{
    "section": "kct-mdm",
    "templateSet": "Injectable Medications",
    "templates": [
        {
            "text": "ceftriaxone (mixed with 1% Lidocaine, Plain)",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "ceftriaxone (gm) IM",
                    "template": "ceftriaxone {text} gm IM (mixed with 1% Lidocaine, Plain)",
                    "type": "number"
                },
                {
                    "text": "ceftriaxone (mg) IM",
                    "template": "ceftriaxone {text} mg IM (mixed with 1% Lidocaine, Plain)",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "ketorolac",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "ketorolac (mg) IM",
                    "template": "ketorolac {text} mg IM",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "epinephrine (1:1000)",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "epinephrine (1:1000) (ml) SQ",
                    "template": "epinephrine (1:1000) {text} ml SQ",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Zofran",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "Zofran (mg) IM",
                    "template": "Zofran {text} mg IM",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "dephenhydramine",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "dephenhydramine (mg) IM",
                    "template": "dephenhydramine {text} mg IM",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "cefazolin",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "cefazolin (gm) IM",
                    "template": "cefazolin {text} gm IM",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Kenalog",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "Kenalog (mg) IM",
                    "template": "Kenolog {text} mg IM",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Solumedrol",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "Solumedrol (mg) IM",
                    "template": "Solumedrol {text} mg IM",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Phenergran",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "Phenergan 25 mg\/1ml IM (ml)",
                    "template": "Phenergan 25 mg\/1ml, total given: {text} ml IM",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Ativan",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "Ativan 25mg\/1 ml (ml) IM",
                    "template": "Ativan 2mg\/ml, total given: {text} ml IM",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Tetanus IG",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "Tetanus IG 250 Units IM",
                    "template": "Tetanus IG 250 Units IM"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Serum IG",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "Serum IG (ml) IM",
                    "template": "Serum IG {text} ml IM",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Hepatitis IG",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "Hepatitis IG (ml) IM",
                    "template": "Hepatitis IG {text} ml IM",
                    "type": "number"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Medication #1",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "medication (specify)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Medication #2",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "medication (specify)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Medication #3",
            "template": "Medication Given{children}",
            "children": [
                {
                    "text": "medication (specify)",
                    "template": "{text}",
                    "type": "alpha"
                },
                {
                    "text": "time (specify)",
                    "template": "time",
                    "type": "alpha"
                },
                {
                    "text": "site (specify)",
                    "template": "site {children}",
                    "children": [
                        {
                            "text": "left deltoid",
                            "template": "left deltoid"
                        },
                        {
                            "text": "left upper arm",
                            "template": "left upper arm"
                        },
                        {
                            "text": "left lower arm",
                            "template": "left lower arm"
                        },
                        {
                            "text": "left gluteus medius",
                            "template": "left gluteus medius"
                        },
                        {
                            "text": "left vastus lateralis",
                            "template": "left vastus lateralis"
                        },
                        {
                            "text": "left thigh",
                            "template": "left thigh"
                        },
                        {
                            "text": "right deltoid",
                            "template": "right deltoid"
                        },
                        {
                            "text": "right upper arm",
                            "template": "right upper arm"
                        },
                        {
                            "text": "right lower arm",
                            "template": "right lower arm"
                        },
                        {
                            "text": "right gluteus medius",
                            "template": "right gluteus medius"
                        },
                        {
                            "text": "right vastus lateralis",
                            "template": "right vastus lateralis"
                        },
                        {
                            "text": "right thigh",
                            "template": "right thigh"
                        }
                    ]
                },
                {
                    "text": "given by (specify)",
                    "template": "given by",
                    "type": "alpha"
                },
                {
                    "text": "manufacturer (specify)",
                    "template": "manufacturer",
                    "type": "alpha"
                },
                {
                    "text": "lot (#)",
                    "template": "lot",
                    "type": "alpha"
                },
                {
                    "text": "expiration (date)",
                    "template": "expiration date",
                    "type": "date"
                }
            ]
        },
        {
            "text": "Reassessment (time)",
            "template": "Reassessment:Time: {text}",
            "type": "alpha"
        },
        {
            "text": "Reassessment Vitals",
            "template": "{tb}Vitals: {children}",
            "children": [
                {
                    "text": "BP (specify)",
                    "template": "BP {text}",
                    "type": "alpha"
                },
                {
                    "text": "Temp (F)",
                    "template": "T {text}F",
                    "type": "number"
                },
                {
                    "text": "Pulse (bpm)",
                    "template": "P {text}",
                    "type": "number"
                },
                {
                    "text": "Respirations (#)",
                    "template": "RR {text}",
                    "type": "number"
                },
                {
                    "text": "Pulse Oxygen (%)",
                    "template": "pulse oxygen {text}%",
                    "type": "number"
                },
                {
                    "text": "comments (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        },
        {
            "text": "Physician Assessment (time)",
            "template": "Physician Assessment of Response to Medication(s)Time: {text}",
            "type": "alpha"
        },
        {
            "text": "Physician Assessment, Response",
            "template": "{tb}Response: {children}",
            "children": [
                {
                    "text": "no adverse reaction",
                    "template": "no adverse reaction"
                },
                {
                    "text": "symptoms improved",
                    "template": "symptoms improved"
                },
                {
                    "text": "pt stable\/discharge home",
                    "template": "patient stable for discharge home"
                },
                {
                    "text": "other (describe)",
                    "template": "{text}",
                    "type": "alpha"
                }
            ]
        }
    ]
}