                        },
                        {
                            "text": "Return visit in 2 weeks",
                            "template": "Return visit in 2 weeks"
                        },
                        {
                            "text": "Return visit in 3 weeks",
                            "template": "Return visit in 3 weeks"
                        },
                        {
                            "text": "Return visit in 4 weeks",
                            "template": "Return visit in 4 weeks"
                        }
                    ]
                },
                {
                    "text": "Admit to ER\/inpatient care",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Admit to ER",
                            "template": "Admit to ER"
                        },
                        {
                            "text": "Admit to hospital",
                            "template": "Admit to hospital"
                        }
                    ]
                },
                {
                    "text": "Referrals",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Refer to Rheumatology",
                            "template": "Refer to Rheumatology"
                        },
                        {
                            "text": "Refer to Orthopedic Surgery",
                            "template": "Refer to Orthopedic Surgery"
                        },
                        {
                            "text": "Refer to PM&R",
                            "template": "Refer to PM&R"
                        },
                        {
                            "text": "Refer to Orthotics",
                            "template": "Refer to Orthotics"
                        },
                        {
                            "text": "Refer to Physical Therapy",
                            "template": "Refer to Physical Therapy"
                        }
                    ]
                }
            ]
        }
    ]
}