Abwehrreaktionen auf Wundprodukte, Allergien

Abwehrreaktionen und Allergien werden als AllergyIntolerance hinterlegt. Die allergieauslösende Substanz sowie die Manifestation können optional entweder als Code hinterlegt oder mittels entsprechender, unten genannter Extensions referenziert werden.

AllergyIntolerance

idΣ0..1string
metaΣ0..1Meta
implicitRulesΣ ?!0..1uri
language0..1codeBinding
text0..1Narrative
contained0..*Resource
extensionI0..*Extension
modifierExtension?! I0..*Extension
identifierΣ0..*Identifier
clinicalStatusΣ ?! I0..1CodeableConceptBinding
verificationStatusΣ ?! I0..1CodeableConceptBinding
typeΣ0..1codeBinding
categoryΣ0..*codeBinding
criticalityS Σ0..1codeBinding
id0..1string
extensionI0..*Extension
id0..1string
extensionI0..*Extension
systemΣ0..1uriFixed Value
versionΣ0..1string
codeΣ0..1code
displayΣ0..1string
userSelectedΣ0..1boolean
textΣ0..1string
patientΣ I1..1Reference(Patient)
encounterI0..1Reference(Encounter)
onsetDateTimedateTime
onsetAgeAge
onsetPeriodPeriod
onsetRangeRange
onsetStringstring
recordedDate0..1dateTime
recorderI0..1Reference(Practitioner | PractitionerRole | Patient | RelatedPerson)
asserterΣ I0..1Reference(Patient | RelatedPerson | Practitioner | PractitionerRole)
lastOccurrence0..1dateTime
note0..*Annotation
id0..1string
extensionI0..*Extension
modifierExtensionΣ ?! I0..*Extension
id0..1string
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueReferenceReference(Medication | Device | Substance)
codingΣ0..*Coding
textΣ0..1string
id0..1string
id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueReferenceReference(Observation)
codingΣ0..*Coding
textΣ0..1string
description0..1string
onset0..1dateTime
severity0..1codeBinding
exposureRoute0..1CodeableConcept
note0..*Annotation

Extension zur Substance

AllergySubstance

id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueReferenceReference(Medication | Device | Substance)

Extension zur Manifestation

AllergyManifestation

id0..1string
extensionI0..*Extension
url1..1uriFixed Value
valueReferenceReference(Observation)

Anmerkungen zu Must-Support-Feldern

AllergyIntolerance.criticality

Bedeutung: Code, der die Kritikalität der Allergie oder Intoleranz angibt. Mögliche Werte sind high, low und unable to access.

AllergyIntolerance.code

Bedeutung: Mit dem Code kann die Allergie oder Intoleranz genauer beschrieben werden.

AllergyIntolerance.reaction.substance

Bedeutung: Die Substanz, die die entsprechende Reaktion hervorruft. Dies Substanz kann über die Extension referenziert werden.

AllergyIntolerance.reaction.manifestation

Bedeutung: Die Manifestation der Reaktion der Allergie oder Interoleranz.

Einfaches Beispiel

{
    "resourceType": "AllergyIntolerance",
    "meta": {
        "profile":  [
            "http://hs-osnabrueck.de/fhir/eWundbericht/StructureDefinition/AllergyIntolerance"
        ]
    },
    "id": "ExampleAllergy",
    "clinicalStatus": {
        "coding":  [
            {
                "code": "inactive",
                "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"
            }
        ]
    },
    "type": "allergy",
    "category":  [
        "medication"
    ],
    "code": {
        "text": "Silber"
    },
    "patient": {
        "reference": "Patient/example"
    },
    "recordedDate": "2021-06-16",
    "reaction":  [
        {
            "manifestation":  [
                {
                    "coding":  [
                        {
                            "code": "238575004",
                            "system": "http://snomed.info/sct",
                            "display": "Allergic contact dermatitis"
                        }
                    ]
                }
            ]
        }
    ]
}

Komplexes Beispiel

{
    "resourceType": "AllergyIntolerance",
    "meta": {
        "profile":  [
            "http://hs-osnabrueck.de/fhir/eWundbericht/StructureDefinition/AllergyIntolerance"
        ]
    },
    "id": "ExampleAllergyComplex",
    "type": "allergy",
    "clinicalStatus": {
        "coding":  [
            {
                "code": "inactive",
                "system": "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical"
            }
        ]
    },
    "category":  [
        "medication"
    ],
    "code": {
        "coding":  [
            {
                "code": "334688000",
                "system": "http://snomed.info/sct",
                "display": "Hydrogel dressing (physical object)"
            }
        ]
    },
    "patient": {
        "reference": "Patient/example"
    },
    "recordedDate": "2021-06-16",
    "reaction":  [
        {
            "substance": {
                "extension":  [
                    {
                        "url": "http://hs-osnabrueck.de/fhir/eWundbericht/StructureDefinition/AllergySubstance",
                        "valueReference": {
                            "reference": "Substance/exampleTyrothricin"
                        }
                    }
                ]
            },
            "manifestation":  [
                {
                    "extension":  [
                        {
                            "url": "http://hs-osnabrueck.de/fhir/eWundbericht/StructureDefinition/AllergyManifestation",
                            "valueReference": {
                                "reference": "Observation/exampleExanthem"
                            }
                        }
                    ]
                }
            ]
        }
    ]
}