BACKAppearance* Normal Swelling Redness Erythema Deformity ScarsOtherPalpation* 1. Top Right 2. Top Left 3. Mid Right 4. Mid Left 5. Low Right 6. Low Left 7. OtherObserved Abnormality? Yes NoSensation Intact? Yes NoMoves Extremities w/o Deficit? Yes NoStrength 1 2 3 4 5Deep Tendon Reflexes 0 1 2 3 4Range Of MotionFlexion Full LimitedLevelPainPlease enter a number from 0 to 10.ExplainExtension Full LimitedLevelPainPlease enter a number from 0 to 10.ExplainSidebending Right Full LimitedLevelPainPlease enter a number from 0 to 10.ExplainSidebending Left Full LimitedLevelPainPlease enter a number from 0 to 10.ExplainRotation Full LimitedLevelPainPlease enter a number from 0 to 10.ExplainProcedure Note Consent Skin Cleaned with Chlohexadine OtherTender Points Injected with: Dextrose PRPJoint Injection: Dextrose PRP Stem CellResolution of Symptoms? Yes NoTolerated Well? Yes NoProceedural Sedation:Medication 1AtivanDilaudidDemerolFentanylKetamineMorphineValiumVerscelDoseMedication 2AtivanDilaudidDemerolFentanylKetamineMorphineValiumVerscelDoseMedication 3AtivanDilaudidDemerolFentanylKetamineMorphineValiumVerscelDose
