Clinical Observations

This guidance is under active development by NHS Digital and content may be added or updated on a regular basis.

NPEWS1 Observation Example

<Observation xmlns="http://hl7.org/fhir">
    <id value="NPEWS1ObservationWithSubScores" />
    <identifier>
        <system value="https://tools.ietf.org/html/rfc4122" />
        <value value="ea45c120-504f-40f2-a79f-cb8cd3dd1307" />
    </identifier>
    <status value="final" />
    <category>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/observation-category" />
            <code value="survey" />
            <display value="Survey" />
        </coding>
    </category>
    <code>
        <coding>
            <system value="http://snomed.info/sct" />
            <code value="1363261000000104" />
            <display value="NPEWS (National Paediatric Early Warning Score) - total score" />
        </coding>
    </code>
    <subject>
        <reference value="Patient/30d3de6f-e800-47fa-b610-b02c7c8e9d57" />
    </subject>
    <effectiveDateTime value="2018-10-04T14:17:59+01:00" />
    <performer>
        <reference value="Practitioner/627be677-3eb2-4db4-9570-5669fd8c92f5" />
    </performer>
    <performer>
        <reference value="Organization/cdaea3db-8b40-41dc-9834-b42503e12382" />
    </performer>
    <valueQuantity>
        <value value="12" />
        <unit value="ScoreOf" />
        <system value="http://unitsofmeasure.org" />
        <code value="{ScoreOf}" />
    </valueQuantity>
    <derivedFrom>
        <reference value="Observation/f47cb818-29e1-49db-ae6c-19ddf0303ead" />
    </derivedFrom>
    <derivedFrom>
        <reference value="Observation/7bfdba8e-c1f2-4d66-96fc-d7ee1e9c2b06" />
    </derivedFrom>
    <derivedFrom>
        <reference value="Observation/8504223d-ec0d-455e-8401-c84ae1577406" />
    </derivedFrom>
    <derivedFrom>
        <reference value="Observation/71006952-f165-40a6-a636-b922d60790b6" />
    </derivedFrom>
    <derivedFrom>
        <reference value="Observation/764d6298-b444-4489-9882-1cf68d969330" />
    </derivedFrom>
    <derivedFrom>
        <reference value="Observation/7c38444d-81dc-47cb-8439-0d38a1d1c229" />
    </derivedFrom>
    <derivedFrom>
        <reference value="Observation/d7234e73-6efe-4528-b1f5-bd721a91d8c6" />
    </derivedFrom>
    <derivedFrom>
        <reference value="Observation/d7234e73-6efe-4528-b1f5-bd721a91d8c9" />
    </derivedFrom>
    <derivedFrom>
        <reference value="Observation/d7234e73-6efe-4528-b1f5-bd721a91d8c4" />
    </derivedFrom>
    <component>
        <code>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="1363271000000106" />
                <display value="NPEWS (National Paediatric Early Warning Score) - respiration rate score" />
            </coding>
        </code>
        <valueQuantity>
            <value value="1" />
            <unit value="ScoreOf" />
            <system value="http://unitsofmeasure.org" />
            <code value="{ScoreOf}" />
        </valueQuantity>
    </component>
    <component>
        <code>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="1363301000000109" />
                <display value="NPEWS (National Paediatric Early Warning Score) - respiratory distress score" />
            </coding>
        </code>
        <valueQuantity>
            <value value="1" />
            <unit value="ScoreOf" />
            <system value="http://unitsofmeasure.org" />
            <code value="{ScoreOf}" />
        </valueQuantity>
    </component>
    <component>
        <code>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="1363311000000106" />
                <display value="NPEWS (National Paediatric Early Warning Score) - peripheral oxygen saturation score" />
            </coding>
        </code>
        <valueQuantity>
            <value value="1" />
            <unit value="ScoreOf" />
            <system value="http://unitsofmeasure.org" />
            <code value="{ScoreOf}" />
        </valueQuantity>
    </component>
    <component>
        <code>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="1363321000000100" />
                <display value="NPEWS (National Paediatric Early Warning Score) - inspired oxygen score" />
            </coding>
        </code>
        <valueQuantity>
            <value value="2" />
            <unit value="ScoreOf" />
            <system value="http://unitsofmeasure.org" />
            <code value="{ScoreOf}" />
        </valueQuantity>
    </component>
    <component>
        <code>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="1363331000000103" />
                <display value="NPEWS (National Paediatric Early Warning Score) - heart rate score" />
            </coding>
        </code>
        <valueQuantity>
            <value value="1" />
            <unit value="ScoreOf" />
            <system value="http://unitsofmeasure.org" />
            <code value="{ScoreOf}" />
        </valueQuantity>
    </component>
    <component>
        <code>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="1363291000000105" />
                <display value="NPEWS (National Paediatric Early Warning Score) - systolic blood pressure score" />
            </coding>
        </code>
        <valueQuantity>
            <value value="1" />
            <unit value="ScoreOf" />
            <system value="http://unitsofmeasure.org" />
            <code value="{ScoreOf}" />
        </valueQuantity>
    </component>
    <component>
        <code>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="1363341000000107" />
                <display value="NPEWS (National Paediatric Early Warning Score) - capillary refill time score" />
            </coding>
        </code>
        <valueQuantity>
            <value value="3" />
            <unit value="ScoreOf" />
            <system value="http://unitsofmeasure.org" />
            <code value="{ScoreOf}" />
        </valueQuantity>
    </component>
    <component>
        <code>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="1363351000000105" />
                <display value="NPEWS (National Paediatric Early Warning Score) - consciousness score" />
            </coding>
        </code>
        <valueQuantity>
            <value value="1" />
            <unit value="ScoreOf" />
            <system value="http://unitsofmeasure.org" />
            <code value="{ScoreOf}" />
        </valueQuantity>
    </component>
    <component>
        <code>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="1363361000000108" />
                <display value="NPEWS (National Paediatric Early Warning Score) - temperature score" />
            </coding>
        </code>
        <valueQuantity>
            <value value="1" />
            <unit value="ScoreOf" />
            <system value="http://unitsofmeasure.org" />
            <code value="{ScoreOf}" />
        </valueQuantity>
    </component>
</Observation>

{
    "resourceType": "Observation",
    "id": "NPEWS1ObservationWithSubScores",
    "identifier":  [
        {
            "system": "https://tools.ietf.org/html/rfc4122",
            "value": "ea45c120-504f-40f2-a79f-cb8cd3dd1307"
        }
    ],
    "status": "final",
    "category":  [
        {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/observation-category",
                    "code": "survey",
                    "display": "Survey"
                }
            ]
        }
    ],
    "code": {
        "coding":  [
            {
                "system": "http://snomed.info/sct",
                "code": "1363261000000104",
                "display": "NPEWS (National Paediatric Early Warning Score) - total score"
            }
        ]
    },
    "subject": {
        "reference": "Patient/30d3de6f-e800-47fa-b610-b02c7c8e9d57"
    },
    "effectiveDateTime": "2018-10-04T14:17:59+01:00",
    "performer":  [
        {
            "reference": "Practitioner/627be677-3eb2-4db4-9570-5669fd8c92f5"
        },
        {
            "reference": "Organization/cdaea3db-8b40-41dc-9834-b42503e12382"
        }
    ],
    "valueQuantity": {
        "value": 12,
        "unit": "ScoreOf",
        "system": "http://unitsofmeasure.org",
        "code": "{ScoreOf}"
    },
    "derivedFrom":  [
        {
            "reference": "Observation/f47cb818-29e1-49db-ae6c-19ddf0303ead"
        },
        {
            "reference": "Observation/7bfdba8e-c1f2-4d66-96fc-d7ee1e9c2b06"
        },
        {
            "reference": "Observation/8504223d-ec0d-455e-8401-c84ae1577406"
        },
        {
            "reference": "Observation/71006952-f165-40a6-a636-b922d60790b6"
        },
        {
            "reference": "Observation/764d6298-b444-4489-9882-1cf68d969330"
        },
        {
            "reference": "Observation/7c38444d-81dc-47cb-8439-0d38a1d1c229"
        },
        {
            "reference": "Observation/d7234e73-6efe-4528-b1f5-bd721a91d8c6"
        },
        {
            "reference": "Observation/d7234e73-6efe-4528-b1f5-bd721a91d8c9"
        },
        {
            "reference": "Observation/d7234e73-6efe-4528-b1f5-bd721a91d8c4"
        }
    ],
    "component":  [
        {
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "1363271000000106",
                        "display": "NPEWS (National Paediatric Early Warning Score) - respiration rate score"
                    }
                ]
            },
            "valueQuantity": {
                "value": 1,
                "unit": "ScoreOf",
                "system": "http://unitsofmeasure.org",
                "code": "{ScoreOf}"
            }
        },
        {
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "1363301000000109",
                        "display": "NPEWS (National Paediatric Early Warning Score) - respiratory distress score"
                    }
                ]
            },
            "valueQuantity": {
                "value": 1,
                "unit": "ScoreOf",
                "system": "http://unitsofmeasure.org",
                "code": "{ScoreOf}"
            }
        },
        {
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "1363311000000106",
                        "display": "NPEWS (National Paediatric Early Warning Score) - peripheral oxygen saturation score"
                    }
                ]
            },
            "valueQuantity": {
                "value": 1,
                "unit": "ScoreOf",
                "system": "http://unitsofmeasure.org",
                "code": "{ScoreOf}"
            }
        },
        {
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "1363321000000100",
                        "display": "NPEWS (National Paediatric Early Warning Score) - inspired oxygen score"
                    }
                ]
            },
            "valueQuantity": {
                "value": 2,
                "unit": "ScoreOf",
                "system": "http://unitsofmeasure.org",
                "code": "{ScoreOf}"
            }
        },
        {
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "1363331000000103",
                        "display": "NPEWS (National Paediatric Early Warning Score) - heart rate score"
                    }
                ]
            },
            "valueQuantity": {
                "value": 1,
                "unit": "ScoreOf",
                "system": "http://unitsofmeasure.org",
                "code": "{ScoreOf}"
            }
        },
        {
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "1363291000000105",
                        "display": "NPEWS (National Paediatric Early Warning Score) - systolic blood pressure score"
                    }
                ]
            },
            "valueQuantity": {
                "value": 1,
                "unit": "ScoreOf",
                "system": "http://unitsofmeasure.org",
                "code": "{ScoreOf}"
            }
        },
        {
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "1363341000000107",
                        "display": "NPEWS (National Paediatric Early Warning Score) - capillary refill time score"
                    }
                ]
            },
            "valueQuantity": {
                "value": 3,
                "unit": "ScoreOf",
                "system": "http://unitsofmeasure.org",
                "code": "{ScoreOf}"
            }
        },
        {
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "1363351000000105",
                        "display": "NPEWS (National Paediatric Early Warning Score) - consciousness score"
                    }
                ]
            },
            "valueQuantity": {
                "value": 1,
                "unit": "ScoreOf",
                "system": "http://unitsofmeasure.org",
                "code": "{ScoreOf}"
            }
        },
        {
            "code": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "1363361000000108",
                        "display": "NPEWS (National Paediatric Early Warning Score) - temperature score"
                    }
                ]
            },
            "valueQuantity": {
                "value": 1,
                "unit": "ScoreOf",
                "system": "http://unitsofmeasure.org",
                "code": "{ScoreOf}"
            }
        }
    ]
}
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