{
    "section": "plan",
    "templateSet": "Venous thromboembolism",
    "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": "Creatinine kinase (CK), serum",
                            "template": "Creatinine kinase (CK), serum"
                        },
                        {
                            "text": "Troponin T, serum",
                            "template": "Troponin T, serum"
                        },
                        {
                            "text": "B-type natriuretic peptide (BNP), serum",
                            "template": "B-type natriuretic peptide (BNP), serum"
                        },
                        {
                            "text": "Hepatic function panel (LFTs)",
                            "template": "Hepatic function panel (LFTs)"
                        },
                        {
                            "text": "Albumin, serum",
                            "template": "Albumin, serum"
                        },
                        {
                            "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": "Beta-hCG, qualitative, serum",
                            "template": "Beta-hCG, qualitative, serum"
                        },
                        {
                            "text": "PT\/INR",
                            "template": "PT\/INR"
                        },
                        {
                            "text": "PTT (partial thromboplastin time), serum",
                            "template": "PTT (partial thromboplastin time), serum"
                        },
                        {
                            "text": "D-dimer, plasma",
                            "template": "D-dimer, plasma"
                        },
                        {
                            "text": "Antithrombin activity, plasma",
                            "template": "Antithrombin activity, plasma"
                        },
                        {
                            "text": "Anticardiolipin antibodies, IgG+IgM, serum",
                            "template": "Anticardiolipin antibodies, IgG+IgM, serum"
                        },
                        {
                            "text": "Beta-2 glycoprotein 1 antibodies, serum",
                            "template": "Beta-2 glycoprotein 1 antibodies, serum"
                        },
                        {
                            "text": "Lupus anticoagulant, plasma",
                            "template": "Lupus anticoagulant, plasma"
                        },
                        {
                            "text": "Protein C activity, plasma",
                            "template": "Protein C activity, plasma"
                        },
                        {
                            "text": "Protein S antigen, free, plasma",
                            "template": "Protein S antigen, free, plasma"
                        },
                        {
                            "text": "Heparin anti-factor Xa",
                            "template": "Heparin anti-factor Xa"
                        },
                        {
                            "text": "Fondaparinux anti-factor Xa",
                            "template": "Fondaparinux anti-factor Xa"
                        }
                    ]
                },
                {
                    "text": "Urine",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Beta-hCG, qualitative, urine",
                            "template": "Beta-hCG, qualitative, urine"
                        }
                    ]
                },
                {
                    "text": "Blood\/Skin cultures",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Culture, blood, bacterial x2",
                            "template": "Culture, blood, bacterial x2"
                        },
                        {
                            "text": "Culture, wound, bacterial",
                            "template": "Culture, wound, bacterial"
                        }
                    ]
                }
            ]
        },
        {
            "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": "X-ray soft tissue [specify]",
                            "template": "X-ray soft tissue [specify]"
                        },
                        {
                            "text": "US",
                            "template": "US"
                        },
                        {
                            "text": "MRI [specify]",
                            "template": "MRI [specify]"
                        },
                        {
                            "text": "Angiography lower extremity veins bilateral",
                            "template": "Angiography lower extremity veins bilateral"
                        },
                        {
                            "text": "Angiography lower extremity veins right",
                            "template": "Angiography lower extremity veins right"
                        },
                        {
                            "text": "Angiography lower extremity veins left",
                            "template": "Angiography lower extremity veins left"
                        },
                        {
                            "text": "Ventilation\/perfusion (V\/Q) scan",
                            "template": "Ventilation\/perfusion (V\/Q) scan"
                        },
                        {
                            "text": "Compression US",
                            "template": "Compression US"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Procedures",
            "template": "{children}",
            "children": [
                {
                    "text": "Procedures",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "EKG, 12-lead",
                            "template": "EKG, 12-lead"
                        },
                        {
                            "text": "Echocardiogram",
                            "template": "Echocardiogram"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Medications",
            "template": "{children}",
            "children": [
                {
                    "text": "Anticoagulants",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "enoxaparin INJ",
                            "template": "enoxaparin INJ"
                        },
                        {
                            "text": "warfarin 1 mg tab",
                            "template": "warfarin 1 mg tab"
                        },
                        {
                            "text": "warfarin 2 mg tab",
                            "template": "warfarin 2 mg tab"
                        },
                        {
                            "text": "warfarin 2.5 mg tab",
                            "template": "warfarin 2.5 mg tab"
                        },
                        {
                            "text": "warfarin 5 mg tab",
                            "template": "warfarin 5 mg tab"
                        },
                        {
                            "text": "warfarin 7.5 mg tab",
                            "template": "warfarin 7.5 mg tab"
                        },
                        {
                            "text": "warfarin 10 mg tab",
                            "template": "warfarin 10 mg tab"
                        },
                        {
                            "text": "Arixtra INJ",
                            "template": "Arixtra INJ"
                        },
                        {
                            "text": "Arixtra INJ",
                            "template": "Arixtra INJ"
                        },
                        {
                            "text": "Fragmin INJ",
                            "template": "Fragmin INJ"
                        }
                    ]
                },
                {
                    "text": "Acetaminophen\/NSAIDs",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "acetaminophen 500 mg tab",
                            "template": "acetaminophen 500 mg tab"
                        },
                        {
                            "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": "naproxen 500 mg tab",
                            "template": "naproxen 500 mg tab"
                        }
                    ]
                },
                {
                    "text": "Opioids",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "hydrocodone\/acetaminophen 5 mg\/500 mg tab",
                            "template": "hydrocodone\/acetaminophen 5 mg\/500 mg tab"
                        },
                        {
                            "text": "oxycodone\/acetaminophen 5 mg\/325 mg tab",
                            "template": "oxycodone\/acetaminophen 5 mg\/325 mg tab"
                        }
                    ]
                },
                {
                    "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": "Supplies, Equipment",
            "template": "{children}",
            "children": [
                {
                    "text": "Supplies, compression stockings",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Compression stockings",
                            "template": "Compression stockings"
                        },
                        {
                            "text": "Pneumatic compression stockings",
                            "template": "Pneumatic compression stockings"
                        },
                        {
                            "text": "T.E.D. compression stockings",
                            "template": "T.E.D. compression stockings"
                        },
                        {
                            "text": "Jobst, fitted compression stockings",
                            "template": "Jobst, fitted compression stockings"
                        },
                        {
                            "text": "Elastic compression stockings",
                            "template": "Elastic compression stockings"
                        }
                    ]
                }
            ]
        },
        {
            "text": "Patient instructions",
            "template": "{children}",
            "children": [
                {
                    "text": "Home care for DVT",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "LMWH and warfarin instructions given",
                            "template": "LMWH and warfarin instructions given"
                        },
                        {
                            "text": "Take NSAIDs as needed for pain",
                            "template": "Take NSAIDs as needed for pain"
                        },
                        {
                            "text": "Wear compression stockings as instructed (after acute swelling resolves)",
                            "template": "Wear compression stockings as instructed (after acute swelling resolves)"
                        },
                        {
                            "text": "Walk as much as possible",
                            "template": "Walk as much as possible"
                        }
                    ]
                },
                {
                    "text": "Home care for superficial thrombophlebitis",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Instructed on use of LMWH",
                            "template": "Instructed on use of LMWH"
                        },
                        {
                            "text": "Wear compression stockings as instructed",
                            "template": "Wear compression stockings as instructed"
                        },
                        {
                            "text": "Walk as much as possible",
                            "template": "Walk as much as possible"
                        },
                        {
                            "text": "Avoid NSAIDs",
                            "template": "Avoid NSAIDs"
                        }
                    ]
                },
                {
                    "text": "Home care for superficial thrombophlebitis",
                    "template": "{children}",
                    "children": [
                        {
                            "text": "Wear compression stockings as instructed",
                            "template": "Wear compression stockings as instructed"
                        },
                        {
                            "text": "Take NSAIDs as needed for pain",
                            "template": "Take NSAIDs as needed for pain"
                        },
                        {
                            "text": "Walk as much as possible",
                            "template": "Walk as much as possible"
                        },
                        {
                            "text": "Return for repeat US in one week to evaluate for extension",
                            "template": "Return for repeat US in one week to evaluate for extension"
                        }
                    ]
                },
                {
                    "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": "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 48-72 hours",
                            "template": "Return visit in 48-72 hours"
                        },
                        {
                            "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": "Return visit in 3 months",
                            "template": "Return visit in 3 months"
                        },
                        {
                            "text": "Return visit in 6 months",
                            "template": "Return visit in 6 months"
                        },
                        {
                            "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 Hematology\/Oncology",
                            "template": "Refer to Hematology\/Oncology"
                        },
                        {
                            "text": "Refer to Vascular Surgery",
                            "template": "Refer to Vascular Surgery"
                        }
                    ]
                }
            ]
        }
    ]
}