<?xml version=“1.0” encoding=“UTF-8”?><Observation xmlns=“hl7.org/fhir”>

<id value="1minute-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>: 1minute-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 &#39;survey&#39; = &#39;Survey&#39;, given as &#39;Survey&#39;})</span></p><p><b>code</b>: 1 minute Apgar Score <span>(Details : {LOINC code &#39;9272-6&#39; = &#39;1 minute Apgar Score&#39;, given as &#39;1 minute Apgar Score&#39;}; {SNOMED CT code &#39;169895004&#39; = &#39;Apgar at 1 minute&#39;, given as &#39;Apgar at 1 minute&#39;})</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>: 0 {score}<span> (Details: UCUM code {score} = &#39;{score}&#39;)</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Apgar color score <span>(Details : {LOINC code &#39;32406-1&#39; = &#39;1 minute Apgar Color&#39;, given as &#39;1 minute Apgar Color&#39;}; {SNOMED CT code &#39;249227004&#39; = &#39;Apgar color score&#39;, given as &#39;Apgar color score&#39;})</span></p><p><b>value</b>: 0. The baby&#39;s whole body is completely bluish-gray or pale <span>(Details : {http://loinc.org/la code &#39;LA6722-8&#39; = &#39;LA6722-8&#39;, given as &#39;The baby&#39;s whole body is completely bluish-gray or pale&#39;}; {http:/acme.ped/apgarcolor code &#39;0&#39; = &#39;0)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span>(Details : {LOINC code &#39;32407-9&#39; = &#39;1 minute Apgar Heart rate&#39;, given as &#39;1 minute Apgar Heart Rate&#39;}; {SNOMED CT code &#39;249223000&#39; = &#39;Apgar heart rate score&#39;, given as &#39;Apgar heart rate score&#39;})</span></p><p><b>value</b>: 0. No heart rate <span>(Details : {http://loinc.org/la code &#39;LA6716-0&#39; = &#39;LA6716-0&#39;, given as &#39;No heart rate&#39;}; {http:/acme.ped/apgarheartrate code &#39;0&#39; = &#39;0)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar response to stimulus score <span>(Details : {LOINC code &#39;32409-5&#39; = &#39;1 minute Apgar Reflex irritability&#39;, given as &#39;1 minute Apgar Reflex Irritability&#39;}; {SNOMED CT code &#39;249226008&#39; = &#39;Apgar response to stimulus score&#39;, given as &#39;Apgar response to stimulus score&#39;})</span></p><p><b>value</b>: 0. No response to airways being suctioned <span>(Details : {http://loinc.org/la code &#39;LA6719-4&#39; = &#39;LA6719-4&#39;, given as &#39;No response to airways being suctioned&#39;}; {http:/acme.ped/apgarreflexirritability code &#39;0&#39; = &#39;0)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar muscle tone score <span>(Details : {LOINC code &#39;32408-7&#39; = &#39;1 minute Apgar Muscle tone&#39;, given as &#39;1 minute Apgar Muscle Tone&#39;}; {SNOMED CT code &#39;249225007&#39; = &#39;Apgar muscle tone score&#39;, given as &#39;Apgar muscle tone score&#39;})</span></p><p><b>value</b>: 0. Limp; no movement <span>(Details : {http://loinc.org/la code &#39;LA6713-7&#39; = &#39;LA6713-7&#39;, given as &#39;Limp; no movement&#39;}; {http:/acme.ped/apgarmuscletone code &#39;0&#39; = &#39;0)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span>(Details : {LOINC code &#39;32410-3&#39; = &#39;1 minute Apgar Respiratory effort&#39;, given as &#39;1 minute Apgar Respiratory effort&#39;}; {SNOMED CT code &#39;249224006&#39; = &#39;Apgar respiratory effort score&#39;, given as &#39;Apgar respiratory effort score&#39;})</span></p><p><b>value</b>: 0. Not breathing <span>(Details : {http://loinc.org/la code &#39;LA6725-1&#39; = &#39;LA6725-1&#39;, given as &#39;Not breathing&#39;}; {http:/acme.ped/apgarrespiratoryeffort code &#39;0&#39; = &#39;0)</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://loinc.org"/>
                <code value="9272-6"/>
                <display value="1 minute Apgar Score"/>
        </coding>
        <coding>
                <system value="http://snomed.info/sct"/>
                <code value="169895004"/>
                <display value="Apgar at 1 minute"/>
        </coding>
        <text value="1 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="0"/>
        <system value="http://unitsofmeasure.org"/>
        <code value="{score}"/>
</valueQuantity>
<component>
        <code>
                <coding>
                        <system value="http://loinc.org"/>
                        <code value="32406-1"/>
                        <display value="1 minute Apgar Color"/>
                </coding>
                <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="0"/>
                        </extension>
                        <system value="http://loinc.org/la"/>
                        <code value="LA6722-8"/>
                        <display value="The baby&#39;s whole body is completely bluish-gray or pale"/>
                </coding>
                <coding>
                        <system value="http:/acme.ped/apgarcolor"/>
                        <code value="0"/>
                </coding>
                <text value="0. The baby&#39;s whole body is completely bluish-gray or pale"/>
        </valueCodeableConcept>
</component>
<component>
        <code>
                <coding>
                        <system value="http://loinc.org"/>
                        <code value="32407-9"/>
                        <display value="1 minute Apgar Heart Rate"/>
                </coding>
                <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="0"/>
                        </extension>
                        <system value="http://loinc.org/la"/>
                        <code value="LA6716-0"/>
                        <display value="No heart rate"/>
                </coding>
                <coding>
                        <system value="http:/acme.ped/apgarheartrate"/>
                        <code value="0"/>
                </coding>
                <text value="0. No heart rate"/>
        </valueCodeableConcept>
</component>
<component>
        <code>
                <coding>
                        <system value="http://loinc.org"/>
                        <code value="32409-5"/>
                        <display value="1 minute Apgar Reflex Irritability"/>
                </coding>
                <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="0"/>
                        </extension>
                        <system value="http://loinc.org/la"/>
                        <code value="LA6719-4"/>
                        <display value="No response to airways being suctioned"/>
                </coding>
                <coding>
                        <system value="http:/acme.ped/apgarreflexirritability"/>
                        <code value="0"/>
                </coding>
                <text value="0. No response to airways being suctioned"/>
        </valueCodeableConcept>
</component>
<component>
        <code>
                <coding>
                        <system value="http://loinc.org"/>
                        <code value="32408-7"/>
                        <display value="1 minute Apgar Muscle Tone"/>
                </coding>
                <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="0"/>
                        </extension>
                        <system value="http://loinc.org/la"/>
                        <code value="LA6713-7"/>
                        <display value="Limp; no movement"/>
                </coding>
                <coding>
                        <system value="http:/acme.ped/apgarmuscletone"/>
                        <code value="0"/>
                </coding>
                <text value="0. Limp; no movement"/>
        </valueCodeableConcept>
</component>
<component>
        <code>
                <coding>
                        <system value="http://loinc.org"/>
                        <code value="32410-3"/>
                        <display value="1 minute Apgar Respiratory effort"/>
                </coding>
                <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="0"/>
                        </extension>
                        <system value="http://loinc.org/la"/>
                        <code value="LA6725-1"/>
                        <display value="Not breathing"/>
                </coding>
                <coding>
                        <system value="http:/acme.ped/apgarrespiratoryeffort"/>
                        <code value="0"/>
                </coding>
                <text value="0. Not breathing"/>
        </valueCodeableConcept>
</component>

</Observation>