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Source1

{
  "resourceType": "Procedure",
  "id": "example-procedure",
  "meta": {
    "versionId": "2",
    "lastUpdated": "2022-09-07T09:04:34.378+00:00",
    "source": "http://provider.hie.moh.gov.my",
    "profile": [
      "http://fhir.hie.moh.gov.my/StructureDefinition/Procedure-my-core"
    ]
  },
  "status": "completed",
  "category": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "387713003",
        "display": "Surgical procedure"
      }
    ]
  },
  "code": {
    "coding": [
      {
        "system": "http://fhir.hie.moh.gov.my/CodeSystem/procedure-code-my-core",
        "code": "34",
        "display": "Operations on chest wall, pleura, mediastinum, and diaphragm"
      }
    ]
  },
  "subject": {
    "reference": "Patient/f92c383f-68de-46c1-8cde-970efa2d0f15"
  },
  "encounter": {
    "reference": "Encounter/5579c35d-97af-463a-b4d7-df2d9e3dc267"
  },
  "performedPeriod": {
    "start": "2022-06-28T15:30:00.000+08:00",
    "end": "2022-06-28T18:00:00.000+08:00"
  },
  "recorder": {
    "reference": "PractitionerRole/cd16e0cb-3e0f-43bb-9197-901f5daff3ba"
  },
  "asserter": {
    "reference": "PractitionerRole/6f1d7a69-b46b-4464-ade6-08a967eb518f"
  },
  "performer": [
    {
      "function": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "309294001",
            "display": "Accident and emergency doctor"
          }
        ]
      },
      "actor": {
        "reference": "PractitionerRole/6f1d7a69-b46b-4464-ade6-08a967eb518f"
      },
      "onBehalfOf": {
        "reference": "Organization/11-05040012"
      }
    },
    {
      "function": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "158972004",
            "display": "House officer"
          }
        ]
      },
      "actor": {
        "reference": "PractitionerRole/cd16e0cb-3e0f-43bb-9197-901f5daff3ba"
      },
      "onBehalfOf": {
        "reference": "Organization/11-05060009"
      }
    }
  ],
  "location": {
    "reference": "Location/8d988a14-4e08-4b57-a6d2-323218dcb76e"
  },
  "bodySite": [
    {
      "text": "Left thorax structure"
    }
  ],
  "outcome": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "385669000",
        "display": "Successful"
      }
    ]
  },
  "complication": [
    {
      "text": "Complication 1"
    },
    {
      "text": "Complication 2"
    }
  ],
  "note": [
    {
      "authorReference": {
        "reference": "PractitionerRole/cd16e0cb-3e0f-43bb-9197-901f5daff3ba"
      },
      "time": "2022-06-28T18:00:00.000+08:00",
      "text": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Procedure: Left chest tube insertion.\nIndication: Left lung hemothorax post MVA\n\n- Explained to patient procedure indication and complication. Patient understood and agreed\n- Positioned patient in a lying supine position with left arm above the head\n- Placed the patient on the cardiac monitor, pulse oximetry and supplemental oxygen\n- 2 large 16G bore cannula secured \n- Safety triangle landmark identified, cleaned and draped\n- Chest tube 22fr prepared and clamped with Kelly clamp\n- LA 10ml given around incision area\n- 3cm incision done between 4th and 5th  rib intercostal space, mid axillary line\n- Kelly clamp used to bluntly dissect the underlying subcutaneous tissue muscle until left lung pleura reached\n- Index finger inserted into incision and used to sweep inside left chest cavity\n- chests tube size 22fr inserted with index finger guidance and chest tube connected to functioning underwater seal\n- incision site cleaned and chest tube secured with Prolene 1 purse-string suture.</div>"
    },
    {
      "authorReference": {
        "reference": "PractitionerRole/6f1d7a69-b46b-4464-ade6-08a967eb518f"
      },
      "time": "2022-06-28T18:10:00.000+08:00",
      "text": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Keep left chest tube in secured\nmonitor VS every 30m, keep BP &gt; 120/90\nContinue NP 3L/min\nProvide adequate analgesia\nSend for repeat chest PA once patient more conscious\nTrace CT brain preliminary report\nUpdate surgical team on finding, push for admission once patient return from X-ray</div>"
    }
  ],
  "usedCode": [
    {
      "text": "Silk suture"
    },
    {
      "text": "Forceps"
    },
    {
      "text": "Cannula, tube AND/OR catheter"
    }
  ]
}