| Package | IdHIE.0v |
| Resource Type | Questionnaire |
| Id | questionnaire-bbis-01-001-0001.R4 |
| FHIR Version | R4 |
| Source | https://simplifier.net/resolve?scope=IdHIE.0v@0.0.1&canonical=http://fhir.hie.moh.gov.my/Questionnaire/01-001-0001 |
| URL | http://fhir.hie.moh.gov.my/Questionnaire/01-001-0001 |
| Version | 1.0.0 |
| Status | active |
| Date | 2023-03-30T22:48:32.9749675+00:00 |
| Name | questionnaire-bbis-01-001-0001 |
| Title | BBIS - Reporting Form For Transfusion-Related Adverse Event |
No resources found
No resources found
No narrative content found in resource
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"date": "2023-03-30T22:48:32.9749675+00:00",
"publisher": "Malaysia MOH - HIE Steering Committee",
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"text": "Apheresis Platelet",
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"text": "Random Platelet",
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"text": "Cryosupernatant/Liver Plasma",
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"repeats": true,
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},
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"text": "Others",
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{
"text": "SECTION E: Date Rection Occured",
"type": "group",
"required": false,
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"text": "Date reaction occured",
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"required": false,
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"text": "Patient Diagnosis",
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"required": false
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},
{
"text": "SECTION I: Patient Outcome From The Adverse Event",
"type": "group",
"required": false,
"item": [
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"text": "Recovered",
"type": "boolean",
"required": false
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{
"text": "Imputability",
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"required": false,
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},
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"text": "Possible",
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"linkId": "undefined-help",
"text": "Evidence is indeterminate for attributing the adverse event to the transfusion",
"type": "display"
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},
{
"text": "Likely / Probable",
"type": "boolean",
"required": false,
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"text": "When the evidence is clearly in favour of the reaction",
"type": "display"
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{
"text": "Confirmed / Definite",
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"linkId": "undefined-help",
"text": "When there is conclusive evidence beyond reasonable doubt for the relation",
"type": "display"
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},
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"linkId": "undefined-help",
"text": "Relation between adverse event and transfusion",
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},
{
"text": "SECTION J: Type Of Adverse Event",
"type": "group",
"required": false,
"item": [
{
"text": "Incorrect Blood Component/Product Transfused",
"type": "group",
"required": false,
"item": [
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"text": "Acute Immune Haemolytic Anaemia",
"type": "boolean",
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"item": [
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"linkId": "undefined-help",
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"text": "Blood is compatible but meant for another patient",
"type": "boolean",
"required": false
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{
"text": "Others",
"type": "boolean",
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"text": "Special requirement not met",
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"text": "Inappropriate transfusion",
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"linkId": "undefined-help",
"text": "Proceed to SECTION K for 'IBCT'",
"type": "display"
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},
{
"text": "Delayed Heamolytic Transfusion Reaction",
"type": "boolean",
"required": false
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{
"text": "Non-immune haemolytic reaction",
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"text": "Febrile Non-Haemolytic Transfusion Reaction (FNHTR)",
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"text": "Allergic Reaction",
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"valueCoding": {
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{
"valueCoding": {
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},
{
"text": "Transfusion-Related Acute Lung Injury (TRALI)",
"type": "boolean",
"required": false
},
{
"text": "Transfusion-Associated Circulatory Overload (TACO)",
"type": "boolean",
"required": false
},
{
"text": "Transfusion-Associated Dyspnoea (TAD)",
"type": "boolean",
"required": false
},
{
"text": "Transfusion-Associated Graft-versus-Host Disease (TA-GvHD)",
"type": "boolean",
"required": false
},
{
"text": "Post-Transfusion Purpura (PTP)",
"type": "boolean",
"required": false
},
{
"text": "Post-Transfusion Infection: Virus",
"type": "boolean",
"required": false,
"item": [
{
"text": "Please specify",
"type": "text",
"required": true
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},
{
"text": "Post-Transfusion Infection: Bacteria",
"type": "boolean",
"required": false,
"item": [
{
"text": "Please specify",
"type": "text",
"required": true
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]
},
{
"text": "Post-Transfusion Infection: Parasite",
"type": "boolean",
"required": false,
"item": [
{
"text": "Please specify",
"type": "text",
"required": true
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},
{
"text": "Handling and storage error",
"type": "boolean",
"required": false
},
{
"text": "Equipment related (e.g. faulty waterbath, transfusion set, etc)",
"type": "boolean",
"required": false
},
{
"text": "Unclassifiable Complication of Transfusion",
"type": "boolean",
"required": false,
"item": [
{
"text": "Please specify",
"type": "text",
"required": true
}
]
},
{
"text": "Not Related To Transfusion",
"type": "boolean",
"required": false,
"item": [
{
"text": "Please specify",
"type": "text",
"required": true
}
]
},
{
"text": "Hypotensive Transfusion Reaction",
"type": "boolean",
"required": false
},
{
"text": "Others",
"type": "boolean",
"required": false,
"item": [
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"text": "File Upload",
"type": "attachment",
"required": false
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{
"text": "Please specify",
"type": "text",
"required": true
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}
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