<?xml version=“1.0” encoding=“UTF-8”?><Observation xmlns=“hl7.org/fhir”>
<id value="20minute-apgar-score"/> <!-- Using a contained patient for the purposes of this example Observation. Typically the reference would be to an external resource --> <text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 20minute-apgar-score</p><p><b>contained</b>: </p><p><b>status</b>: final</p><p><b>category</b>: Survey <span>(Details : {http://hl7.org/fhir/observation-category code 'survey' = 'Survey', given as 'Survey'})</span></p><p><b>code</b>: 20 minute Apgar Score <span>(Details : {SNOMED CT code '443849008' = 'Apgar score at 20 minutes', given as 'Apgar score at 20 minutes'})</span></p><p><b>subject</b>: id: newborn; 12345; active; Peter James Chalmers ; gender: male; birthDate: May 18, 2016</p><p><b>effective</b>: May 18, 2016 10:33:22 PM</p><p><b>performer</b>: <a>Practitioner/example</a></p><p><b>value</b>: 10 {score}<span> (Details: UCUM code {score} = '{score}')</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Apgar color score <span>(Details : {SNOMED CT code '249227004' = 'Apgar color score', given as 'Apgar color score'})</span></p><p><b>value</b>: 2. Good color all over <span>(Details : {http://loinc.org/la code 'LA6724-4' = 'LA6724-4', given as 'Good color all over'}; {http:/acme.ped/apgarcolor code '2' = '2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span>(Details : {SNOMED CT code '249223000' = 'Apgar heart rate score', given as 'Apgar heart rate score'})</span></p><p><b>value</b>: 2. At least 100 beats per minute <span>(Details : {http://loinc.org/la code 'LA6718-6' = 'LA6718-6', given as 'At least 100 beats per minute'}; {http:/acme.ped/apgarheartrate code '2' = '2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar response to stimulus score <span>(Details : {SNOMED CT code '249226008' = 'Apgar response to stimulus score', given as 'Apgar response to stimulus score'})</span></p><p><b>value</b>: 2. Grimace and pulling away, cough, or sneeze during suctioning <span>(Details : {http://loinc.org/la code 'LA6721-0' = 'LA6721-0', given as 'Grimace and pulling away, cough, or sneeze during suctioning'}; {http:/acme.ped/apgarreflexirritability code '2' = '2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar muscle tone score <span>(Details : {SNOMED CT code '249225007' = 'Apgar muscle tone score', given as 'Apgar muscle tone score'})</span></p><p><b>value</b>: 2. Active motion <span>(Details : {http://loinc.org/la code 'LA6715-2' = 'LA6715-2', given as 'Active motion '}; {http:/acme.ped/apgarmuscletone code '2' = '2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span>(Details : {SNOMED CT code '249224006' = 'Apgar respiratory effort score', given as 'Apgar respiratory effort score'})</span></p><p><b>value</b>: 2. Good, strong cry; normal rate and effort of breathing <span>(Details : {http://loinc.org/la code 'LA6727-7' = 'LA6727-7', given as 'Good, strong cry; normal rate and effort of breathing '}; {http:/acme.ped/apgarrespiratoryeffort code '2' = '2)</span></p></blockquote></div></text><contained> <Patient> <id value="newborn"/> <!-- MRN assigned by ACME healthcare on --> <identifier> <system value="http://acmehealthcare/org/mrns"/> <value value="12345"/> </identifier> <active value="true"/> <!-- Peter James Chalmers --> <name> <family value="Chalmers"/> <given value="Peter"/> <given value="James"/> </name> <!-- use FHIR code system for male / female --> <gender value="male"/> <birthDate value="2016-05-18"> <extension url="http://hl7.org/fhir/StructureDefinition/patient-birthTime"> <valueDateTime value="2016-05-18T10:28:45Z"/> </extension> </birthDate> </Patient> </contained> <status value="final"/> <category> <coding> <system value="http://hl7.org/fhir/observation-category"/> <code value="survey"/> <display value="Survey"/> </coding> <text value="Survey"/> </category> <code> <coding> <system value="http://snomed.info/sct"/> <code value="443849008"/> <display value="Apgar score at 20 minutes"/> </coding> <text value="20 minute Apgar Score"/> </code> <subject> <reference value="#newborn"/> </subject> <effectiveDateTime value="2016-05-18T22:33:22Z"/> <performer> <reference value="Practitioner/example"/> </performer> <valueQuantity> <value value="10"/> <system value="http://unitsofmeasure.org"/> <code value="{score}"/> </valueQuantity> <component> <code> <coding> <system value="http://snomed.info/sct"/> <code value="249227004"/> <display value="Apgar color score"/> </coding> <text value="Apgar color score"/> </code> <valueCodeableConcept> <coding> <!-- this extension maps a numeric score to the code this may already be known and unecessary --> <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-CO-value"> <valueDecimal value="2"/> </extension> <system value="http://loinc.org/la"/> <code value="LA6724-4"/> <display value="Good color all over"/> </coding> <coding> <system value="http:/acme.ped/apgarcolor"/> <code value="2"/> </coding> <text value="2. Good color all over"/> </valueCodeableConcept> </component> <component> <code> <coding> <system value="http://snomed.info/sct"/> <code value="249223000"/> <display value="Apgar heart rate score"/> </coding> <text value="Apgar respiratory effort score"/> </code> <valueCodeableConcept> <coding> <!-- this extension maps a numeric score to the code this may already be known and unecessary --> <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-CO-value"> <valueDecimal value="2"/> </extension> <system value="http://loinc.org/la"/> <code value="LA6718-6"/> <display value="At least 100 beats per minute"/> </coding> <coding> <system value="http:/acme.ped/apgarheartrate"/> <code value="2"/> </coding> <text value="2. At least 100 beats per minute"/> </valueCodeableConcept> </component> <component> <code> <coding> <system value="http://snomed.info/sct"/> <code value="249226008"/> <display value="Apgar response to stimulus score"/> </coding> <text value="Apgar response to stimulus score"/> </code> <valueCodeableConcept> <coding> <!-- this extension maps a numeric score to the code this may already be known and unecessary --> <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-CO-value"> <valueDecimal value="2"/> </extension> <system value="http://loinc.org/la"/> <code value="LA6721-0"/> <display value="Grimace and pulling away, cough, or sneeze during suctioning"/> </coding> <coding> <system value="http:/acme.ped/apgarreflexirritability"/> <code value="2"/> </coding> <text value="2. Grimace and pulling away, cough, or sneeze during suctioning"/> </valueCodeableConcept> </component> <component> <code> <coding> <system value="http://snomed.info/sct"/> <code value="249225007"/> <display value="Apgar muscle tone score"/> </coding> <text value="Apgar muscle tone score"/> </code> <valueCodeableConcept> <coding> <!-- this extension maps a numeric score to the code this may already be known and unecessary --> <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-CO-value"> <valueDecimal value="2"/> </extension> <system value="http://loinc.org/la"/> <code value="LA6715-2"/> <display value="Active motion "/> </coding> <coding> <system value="http:/acme.ped/apgarmuscletone"/> <code value="2"/> </coding> <text value="2. Active motion"/> </valueCodeableConcept> </component> <component> <code> <coding> <system value="http://snomed.info/sct"/> <code value="249224006"/> <display value="Apgar respiratory effort score"/> </coding> <text value="Apgar respiratory effort score"/> </code> <valueCodeableConcept> <coding> <!-- this extension maps a numeric score to the code this may already be known and unecessary --> <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-CO-value"> <valueDecimal value="2"/> </extension> <system value="http://loinc.org/la"/> <code value="LA6727-7"/> <display value="Good, strong cry; normal rate and effort of breathing "/> </coding> <coding> <system value="http:/acme.ped/apgarrespiratoryeffort"/> <code value="2"/> </coding> <text value="2. Good, strong cry; normal rate and effort of breathing"/> </valueCodeableConcept> </component>
</Observation>