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            [0] => a:17:{i:0;a:3:{s:8:"question";s:15:"Chief Complaint";s:6:"answer";s:9:"Epistaxis";s:13:"preload_value";s:0:"";}i:1;a:3:{s:8:"question";s:26:"History of Present Illness";s:6:"answer";s:704:"The patient is a 21-year-old female with no significant past medical history who presents to the emergency department with a chief complaint of epistaxis. Symptoms began this morning after the patient sneezed and have been constant since onset. She states that she is allergic to cats and a cat was the cause of her sneeze. The bleeding is coming from the right nostril and has been slowing down, however the patient cannot get it to stop completely. Overall, she states that she has bled less than one cup of blood since symptom onset. There are no aggravating or alleviating factors. The patient denies head trauma, nose trauma, any pain, or any other symptoms. No other reported symptoms at this time.";s:13:"preload_value";s:486:"The patient is a [age] [sex] who presents to the emergency department with a chief complaint of ***. The symptoms began *** and have been *** since onset. His/her*** pain is currently rated as a ***/10 in severity and described as *** with radiation to ***. Associated symptoms include ***. Symptoms are aggravated with *** and improve with ***. The patient denies ***.  He/she*** reports taking *** prior to arrival with *** relief of symptoms. No other reported symptoms at this time.";}i:2;a:3:{s:8:"question";s:17:"Review of Systems";s:6:"answer";s:89:"All pertinent positive findings are listed in the HPI and all other systems are negative.";s:13:"preload_value";s:0:"";}i:3;a:3:{s:8:"question";s:20:"Past Medical History";s:6:"answer";s:18:"Previously Healthy";s:13:"preload_value";s:0:"";}i:4;a:3:{s:8:"question";s:19:"Current Medications";s:6:"answer";s:4:"None";s:13:"preload_value";s:0:"";}i:5;a:3:{s:8:"question";s:9:"Allergies";s:6:"answer";s:47:"No known drug allergies
Allergic to cat dander";s:13:"preload_value";s:0:"";}i:6;a:3:{s:8:"question";s:14:"Social History";s:6:"answer";s:105:"Smoking Status - No
Smokeless Tobacco - No
Alcohol Use - No
Drug Use - No
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HEENT: Normocephalic, atraumatic.  Pupils are 3mm equal round and reactive to light.  Epistaxis present. There is no rhinorrhea.  Pharynx is moist and without erythema, exudate, or edema.  Uvula is midline.  Tympanic membranes are clear bilaterally.  There is no hemotympanum.
NECK: Supple, trachea is midline.  There is no JVD or carotid bruits.  There is no stridor.  There is no midline or paraspinal tenderness to palpation. There is no lymphadenopathy.
BACK: There is no midline or paraspinal tenderness to palpation, no evidence of trauma, there is no CVA tenderness.
CHEST: Symmetric, there is no crepitus. There is no visible evidence of trauma to the chest. 
LUNGS: Breath sounds are present and equal bilaterally, there are no rales, rhonchi or wheezes. There is no respiratory distress.
CARDIOVASCULAR: Regular rate and rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: Abdomen is nondistended. There is no palpable tenderness. There is no rebound or guarding. There is no palpable mass. Bowel sounds are present and equal throughout.
PELVIS: Stable to rock. There is no visible trauma.
MUSCULOSKELETAL: There are no deformities to the extremities. Capillary refill is less than two seconds to nail beds of the bilateral hands. There is no clubbing, cyanosis or edema. Radial pulses are +2/4 bilaterally.
NEUROLOGIC: The patient is alert and oriented x3. No cranial nerve deficit. Motor examination reveals +5/5 strength throughout. Sensation is normal throughout. Finger-to-nose intact. Heel-to-shin intact. Negative Romberg sign. Gait and station appear normal. Visual fields are full to confrontation.
SKIN: Skin is warm and dry. There is no pallor. There are no signs of acute dermatologic abnormality. There is no rash, petechiae, purpura, or ecchymosis. There is good skin turgor.
PSYCH: The patient does not have suicidal ideation or homicidal ideation.  Mood is normal. The patient does not have auditory or visual hallucinations. Judgment and cognition are normal.";s:13:"preload_value";s:2050:"GENERAL: Alert and oriented x3. No significant distress noted.
HEENT: Normocephalic, atraumatic.  Pupils are 3mm equal round and reactive to light.  Nose***  Pharynx is moist and without erythema, exudate, or edema.  Uvula is midline.  Tympanic membranes are clear bilaterally.  There is no hemotympanum.
NECK: Supple, trachea is midline.  There is no JVD or carotid bruits.  There is no stridor.  There is no midline or paraspinal tenderness to palpation. There is no lymphadenopathy.
BACK: There is no midline or paraspinal tenderness to palpation, no evidence of trauma, there is no CVA tenderness.
CHEST: Symmetric, there is no crepitus. There is no visible evidence of trauma to the chest. 
LUNGS: Breath sounds are present and equal bilaterally, there are no rales, rhonchi or wheezes. There is no respiratory distress.
CARDIOVASCULAR: Regular rate and rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: Abdomen is nondistended. There is no palpable tenderness. There is no rebound or guarding. There is no palpable mass. Bowel sounds are present and equal throughout.
PELVIS: Stable to rock. There is no visible trauma.
MUSCULOSKELETAL: There are no deformities to the extremities. Capillary refill is less than two seconds to nail beds of the bilateral hands. There is no clubbing, cyanosis or edema. Radial pulses are +2/4 bilaterally.
NEUROLOGIC: The patient is alert and oriented x3. No cranial nerve deficit. Motor examination reveals +5/5 strength throughout. Sensation is normal throughout. Finger-to-nose intact. Heel-to-shin intact. Negative Romberg sign. Gait and station appear normal. Visual fields are full to confrontation.
SKIN: Skin is warm and dry. There is no pallor. There are no signs of acute dermatologic abnormality. There is no rash, petechiae, purpura, or ecchymosis. There is good skin turgor.
PSYCH: The patient does not have suicidal ideation or homicidal ideation.  Mood is normal. The patient does not have auditory or visual hallucinations. Judgment and cognition are normal.";}i:10;a:3:{s:8:"question";s:18:"ED COURSE:
Orders";s:6:"answer";s:4:"None";s:13:"preload_value";s:4:"None";}i:11;a:3:{s:8:"question";s:9:"Radiology";s:6:"answer";s:4:"None";s:13:"preload_value";s:4:"None";}i:12;a:3:{s:8:"question";s:10:"Procedures";s:6:"answer";s:182:"Rhino Rocket
A Rhino Rocket was inserted into the patient’s right nare by Dr. ***. The Rhino Rocket successfully controlled the bleeding. The patient tolerated the procedure well.";s:13:"preload_value";s:0:"";}i:13;a:3:{s:8:"question";s:23:"Calls/Consults/Rechecks";s:6:"answer";s:163:"***: Finished physical exam and packed the patient’s right nare. The plan for discharge was discussed. Patient agrees with the plan. All questions were answered.";s:13:"preload_value";s:0:"";}i:14;a:3:{s:8:"question";s:23:"Medical Decision Making";s:6:"answer";s:584:"The patient is a female who presents to the emergency department with a chief complaint of a nose bleed.  Medical records were reviewed. A Rhino Rocket was placed in the patient’s right nare by Dr. ***, which successfully controlled the bleeding. The patient was discharged home with a diagnosis of epistaxis. It was recommended for the patient to follow up with her PCP in one day. The patient's vital signs and condition remained stable while undergoing evaluation in the Emergency Department. The patient agreed with the plan for care.  All questions and concerns were addressed.";s:13:"preload_value";s:676:"The patient is a @AGE@ @SEX@ who presents to the emergency department with a chief complaint of ***.  Medical records were reviewed. Multiple diagnoses were considered.  Lab work was ordered and reviewed. A *** was also ordered and reviewed. Imaging shows ***.  The patient was provided with *** resulting in *** of symptoms. The patient was diagnosed with ***. The patient was advised to ***. It was recommended for the patient to follow up with ***.  The patient was prescribed ***.  The patient's vital signs and condition *** while undergoing evaluation in the Emergency Department. The patient*** agreed with the plan for care.  All questions and concerns were addressed.";}i:15;a:3:{s:8:"question";s:16:"Final Impression";s:6:"answer";s:9:"Epistaxis";s:13:"preload_value";s:0:"";}i:16;a:3:{s:8:"question";s:4:"Plan";s:6:"answer";s:103:"The patient is discharged home in stable condition and does not have any further questions or concerns.";s:13:"preload_value";s:0:"";}}
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            [0] => Mock Patient #14: EPISTAXIS - AGE 21
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            [0] => Mock Patient #14 REVIEW: EPISTAXIS - AGE 21
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            [0] => May 4, 2019 @ 7:15 pm
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Array
(
    [0] => Array
        (
            [question] => Chief Complaint
            [answer] => Epistaxis
            [preload_value] => 
        )

    [1] => Array
        (
            [question] => History of Present Illness
            [answer] => The patient is a 21-year-old female with no significant past medical history who presents to the emergency department with a chief complaint of epistaxis. Symptoms began this morning after the patient sneezed and have been constant since onset. She states that she is allergic to cats and a cat was the cause of her sneeze. The bleeding is coming from the right nostril and has been slowing down, however the patient cannot get it to stop completely. Overall, she states that she has bled less than one cup of blood since symptom onset. There are no aggravating or alleviating factors. The patient denies head trauma, nose trauma, any pain, or any other symptoms. No other reported symptoms at this time.
            [preload_value] => The patient is a [age] [sex] who presents to the emergency department with a chief complaint of ***. The symptoms began *** and have been *** since onset. His/her*** pain is currently rated as a ***/10 in severity and described as *** with radiation to ***. Associated symptoms include ***. Symptoms are aggravated with *** and improve with ***. The patient denies ***.  He/she*** reports taking *** prior to arrival with *** relief of symptoms. No other reported symptoms at this time.
        )

    [2] => Array
        (
            [question] => Review of Systems
            [answer] => All pertinent positive findings are listed in the HPI and all other systems are negative.
            [preload_value] => 
        )

    [3] => Array
        (
            [question] => Past Medical History
            [answer] => Previously Healthy
            [preload_value] => 
        )

    [4] => Array
        (
            [question] => Current Medications
            [answer] => None
            [preload_value] => 
        )

    [5] => Array
        (
            [question] => Allergies
            [answer] => No known drug allergies
Allergic to cat dander
            [preload_value] => 
        )

    [6] => Array
        (
            [question] => Social History
            [answer] => Smoking Status - No
Smokeless Tobacco - No
Alcohol Use - No
Drug Use - No
Sexual Activity - Not Asked
            [preload_value] => 
        )

    [7] => Array
        (
            [question] => Family History
            [answer] => Denies family history of clotting disorder
            [preload_value] => 
        )

    [8] => Array
        (
            [question] => Initial Vital Signs
            [answer] => N/A
            [preload_value] => N/A
        )

    [9] => Array
        (
            [question] => Physical Exam
            [answer] => GENERAL: Alert and oriented x3. No significant distress noted.
HEENT: Normocephalic, atraumatic.  Pupils are 3mm equal round and reactive to light.  Epistaxis present. There is no rhinorrhea.  Pharynx is moist and without erythema, exudate, or edema.  Uvula is midline.  Tympanic membranes are clear bilaterally.  There is no hemotympanum.
NECK: Supple, trachea is midline.  There is no JVD or carotid bruits.  There is no stridor.  There is no midline or paraspinal tenderness to palpation. There is no lymphadenopathy.
BACK: There is no midline or paraspinal tenderness to palpation, no evidence of trauma, there is no CVA tenderness.
CHEST: Symmetric, there is no crepitus. There is no visible evidence of trauma to the chest. 
LUNGS: Breath sounds are present and equal bilaterally, there are no rales, rhonchi or wheezes. There is no respiratory distress.
CARDIOVASCULAR: Regular rate and rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: Abdomen is nondistended. There is no palpable tenderness. There is no rebound or guarding. There is no palpable mass. Bowel sounds are present and equal throughout.
PELVIS: Stable to rock. There is no visible trauma.
MUSCULOSKELETAL: There are no deformities to the extremities. Capillary refill is less than two seconds to nail beds of the bilateral hands. There is no clubbing, cyanosis or edema. Radial pulses are +2/4 bilaterally.
NEUROLOGIC: The patient is alert and oriented x3. No cranial nerve deficit. Motor examination reveals +5/5 strength throughout. Sensation is normal throughout. Finger-to-nose intact. Heel-to-shin intact. Negative Romberg sign. Gait and station appear normal. Visual fields are full to confrontation.
SKIN: Skin is warm and dry. There is no pallor. There are no signs of acute dermatologic abnormality. There is no rash, petechiae, purpura, or ecchymosis. There is good skin turgor.
PSYCH: The patient does not have suicidal ideation or homicidal ideation.  Mood is normal. The patient does not have auditory or visual hallucinations. Judgment and cognition are normal.
            [preload_value] => GENERAL: Alert and oriented x3. No significant distress noted.
HEENT: Normocephalic, atraumatic.  Pupils are 3mm equal round and reactive to light.  Nose***  Pharynx is moist and without erythema, exudate, or edema.  Uvula is midline.  Tympanic membranes are clear bilaterally.  There is no hemotympanum.
NECK: Supple, trachea is midline.  There is no JVD or carotid bruits.  There is no stridor.  There is no midline or paraspinal tenderness to palpation. There is no lymphadenopathy.
BACK: There is no midline or paraspinal tenderness to palpation, no evidence of trauma, there is no CVA tenderness.
CHEST: Symmetric, there is no crepitus. There is no visible evidence of trauma to the chest. 
LUNGS: Breath sounds are present and equal bilaterally, there are no rales, rhonchi or wheezes. There is no respiratory distress.
CARDIOVASCULAR: Regular rate and rhythm without murmur, rubs, clicks, or gallops. Normal S1 and S2.
ABDOMEN: Abdomen is nondistended. There is no palpable tenderness. There is no rebound or guarding. There is no palpable mass. Bowel sounds are present and equal throughout.
PELVIS: Stable to rock. There is no visible trauma.
MUSCULOSKELETAL: There are no deformities to the extremities. Capillary refill is less than two seconds to nail beds of the bilateral hands. There is no clubbing, cyanosis or edema. Radial pulses are +2/4 bilaterally.
NEUROLOGIC: The patient is alert and oriented x3. No cranial nerve deficit. Motor examination reveals +5/5 strength throughout. Sensation is normal throughout. Finger-to-nose intact. Heel-to-shin intact. Negative Romberg sign. Gait and station appear normal. Visual fields are full to confrontation.
SKIN: Skin is warm and dry. There is no pallor. There are no signs of acute dermatologic abnormality. There is no rash, petechiae, purpura, or ecchymosis. There is good skin turgor.
PSYCH: The patient does not have suicidal ideation or homicidal ideation.  Mood is normal. The patient does not have auditory or visual hallucinations. Judgment and cognition are normal.
        )

    [10] => Array
        (
            [question] => ED COURSE:
Orders
            [answer] => None
            [preload_value] => None
        )

    [11] => Array
        (
            [question] => Radiology
            [answer] => None
            [preload_value] => None
        )

    [12] => Array
        (
            [question] => Procedures
            [answer] => Rhino Rocket
A Rhino Rocket was inserted into the patient’s right nare by Dr. ***. The Rhino Rocket successfully controlled the bleeding. The patient tolerated the procedure well.
            [preload_value] => 
        )

    [13] => Array
        (
            [question] => Calls/Consults/Rechecks
            [answer] => ***: Finished physical exam and packed the patient’s right nare. The plan for discharge was discussed. Patient agrees with the plan. All questions were answered.
            [preload_value] => 
        )

    [14] => Array
        (
            [question] => Medical Decision Making
            [answer] => The patient is a female who presents to the emergency department with a chief complaint of a nose bleed.  Medical records were reviewed. A Rhino Rocket was placed in the patient’s right nare by Dr. ***, which successfully controlled the bleeding. The patient was discharged home with a diagnosis of epistaxis. It was recommended for the patient to follow up with her PCP in one day. The patient's vital signs and condition remained stable while undergoing evaluation in the Emergency Department. The patient agreed with the plan for care.  All questions and concerns were addressed.
            [preload_value] => The patient is a @AGE@ @SEX@ who presents to the emergency department with a chief complaint of ***.  Medical records were reviewed. Multiple diagnoses were considered.  Lab work was ordered and reviewed. A *** was also ordered and reviewed. Imaging shows ***.  The patient was provided with *** resulting in *** of symptoms. The patient was diagnosed with ***. The patient was advised to ***. It was recommended for the patient to follow up with ***.  The patient was prescribed ***.  The patient's vital signs and condition *** while undergoing evaluation in the Emergency Department. The patient*** agreed with the plan for care.  All questions and concerns were addressed.
        )

    [15] => Array
        (
            [question] => Final Impression
            [answer] => Epistaxis
            [preload_value] => 
        )

    [16] => Array
        (
            [question] => Plan
            [answer] => The patient is discharged home in stable condition and does not have any further questions or concerns.
            [preload_value] => 
        )

)

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