{
    "section": "plan",
    "templateSet": "Syncope",
    "templates": [
        {
            "text": "Labs",
            "template": "{children}",
            "children": [
                {
                    "text": "Serum",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "CBC",
                            "template": "CBC"
                        },
                        {
                            "text": "CBC w\/ auto diff",
                            "template": "CBC w\/ auto diff"
                        },
                        {
                            "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": "D-dimer, plasma",
                            "template": "D-dimer, plasma"
                        },
                        {
                            "text": "PT\/INR",
                            "template": "PT\/INR"
                        },
                        {
                            "text": "PTT (partial thromboplastin time), serum",
                            "template": "PTT (partial thromboplastin time), serum"
                        },
                        {
                            "text": "Beta-hCG, quantitative, serum",
                            "template": "Beta-hCG, quantitative, serum"
                        }
                    ]
                },
                {
                    "text": "Urine",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Beta-hCG, qualitative, urine",
                            "template": "Beta-hCG, qualitative, urine"
                        },
                        {
                            "text": "Toxicology screen, urine",
                            "template": "Toxicology screen, urine"
                        }
                    ]
                },
                {
                    "text": "Stool",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Fecal occult blood test (FOBT)",
                            "template": "Fecal occult blood test (FOBT)"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Imaging",
            "template": "{children}",
            "children": [
                {
                    "text": "Imaging",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "X-ray chest, PA and lateral",
                            "template": "X-ray chest, PA and lateral"
                        },
                        {
                            "text": "Ventilation\/perfusion (V\/Q) scan",
                            "template": "Ventilation\/perfusion (V\/Q) scan"
                        },
                        {
                            "text": "CT head",
                            "template": "CT head"
                        },
                        {
                            "text": "CTA chest",
                            "template": "CTA chest"
                        },
                        {
                            "text": "MRI brain",
                            "template": "MRI brain"
                        },
                        {
                            "text": "MRA brain",
                            "template": "MRA brain"
                        },
                        {
                            "text": "US carotid artery bilateral",
                            "template": "US carotid artery bilateral"
                        },
                        {
                            "text": "US pelvis, transvaginal",
                            "template": "US pelvis, transvaginal"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Procedures",
            "template": "{children}",
            "children": [
                {
                    "text": "Procedures",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "EKG, 12-lead",
                            "template": "EKG, 12-lead"
                        },
                        {
                            "text": "Holter monitor, 24-hour",
                            "template": "Holter monitor, 24-hour"
                        },
                        {
                            "text": "Tilt table test",
                            "template": "Tilt table test"
                        },
                        {
                            "text": "Carotid sinus massage",
                            "template": "Carotid sinus massage"
                        },
                        {
                            "text": "EGD",
                            "template": "EGD"
                        },
                        {
                            "text": "Colonoscopy",
                            "template": "Colonoscopy"
                        },
                        {
                            "text": "Echocardiogram",
                            "template": "Echocardiogram"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Medications",
            "template": "{children}",
            "children": [
                {
                    "text": "Orthostatic hypotension",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "fludrocortisone 0.1 mg tab",
                            "template": "fludrocortisone 0.1 mg tab"
                        },
                        {
                            "text": "midodrine 2.5 mg tab",
                            "template": "midodrine 2.5 mg tab"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Supplies, Equipment",
            "template": "{children}",
            "children": [
                {
                    "text": "Compression stockings",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Pneumatic compression stockings",
                            "template": "Pneumatic compression stockings"
                        },
                        {
                            "text": "T.E.D. compression stockings (18 mm Hg)",
                            "template": "T.E.D. compression stockings (18 mm Hg)"
                        },
                        {
                            "text": "Jobst, fitted compression stockings (20-40 mm Hg)",
                            "template": "Jobst, fitted compression stockings (20-40 mm Hg)"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Patient instructions",
            "template": "{children}",
            "children": [
                {
                    "text": "General instructions",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Call if no improvement in 48-72h or if new sx",
                            "template": "Call if no improvement in 48-72h or if new sx"
                        },
                        {
                            "text": "Syncope safety\/prevention instructions given",
                            "template": "Syncope safety\/prevention instructions given"
                        }
                    ]
                },
                {
                    "text": "Situational\/Vasovagal syncope",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Avoid triggering situations",
                            "template": "Avoid triggering situations"
                        },
                        {
                            "text": "Drink plenty of fluids",
                            "template": "Drink plenty of fluids"
                        },
                        {
                            "text": "Instructions given on prevention maneuvers (squatting, arm tensing, leg crossing)\n                            ",
                            "template": "Instructions given on prevention maneuvers (squatting, arm tensing, leg crossing)\n                            "
                        },
                        {
                            "text": "Sit during micturition",
                            "template": "Sit during micturition"
                        },
                        {
                            "text": "Avoid straining during defecation",
                            "template": "Avoid straining during defecation"
                        }
                    ]
                },
                {
                    "text": "Panic\/Anxiety attack",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Find calm, quiet location to mitigate symptoms",
                            "template": "Find calm, quiet location to mitigate symptoms"
                        },
                        {
                            "text": "Deep breathing techniques given",
                            "template": "Deep breathing techniques given"
                        },
                        {
                            "text": "Consider cognitive behavioral therapy",
                            "template": "Consider cognitive behavioral therapy"
                        },
                        {
                            "text": "Relaxation techniques given",
                            "template": "Relaxation techniques given"
                        }
                    ]
                },
                {
                    "text": "Orthostatic hypotension",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Drink plenty of fluids",
                            "template": "Drink plenty of fluids"
                        },
                        {
                            "text": "Stop taking offending medications",
                            "template": "Stop taking offending medications"
                        },
                        {
                            "text": "Move slowly when rising from laying or sitting",
                            "template": "Move slowly when rising from laying or sitting"
                        },
                        {
                            "text": "Limit number of large meals",
                            "template": "Limit number of large meals"
                        },
                        {
                            "text": "Reduce alcohol intake",
                            "template": "Reduce alcohol intake"
                        },
                        {
                            "text": "Avoid prolonged standing",
                            "template": "Avoid prolonged standing"
                        },
                        {
                            "text": "Wear T.E.D. compression stockings as instructed",
                            "template": "Wear T.E.D. compression stockings as instructed"
                        },
                        {
                            "text": "Wear pneumatic compression stockings as instructed",
                            "template": "Wear pneumatic compression stockings as instructed"
                        },
                        {
                            "text": "Wear Jobst, fitted compression stockings as instructed",
                            "template": "Wear Jobst, fitted compression stockings as instructed"
                        },
                        {
                            "text": "Compression stocking instructions given",
                            "template": "Compression stocking instructions given"
                        }
                    ]
                }
            ]
        },
        {
            "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 24 hours",
                            "template": "Return visit in 24 hours"
                        },
                        {
                            "text": "Return visit in 1-2 days",
                            "template": "Return visit in 1-2 days"
                        },
                        {
                            "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 wks",
                            "template": "Return visit in 2 wks"
                        },
                        {
                            "text": "Return visit in 3 wks",
                            "template": "Return visit in 3 wks"
                        },
                        {
                            "text": "Return visit in 4 wks",
                            "template": "Return visit in 4 wks"
                        },
                        {
                            "text": "Phone follow-up as needed",
                            "template": "Phone follow-up as needed"
                        }
                    ]
                },
                {
                    "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 Neurology",
                            "template": "Refer to Neurology"
                        },
                        {
                            "text": "Refer to Cardiology",
                            "template": "Refer to Cardiology"
                        },
                        {
                            "text": "Refer to Psychology",
                            "template": "Refer to Psychology"
                        },
                        {
                            "text": "Refer to Psychiatry",
                            "template": "Refer to Psychiatry"
                        },
                        {
                            "text": "Refer to GI",
                            "template": "Refer to GI"
                        }
                    ]
                }
            ]
        }
    ]
}