Presentation not consistent with other etiologies upper GI bleeding at this time. For those who never used this, you would have all your custom templates saved and labeled and to get it to pop up while you're typing you would type "." and then the name of the template. Patient presents with renal failure with uncertain cause but likely due to longstanding DM/HTN_. Patient presents with flank pain likely secondary to renal colic from likely non-obstructed non infected kidney stone. DMV was notified to remove patient's licence_, patient was given strict seizure precautions. Considered other etiologies of acute hypoglycemia to include drugs (anti-hyperglycemics, alcohol, beta blockers, ACE-I, APAP) or drug related error (missed meal, incorrect dosing, intentional overdose), systemic illness (sepsis, acute coronary syndrome, renal / hepatic failure, adrenal insufficiency), malignancy, or post-op complications such as Gastric bypass. The CDC guidance for COVID-19 and pregnancy has answers to questions about transmission during delivery, breastfeeding as well as other situations. Other items on the differential include dissection, AMI, hypoglycemia or other metabolic derangement such as hepatic/uremic encephalopathy, medication side effect, or post-ictal Todd's paralysis. There is no indication for emergent dialysis as patient is mentating normally with normal electrolytes and no hypoxemia from pulmonary edema. Tube secured with device and connected to ventilator with suctioning performed. Considered possible causes of DKA to include infection (intrabdominal infection, UTI, pneumonia), infarction / ischemia (acute coronary syndrome, cerebral vascular accident, pulmonary embolism), medication non-compliance with insulin therapy, illicit substance abuse, iatrogenic (including prescription medications and drug-drug interactions), idiopathic causes. Free US Ground shipping, no limit! The Department of Health will have jurisdiction and will provide you with specific instructions on what to do if they develop symptoms. This patient presents with symptoms consistent with acute anxiety reaction / panic attack. Should patients cancel or postpone an upcoming trip? Patient presents for dental pain due to suspected dental cary. Patient is HDS and without a history of coagulopathy or infectious symptoms. Rash does not appear urticarial with no signs of anaphylaxis either. Begin typing real words and phrases before the end of lesson one. Patient presents for swelling and shortness of breath and found to be volume overloaded on exam likely secondary to renal failure _, heart failure _, nephrotic syndrome _, cirrhosis based on history, exam, and work up. 3. No proptosis, vision change, or pain with EOM to suggest orbital cellulitis. Stay home for at least 24 hours after your symptoms have gone away without the use of fever-reducing medicines. This patient presents with initial presentation of local erythema, warmth, swelling concerning for cellulitis. I examined the patient and there was no pupillary response to light. 2. Patient had no reaction to blood transfusion. This is a _ with RLQ pain, most concerning for _. Abdominal exam without peritoneal signs. Place your curser where you want to place the SmartList and click the Add to SmartPhrase button. Anyone who is sick with a fever and cough should stay home from work until at least 24 hours after resolution of fever, regardless of concerns for COVID-19. Also includes a large amount of educational pearls and high-risk diagnoses to consider. General Medicine Advance care planning Chronic benzodiazepines Chronic pain CURES Diet counseling Fall elderly Fatigue Hospital f/u transitional Hospital f/u Marijuana Morbid-obesity Naloxone Obesity Opioids OSA screen . Some EHRs, like Epic, allow clinicians to share their smartphrases. The patient ___ does not take blood thinner medications. I accumulated a good deal of tricks intern year. This patient presents with altered mental status, concerning for _. Labs and exam were inconsistent with toxic metabolic etiologies such as electrolyte disturbances (Na/Ca), hypoglycemia, and uremia; acidosis states, infection (i.e. Stay in a specific room and away from other people in your home as much as possible. This patient presents with dysuria_; vaginal discharge_; penile discharge_ and a history consistent with possible STI. Patient tachycardic with tremors and tongue fasciculations. No evidence of acute ACS complications including cardiogenic shock (2/2 muscle loss or valvular rupture), tachydysrhythmia or electrical conduction disturbance. You need to follow-up with your primary care doctor or cardiologist within 3 to 5 days. Given history, exam, and work up I have low suspicion for atypical appendicitis, genital torsion, acute cholecystitis, AAA, infected obstructed stone, pyelonephritis, or other emergent intraabdominal pathology. Point duty. Do not merely copy and paste a prewritten note . Area extensively irrigated with sterile normal saline under pressure. What other general precautions are advised? Other items on the differential include dissection, AMI, hypoglycemia or other metabolic derangement such as hepatic/uremic encephalopathy, medication side effect, or post-ictal Todds paralysis. Laceration repaired in simple fashion as below (please see procedure note for further details)_. Presentation not consistent with acute respiratory etiologies to include acute PE (Wells low risk), pneumothorax , asthma, COPD exacerbation, allergic etiologies, or infectious etiologies such as PNA. Considered alternate etiologies of the patients symptoms including infectious processes, severe metabolic derangements or electrolyte abnormalities, ischemia/ACS, heart failure, and intracranial/central processes but think these are unlikely given the history and physical exam. This patient with nausea and vomiting which is likely secondary to benign infectious cause_ cannabis hyperemesis syndrome_ gastroparesis_. Patient found to have symptomatic hyperkalemia with ecg changes likely secondary to ESRD_. Urology was consulted_ and patient will follow up with them for trial of void. Patient given temperazing measures of insulin, as well as lasix and lokelma_ to reduce potassium level. Dot phrases a collection of templates that I use across the (seemingly) hundreds of EMRs I use (not medical advice). The likely precipitant is acute respiratory infection_ weather change or air quality _ recent beta-blocker or opiate use_. No urticarial rash to suggest allergic reaction. Stay in a specific room and away from other people in your home as much as possible. If you do visit a healthcare facility, put on a mask to protect other patients and staff. If you have a fever, you should remain home until 24 hours after fever resolves. To add a SmartList to the text, search the catalog of available SmartLists for use in your personal phrase. CT head and CTA head and neck ordered and shows _. Neurology consulted and MRI ordered which shows _. Patient observed for __ and was clinically sober at time of discharge. Are there any special precautions that are recommended if I am pregnant? There is not yet any information available about the susceptibility of pregnant women to COVID-19. Given history and physical temporal arteritis unlikely, as is acute angle closure glaucoma. CT head showed _. CTA head and neck showed _. Given History, Exam, and Workup can not rule out underlying osteomyelitis_, however have low suspicion for Necrotizing Fasciitis, Abscess, DVT. Based on history and physical no signs of PID_ epididymitis or orchitis_, or pyelonephritis at this time_. Doubt invasive bacteria causing diarrhea such as C diff (no recent antibiotics), shiga toxin (non bloody). Prescribed antibiotics and instructed the Pt to follow up closely with ophthalmology and avoid wearing contacts_. Given history and exam I have low suspicion for globe rupture, uveitis, HSV keratitis, Endopthalmitist, Foreign Body. Rest No evidence of acute abdomen at this time, low suspicion for appendicitis given negative CT scan_. Patient is afebrile with no infectious symptoms, no signs of hyperthyroidism in the history and TSH pending_, considered PE but less likely (no chest pain, sob, DVT risk factors, leg swelling, and satting well), doubt ACS (no chest pain, non STEMI ekg, and neg trop_), no anemia on CBC, patient denies any drug/alcohol intoxication or withdrawal, patient euvolemic on exam and does not appear dry so doubt orthostatic changes. WHAT IS A DOTPHRASE? Explained to patient that they will likely be sore for the coming days and can use tylenol/ibuprofen to control the pain, patient given return precautions. This is called a Holter monitor or a ZIO Patch, and needs to be arranged by your PCP or cardiologist. You can find my fall themed words for drill in my Happy Fall Quick Drill which is always a hit in articulation. Patient non toxic appearing with no signs of infection or ischemia. Considered other etiologies but given history, exam and workup have low suspicion for cauda equina, infectious etiology (pyelonephritis or cystitis), constipation induced retention, intraabdominal mass, trauma, nephrolithiasis, urolithiasis, drug reaction. No lymphangitic spread visible and no fluid pockets or fluctuance concerning for abscess noted. Given work up, exam, and history low suspicion for intracranial hemorrhage or trauma, carotid or vertebral artery dissection, intrathoracic trauma (pulmonary contusion, blunt cardiac trauma, pneumothorax, hemothorax, cardiac tamponade, rib fractures), intra abdominal trauma (no liver, spleen, or renal lacerations, doubt hollow viscus injury given soft abdomen on repeat exams, no free air seen, consistently normotensive), extremity fracture, extremity dislocation, compartment syndrome. Patient was persistently in withdrawal despite multiple repeated doses of benzos, plan to admit patient for alcohol withdrawal._, Patient devolved and had withdrawal seizure/delirium tremens/alcoholic hallucinosis plan to admit patient to to ICU._. Given that the patient is not immunocompromised, able to tolerate PO, nontoxic appearing, and no signs of trismus or airway compromise, plan to discharge the patient home with augmentin_. Note that these medicines do not cure the illness and therefore do not stop you from spreading germs. Moot point. normal physical exam), you can put that into a smart phrase and then just put that in every note and edit the parts that need to be changed. Will send UA and empirically treat for gonorrhea/chlamydia with IM CTX and PO doxycycline. Area hemostatic. Wash your hands often with soap and water for at least 20 seconds. Per EMS report, patient was found down_, had witnessed arrest_. Patient to be discharged home with bactrim and keflex with follow up with their PMD. Patient is not immunocompromised, and there is no bullae, pain out of proportion, or rapid progression concerning for necrotizing fasciitis. The mechanism is of low energy. No acute indication for psychiatric consultation (without SI/HI, AH/VH). If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Our beginner typing lessons make it easy to learn typing. The current level of pain is moderate. Differential diagnosis includes other viral causes of LRTI, pneumonia, less likely PE, PTX, primary cardiovascular causes, bacterial sepsis, or other severe metabolic/ischemic derangements. A dot phrase is a colloquial term for a preformed block of text that is inserted using keyboard shortcuts, often preceded by a dot. Patient not hypovolemic so doubt extra renal losses such as GI losses, burns, 3rd spacing, or diuretic use. Considered but low risk for any emergent causes including unstable heart block (ekg with no signs of Mobitz II, complete heart block), right coronary artery myocardial infarction (neg trop_, non STEMI, no chest pain), infection (afebrile, no leukocytosis, no recent illness), hypothyroidism, hyperkalemia, hypoglycemia, dehydration, or intoxication (beta blockade, calcium channel blockade, clonidine, digoxin, opiates, alcohol or other). Low suspicion for alternate etiologies such as pneumothorax, acute PE, pneumonia. Clean your hands often Considered acute chest, stroke, splenic sequestration, and other emergent complications of sickle cell disease. TREATMENT AND MEDICAL CARE Presentation not consistent with esophageal or gastric variceal bleeding or Boerhaaves syndrome. After _ min, I discontinued resuscitation and patient was pronounced deceased. ROSC was achieved and patient admitted to ICU._ Despite all efforts, patient remained in cardiac arrest with no response to treatment measures and resuscitation attempt. Not immunocompromised and without signs of systemic or disseminated infection. The TikTok videos from users who are getting crafty at home, and all of the Instagram posts from your fave influencers who are chilling in front of their full-length mirrors have made one thing . Follow the instructions on the package, unless your doctor gave you instructions. Based on canadian syncope rule, patient is low risk and well appearing here, plan to discharge the patient home with PMD follow up. _ y/o patient with RUQ abdominal pain, consistent with _. Abdominal exam without peritoneal signs. It is best to call ahead of time to discuss your symptoms, if possible. No need for epinephrine. Try to stay at least 6 feet from others. Syncope Dot Phrase. EKG without evidence of STEMI or ischemia, labs with no hypoglycemia, metabolic derangements, and clinical picture does not suggest other stroke mimic. However, given age, cardiovascular risk factors, history & physical, will workup and admit to telemetry. The patient demonstrated a concerning amount of snuffbox tenderness on examination of their __ ha nd. Home Care Instructions for Patients with Mild Respiratory Infection. Antibiotics treat infections caused by bacteria, but they do not work against viruses. The Pt was found to have a closed _ fracture on XR. There ___ is not a laceration associated with the injury. The post-ictal state resolved prior to discharge and the patient had returned to neurological baseline. It is still influenza (flu) season and influenza remains far more common. Given work up have low suspicion for acute hepatobiliary disease (including acute cholecystitis or cholangitis), upper GI bleed, acute pancreatitis, gastric perforation, acute infectious processes (pneumonia, hepatitis, pyelonephritis), atypical appendicitis, vascular catastrophe, bowel obstruction or viscus perforation, or acute coronary syndrome. Patient presents for symptomatic anemia secondary to _. HPI, PE, A/P, procedure, billing code.) (LogOut/ Plan: observation, pain control, PO challenge, reassurance/reassessment, likely discharge. PE = .edVS and .personal PE template (mine is default to level 5 just via visual and basic exam of heat lungs) MDM. Because of how air circulates and is filtered on airplanes, most viruses do not spread easily on airplanes. Not septic. No evidence of acute abdomen at this time. Patient maintained his airway, and metabolized to sobriety and no longer altered. However, presentation most concerning for a CVA. Fall-Mechanical-Ground Level HPI. The mechanism of injury was a mechanical ground level fall without syncope or near-syncope. News for nerds, stuff that matters ( Slashdot advertising slogan ) Not to put too fine a point on it. Given history and exam I have low suspicion for corneal abrasion or ulcer, globe rupture, uveitis, HSV keratitis, Endopthalmitis, Retinal Detachment, Angle Closure Glaucoma, Foreign Body, hyphema. For example ".LBP" might pull in a block of text related to low back pain. Given the H&P, I suspect this patient is suicidal/homicidal/gravely disabled_ and patient was placed on 5150. Change), You are commenting using your Twitter account. Avoid touching your eyes, nose and mouth. (Ex: type "yes" to search for a yes/no drop list. OneNote. Patient given ipratropium, albuterol, solumedrol here with improvement of symptoms. ROS = .personal ROS phrase having most coveted in HPI prose Past hxs = .phrase to populate automatically same with allergies, meds. Discussed return precautions for odontogenic infections and other dental pain emergencies. Patient given fluids and started on insulin drip, admitted to MICU _. The current level of pain is moderate. Given history, exam, and workup, low suspicion for emergent neurovascular or orthopedic complications of gunshot wound to extremity such as compartment syndrome, large vascular injury, hemorrhagic shock, penetrating nerve injury, fracture. This patient presents with non bloody diarrhea consistent with likely viral enteritis. Wear a mask whenever you are indoors (except within your home), within 6 feet of others, or if you are outdoors and cannot maintain distance. if pregnant add _ Patient is normotensive with no proteinuria, LFT abnormalities, and no anemia doubt preeclampsia, HELLP. Patient febrile and given tylenol and normal saline bolus_. This patient has a presentation consistent with rectal bleeding, most likely due to _. No history of discharge so less likely bacterial or viral conjunctivitis. Just was ten systems, fairly minimal observations, minimum for billing. No evidence of acute abdomen at this time. Take over-the-counter cold and flu medications to reduce fever and pain. Low suspicion for mastoiditis, malignant otitis externa, AOM, herpes zoster oticus. Low suspicion for gastric or esophageal dysmotility as cause_. Considered, but think unlikely, CVT given no cranial nerve deficits, blurry vision, diplopia. For pediatric patients, see: MDM for different chief complaints (peds).". This patient presents with generalized weakness and fatigue likely secondary to dehydration. Cover your coughs and sneezes Given History and Exam I have low suspicion for this presentation being caused by PTA, RPA, Ludwigs angina, Epiglottitis or Bacterial Tracheitis, EBV, acute HIV, or Strep throat. History not consistent with meniere's disease. Secondary headache etiologies include but are not limited to tumor, cyst, meningitis, AVM, GCA, cerebral vein thrombosis, and carotic/vertebral artery dissection. Differential diagnosis includes other metabolic causes of hyperglycemia such as HHS, worsened diabetes or medication noncompliance. Low suspicion for acute cardiopulmonary process including ACS, PE, or thoracic aortic dissection. Please read in detail and delete what is not relevant. Patient is not immunocompromised. Patient not immunosuppressed, afebrile and well appearing with patent airway, have low suspicfion for deep space infection or any concern for airway compromise. Also, clean any surfaces that may have body fluids on them. Presentation not consistent with acute PE (Wells low risk _ PERC negative_),pneumothorax (not visualized on chest xr), thoracic aortic dissection, pericarditis, tamponade, pneumonia (no infectious symptoms, clear chest xr), myocarditis (no recent illness, neg trop). demyelinating diseases). However, due to concern for an occult scaphoid fracture, the patient was placed in a thumb spica splint and instructed to follow up with their PCP for repeat exam and radiography in 10-14 days. the tracheostomy if required. Based on history and physical doubt sinusitis. Plan at this time is to treat symptomatically, instruct to follow up with PCP or derm PRN. Cardiac arrest was likely secondary to _. Patient presents with lower abdominal pain/pelvic pain. The tetanus immunization status is ___ up to date. Presentation not consistent with impact seizure related to head trauma. Approximate downtime prior to compressions: _. Syncope: evaluating cardiac, neurological, and metabolic syncope Cardiovascular syncope: Differential diagnosis includes mechanical, electrical, vasovagal, orthostatic Cardiac mechanical (Aortic Stenosis, Hypertrophic cardiomyopathy, Pulmonary Embolism, HTN, Stenosis, Aortic . Denies vomiting, numbness/weakness, fever. What are dot phrases? Initial Rhythm: _, ROSC was achieved and patient was transported to hospital but in route patient rearrested. HEART score:_ so plan to admit patient for risk stratification_; discharge patient home with PMD follow up__. For example, in a medical document, the dot phrase ".consult" would replace the word "consultation.". It's easy to get started with dot phrases. Neurologic exam without evidence of meningismus, AMS, focal neurologic findings so doubt meningitis, encephalitis, stroke. If you develop symptoms that may indicate an infection, contact your physician. BMP witohut evidence of AKI. General Templates . Most people with respiratory infections like colds, the flu, and Coronavirus Disease (COVID-19) will have mild illness and can get better with appropriate home care and without the need to see a provider. Cover your mouth and nose with a tissue when you cough or sneeze. Patient with no signs of increased intracranial pressure or weight loss and history and physical suggest more benign headache so less likely mass effect in brain from tumor or abscess or idiopathic intracranial hypertension. No evidence of acute abdomen at this time. Presentation most consistent with diabetic foot infection. Microsoft 365 & HomeBase. Point blank range. Quickly learn how to type the Home Row Keys: A, S, D, F, J, K, L and ; with the correct finger position. Based on history, exam, and work up low suspicion for pancreatitis, appendicitis, biliary pathology, or other emergent problem. This pediatric patient presents with head trauma. Patient presents with nontraumatic painful, unilateral vision loss for which the initial differential is optic neuritis, temporal arteritis, acute angle closure glaucoma, endophthalmitis, and uveitis. Most likely etiology at this time is _. The decision about travel is personal and should be made in the context of a persons underlying health conditions, reason for travel and necessity of travel. The Pt presents with _ likely due to a corneal abrasion seen on fluorescein staining of eye. Peritonsillar abscess was drained with 18 gauge needle after anesthesia by bupivacaine with no complications_, patient feeling better_. Do not suspect underlying cardiopulmonary process. The patient is suffering from testicular pain, but based on the history, exam, and work up, I do not suspect that the patient has testicular torsion, abscess, severe cellulitis, Fourniers gangrene, orchitis, epididymitis, inguinal hernia or other emergent cause. Patient was pronounced deceased. Key History: Location (especially unilateral vs. bilateral), quality, intensity, duration, timing (does it disturb sleep? Patient given aspirin. CDC does recommend use of facemasks during air travel. Doubt meningitis or appendicitis. History, physical, and work up with low suspicion for temporal arteritis, complex migraine, or stroke. At this time, it is felt that the most likely explanation for the patient's symptoms is concussion. Doubt carotid artery dissection given no focal neuro deficits, no neck trauma or recent neck strain. Will provide strict return precautions and instructions on self-isolation/quarantine and anticipatory guidance. Patient appropriate for discharge with outpatient follow-up and ___ for pain. Patient has ESRD and spoke with nephrology with plan for emergent dialysis _. Patient discharged with nasal gel. Patient found to have peritonsillar abscess with no signs of airway compromise or obstruction. Patient is nontoxic appearing and not in need of emergent medical intervention. Doubt PNA, sepsis, other serious bacterial infection or acute emergent condition. What do you do if you are worried that you have been exposed to COVID-19 but are without any symptoms? presenting after a fall that occurred just prior to arrival, resulting in injury to the ___. Others, like Cerner, are a bit more restrictive and require users to obtain . By avoiding a visit to a healthcare facility, you protect yourself from getting a new infection and protect others from catching an infection from you. There was no loss of consciousness, confusion, seizure, or memory impairment. This patient presents with generalized weakness and fatigue likely secondary to dehydration. Separate yourself from other people and animals in your home. Patient is protecting airway and otherwise has an unremarkable secondary trauma survey. There is no specific treatment for most viruses including those that that cause the common cold and those that cause COVID-19. _ was reduced at bedside with conscious sedation_ and post reduction Xray shows successful reduction. What Are Dot Phrases? Patient discharged with prescription for narcan. Given history, exam and workup, low suspicion for HF, ICH (no trauma, headache), seizure (no witnessed seizure like activity, no postictal period, tongue laceration, bladder incontinence), stroke (no focal neuro deficits), HOCM (no murmur, family history of sudden death), ACS (neg troponin, no anginal pain), aortic dissection (no chest pain), malignant arrhythmia on ekg or any family history of sudden death, or GI bleed (stable hgb). Well appearing. Despite multiple rounds of opioids patients pain was not controlled, so patient was admitted for pain control. Patient to be discharged with zofran and to follow up with PMD. Presentation not consistent with chronic causes of cough (including GERD, asthma, postnasal discharge, medication side effect, CHF, lung cancer or mass). Seek medical attention for: fever >100.4 F, increasing warmth, redness, swelling, drainage at incision site. Patient denies suicidal intention or coingestion. Step #1. Patient presents with altered mental status likely secondary to EtOH intoxication. What should I do if I start feeling sick at work? Patient presented with chest pain concerning for ACS, EKG was non STEMI, however troponin was elevated concerning for NSTEMI, and the patient was given aspirin and started on heparin, pain was controlled with _, cardiology was consulted and patient was admitted. Abdominal exam without peritoneal signs. Per EMS report, patient was found down_, had witnessed arrest_. GSW Note. Patient received empiric Ancef and orthopedics was consulted who reduced the fracture under conscious sedation and placed in splint with plan to admit patient for likely orthopedic operation. No signs or symptoms of alcohol withdrawal while in the emergency department. Separate yourself from other people and animals in your home Autotext Dot Phrases for Cerner EHR. Use a separate bathroom, if available. This patient presents with symptoms most consistent with an acute COPD exacerbation. I have a low suspicion at this time for mastoiditis, malignant otitis externa, herpes or ramsey hunt syndrome, or retained foreign body. Primary headaches include tension, migraine, and cluster. Follow the steps below to help prevent the disease from spreading to people in your home and community. This patient presents with symptoms consistent with an underlying psychiatric disorder, most likely _. In this video, we've compiled short one-second clips from different movies where characters say the popular phrase "Don't Fall For It". No perforated tympanic membrane, discharged with Ciprodex_ and patient to follow up with PMD in 1 to 2 days. Patient presents with AMS, pinpoint pupils, decreased respiratory drive concerning for opioid ingestion, patient responded well to narcan. Patient with persistent vertigo that is not fatigable with no obvious trigger which is concerning for central etiology of either posterior circulation stroke vs intracranial mass vs intracranial hemorrhage vs vertebral basilar artery insufficiency. Patient to follow up with PMD. Patient given zofran and tolerated PO here. Low suspicion for acute pyelonephritis given lack of fever, CVAT, or systemic features. Do not handle pets or other animals while you are sick. People with potentially life-threatening symptoms should call 911. Please visit the CDCs guidance for getting your household ready for COVID-19. Fall-Mechanical-Ground Level Note. Patient prescribed flomax_. Wound care discussed. This pediatric patient presents with a history concerning for a serious intracranial injury. HPC Pre-Clinic HUDDLES. The Pt is otherwise well-appearing without evidence of retained foreign body, corneal ulcer_, globe rupture, or superimposed infection. Patient with known cause of bleeding and follow up scheduled. How To Trade A Shift on HomeBase. Most EHRs have this capability, both for organization-level and individual user-created content. No evidence of tooth fracture, avulsion, or bleeding socket. My kids said their target sound, words, phrases or . []-year-old patient presenting with swollen eye. Fill in your details below or click an icon to log in: You are commenting using your WordPress.com account. Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe. Situations are changing frequently and you should monitor the site for updates. Plan: ***straight cath for urine, antipyretic instructions, reassurance and reassessment, discharge with pediatrics f/u. If symptoms worsen or persist for 48-72 then pt to fill the prescription_. The CDC has excellent information on this. The abscess was anesthetized with lidocaine and then I&D was performed with deloculation and purulence was expressed. I considered, but think unlikely, dangerous causes of this patients symptoms to include ACS, CHF or COPD exacerbations, pneumonia, pneumothorax. Patient presented with bleeding over their fistula site which was controlled with _. No recent travel. Family was made aware._. A dotphrase is a colloquial term for a preformed block of text that is inserted using keyboard shortcuts, often preceded by a dot. Patient denies any history of withdrawal seizures, ICU admissions, or delirium tremens in past_. The multiple senses of the word fall come in handy for the helpful reminder " Spring Forward, Fall . This patient presents with diarrhea consistent with likely viral enteritis. Patient presents to the emergency department complaining of high blood pressure.