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Resource PlanDefinition/FHIR Server from package who.fhir.anc-cds#current (47 ms)

Package who.fhir.anc-cds
Type PlanDefinition
Id Id
FHIR Version R4
Source http://fhir.org/guides/who/anc-cds/https://build.fhir.org/ig/WorldHealthOrganization/smart-anc/PlanDefinition-ANCDT06.html
Url http://fhir.org/guides/who/anc-cds/PlanDefinition/ANCDT06
Version 0.3.0
Status active
Date 2021-06-11T22:32:40-06:00
Name ANCDT06
Title ANC.DT.06 Physical symptoms and exam results requiring referral
Experimental False
Realm uv
Authority who
Description If the woman has any of the following physical exam results, refer to the hospital

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Narrative

Note: links and images are rebased to the (stated) source

Id: ANCDT06
Url: ANC.DT.06 Physical symptoms and exam results requiring referral
Version: 0.3.0
Identifier:

value: ANC.DT.06

Name: ANCDT06
Title: ANC.DT.06 Physical symptoms and exam results requiring referral
Status: active
Experimental: false
Type:

system: http://terminology.hl7.org/CodeSystem/plan-definition-type

code: eca-rule

Date: 2021-06-11 22:32:40-0600
Publisher: World Health Organization (WHO)
Description: If the woman has any of the following physical exam results, refer to the hospital
Use Context:
codevaluedisplay
task ANC.B8. Conduct physical exam
Jurisdiction: 001
Libraries:
ANC.DT.06 Physical symptoms and exam results requiring referral
Actions:
ANC.DT.06 Physical symptoms and exam results requiring referral:
When: Named Event: ANC.B8. Conduct physical exam
Then:
Woman has a fever – provide treatment and refer urgently to hospital! Procedure: – Insert an IV line – Give fluids slowly
If: Applicability: ("Body temperature" ≥ 38°C) AND ("Second body temperature" ≥ 38°C) (Should Conduct further investigation and, if necessary, refer urgently if treatment not available at your facility )
Abnormal pulse rate – refer for further investigation Procedure: – Check for fever, infection, respiratory distress, arrhythmia – Refer for further investigation
If: Applicability: 60 bpm > "Second pulse rate" > 100 bpm (Should Refer to a hospital)
Woman has respiratory distress – refer urgently to the hospital!
If: Applicability: (((((("Respiratory exam result" = "Dyspnoea") OR ("Respiratory exam result" = "Cough")) OR ("Respiratory exam result" = "Rapid breathing")) OR ("Respiratory exam result" = "Slow breathing")) OR ("Respiratory exam result" = "Wheezing")) OR ("Respiratory exam result" = "Rales")) OR ("Respiratory exam result" = "Other abnormal respiratory exam result (specify)") (Should Refer urgently to a hospital)
Woman has low oximetry (<92%) – she should be referred urgently to the hospital
If: Applicability: "Oximetry" < 92% (Should Refer urgently to a hospital 2)
Woman's cardiac condition is abnormal and she should be referred urgently to the hospital
If: Applicability: ((((((("Cardiac exam result" = "Heart murmur") OR ("Cardiac exam result" = "Weak pulse")) OR ("Cardiac exam result" = "Tachycardia")) OR ("Cardiac exam result" = "Bradycardia")) OR ("Cardiac exam result" = "Arrhythmia")) OR ("Cardiac exam result" = "Cyanosis")) OR ("Cardiac exam result" = "Cold sweats")) OR ("Cardiac exam result" = "Other abnormal cardiac exam result (specify)") (Should Refer urgently to a hospital 3)
Woman's breast exam was abnormal and she should be referred to hospital for further investigation
If: Applicability: (((((("Breast exam result" = "Nodule") OR ("Breast exam result" = "Discharge")) OR ("Breast exam result" = "Flushing")) OR ("Breast exam result" = "Local pain")) OR ("Breast exam result" = "Bleeding")) OR ("Breast exam result" = "Increased temperature")) OR ("Breast exam result" = "Other breast exam result (specify)") (Should Conduct further investigation and, if necessary, refer urgently to a hospital)
Woman's abdominal exam was abnormal and she should be referred or further evaluated
If: Applicability: ((((((((((((((((("Abdominal exam result" = "Mass/tumour") OR ("Abdominal exam result" = "Pain on superficial palpation")) OR ("Abdominal exam result" = "Pain on deep palpation")) OR ("Abdominal exam result" = "Painful decompression")) OR ("Abdominal exam result" = "Other abnormal abdominal exam result (specify)")) OR ("Pelvic exam result (visual)" = "Abnormal vaginal discharge")) OR ("Pelvic exam result (visual)" = "Evidence of amniotic fluid")) OR ("Pelvic exam result (visual)" = "Foul-smelling vaginal discharge")) OR ("Pelvic exam result (visual)" = "Clusters of erythematous papules")) OR ("Pelvic exam result (visual)" = "Vesicles")) OR ("Pelvic exam result (visual)" = "Genital ulcer")) OR ("Pelvic exam result (visual)" = "Genital pain")) OR ("Pelvic exam result (visual)" = "Tender bilateral inguinal and femoral lymphadenopathy")) OR ("Pelvic exam result (visual)" = "Cervical friability")) OR ("Pelvic exam result (visual)" = "Mucopurulent cervicitis")) OR ("Pelvic exam result (visual)" = "Tender unilateral lymphadenopathy")) OR ("Pelvic exam result (visual)" = "Curd-like vaginal discharge")) OR ("Pelvic exam result (visual)" = "Other abnormal pelvic exam (visual) result (specify)") (Should Refer to a hospital 2)
Woman should be referred urgently if there is evidence of amniotic fluid, which could indicate the start of labour
If: Applicability: ("Pelvic exam result (visual)" = "Evidence of amniotic fluid") AND ("Gestational age" < 37 weeks) (Should Refer urgently to a hospital 4)
If no fetal heartbeat is observed, inform the woman that there might be a problem and that she needs to be referred to the hospital for further examination and next steps. Procedure: – Inform the woman that you cannot find the heartbeat and need to refer her to check if there's a problem – Refer to hospital
If: Applicability: ("Fetal heartbeat present" = FALSE) AND ("Gestational age" ≥ 20 weeks) (Should Refer to a hospital 3)
Fetal heart rate is abnormal after two readings: the woman should be referred to hospital
If: Applicability: (100 bpm > "Second fetal heart rate" > 180 bpm) AND ("Gestational age" ≥ 20 weeks) (Should Refer to a hospital 4)

Source

{
  "resourceType" : "PlanDefinition",
  "id" : "ANCDT06",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">ANCDT06</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"PlanDefinition-ANCDT06.html\">ANC.DT.06 Physical symptoms and exam results requiring referral</a></td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">0.3.0</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Identifier: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>value: </b> <span>ANC.DT.06</span>\n </p>\n \n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Name: </b></th>\n <td style=\"padding-left: 4px;\">ANCDT06</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">ANC.DT.06 Physical symptoms and exam results requiring referral</td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">active</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Experimental: </b></th>\n <td style=\"padding-left: 4px;\">false</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <b>system: </b> <span><a href=\"http://hl7.org/fhir/R4/codesystem-plan-definition-type.html\">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>code: </b> <span>eca-rule</span>\n </p>\n \n \n \n \n \n </td>\n </tr>\n \n \n \n <tr>\n <th scope=\"row\"><b>Date: </b></th>\n <td style=\"padding-left: 4px;\">2021-06-11 22:32:40-0600</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">World Health Organization (WHO)</td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\">If the woman has any of the following physical exam results, refer to the hospital</td>\n </tr>\n \n \n \n \n <tr>\n <th scope=\"row\"><b>Use Context: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n <tr><th><b>code</b></th><th><b>value</b></th><th><b>display</b></th></tr>\n \n <tr>\n <td>task</td>\n <td>ANC.B8.</td>\n <td>Conduct physical exam</td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n \n <tr>\n <th scope=\"row\"><b>Jurisdiction: </b></th>\n <td style=\"padding-left: 4px;\">001</td>\n </tr>\n \n \n \n \n \n \n \n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr><td><a href=\"Library-ANCDT06.html\">ANC.DT.06 Physical symptoms and exam results requiring referral</a></td></tr>\n \n </table>\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Actions: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td>\n <b> ANC.DT.06 Physical symptoms and exam results requiring referral:</b> <br/>\n <b>When:</b> <i>Named Event:</i> ANC.B8. Conduct physical exam<br/>\n \n \n <b>Then:</b>\n <table class=\"grid-dict\">\n \n <tr>\n <td>\n Woman has a fever – provide treatment and refer urgently to hospital!\nProcedure:\n– Insert an IV line\n– Give fluids slowly<br/>\n \n <b>If:</b> <i>Applicability:</i> (&amp;quot;Body temperature&amp;quot; ≥ 38°C)\n AND (&amp;quot;Second body temperature&amp;quot; ≥ 38°C) <i>(Should Conduct further investigation and, if necessary, refer urgently if treatment not available at your facility )</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n Abnormal pulse rate – refer for further investigation\nProcedure:\n– Check for fever, infection, respiratory distress, arrhythmia\n– Refer for further investigation<br/>\n \n <b>If:</b> <i>Applicability:</i> 60 bpm &amp;gt; &amp;quot;Second pulse rate&amp;quot; &amp;gt; 100 bpm <i>(Should Refer to a hospital)</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n Woman has respiratory distress – refer urgently to the hospital!<br/>\n \n <b>If:</b> <i>Applicability:</i> ((((((&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Dyspnoea&amp;quot;)\n OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Cough&amp;quot;))\n OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Rapid breathing&amp;quot;))\n OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Slow breathing&amp;quot;))\n OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Wheezing&amp;quot;))\n OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Rales&amp;quot;))\n OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Other abnormal respiratory exam result (specify)&amp;quot;) <i>(Should Refer urgently to a hospital)</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n Woman has low oximetry (&amp;lt;92%) – she should be referred urgently to the hospital<br/>\n \n <b>If:</b> <i>Applicability:</i> &amp;quot;Oximetry&amp;quot; &amp;lt; 92% <i>(Should Refer urgently to a hospital 2)</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n Woman's cardiac condition is abnormal and she should be referred urgently to the hospital<br/>\n \n <b>If:</b> <i>Applicability:</i> (((((((&amp;quot;Cardiac exam result&amp;quot; = &amp;quot;Heart murmur&amp;quot;)\n OR (&amp;quot;Cardiac exam result&amp;quot; = &amp;quot;Weak pulse&amp;quot;))\n OR (&amp;quot;Cardiac exam result&amp;quot; = &amp;quot;Tachycardia&amp;quot;))\n OR (&amp;quot;Cardiac exam result&amp;quot; = &amp;quot;Bradycardia&amp;quot;))\n OR (&amp;quot;Cardiac exam result&amp;quot; = &amp;quot;Arrhythmia&amp;quot;))\n OR (&amp;quot;Cardiac exam result&amp;quot; = &amp;quot;Cyanosis&amp;quot;))\n OR (&amp;quot;Cardiac exam result&amp;quot; = &amp;quot;Cold sweats&amp;quot;))\n OR (&amp;quot;Cardiac exam result&amp;quot; = &amp;quot;Other abnormal cardiac exam result (specify)&amp;quot;) <i>(Should Refer urgently to a hospital 3)</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n Woman's breast exam was abnormal and she should be referred to hospital for further investigation<br/>\n \n <b>If:</b> <i>Applicability:</i> ((((((&amp;quot;Breast exam result&amp;quot; = &amp;quot;Nodule&amp;quot;)\n OR (&amp;quot;Breast exam result&amp;quot; = &amp;quot;Discharge&amp;quot;))\n OR (&amp;quot;Breast exam result&amp;quot; = &amp;quot;Flushing&amp;quot;))\n OR (&amp;quot;Breast exam result&amp;quot; = &amp;quot;Local pain&amp;quot;))\n OR (&amp;quot;Breast exam result&amp;quot; = &amp;quot;Bleeding&amp;quot;))\n OR (&amp;quot;Breast exam result&amp;quot; = &amp;quot;Increased temperature&amp;quot;))\n OR (&amp;quot;Breast exam result&amp;quot; = &amp;quot;Other breast exam result (specify)&amp;quot;) <i>(Should Conduct further investigation and, if necessary, refer urgently to a hospital)</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n Woman's abdominal exam was abnormal and she should be referred or further evaluated<br/>\n \n <b>If:</b> <i>Applicability:</i> (((((((((((((((((&amp;quot;Abdominal exam result&amp;quot; = &amp;quot;Mass/tumour&amp;quot;)\n OR (&amp;quot;Abdominal exam result&amp;quot; = &amp;quot;Pain on superficial palpation&amp;quot;))\n OR (&amp;quot;Abdominal exam result&amp;quot; = &amp;quot;Pain on deep palpation&amp;quot;))\n OR (&amp;quot;Abdominal exam result&amp;quot; = &amp;quot;Painful decompression&amp;quot;))\n OR (&amp;quot;Abdominal exam result&amp;quot; = &amp;quot;Other abnormal abdominal exam result (specify)&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Abnormal vaginal discharge&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Evidence of amniotic fluid&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Foul-smelling vaginal discharge&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Clusters of erythematous papules&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Vesicles&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Genital ulcer&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Genital pain&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Tender bilateral inguinal and femoral lymphadenopathy&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Cervical friability&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Mucopurulent cervicitis&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Tender unilateral lymphadenopathy&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Curd-like vaginal discharge&amp;quot;))\n OR (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Other abnormal pelvic exam (visual) result (specify)&amp;quot;) <i>(Should Refer to a hospital 2)</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n Woman should be referred urgently if there is evidence of amniotic fluid, which could indicate the start of labour<br/>\n \n <b>If:</b> <i>Applicability:</i> (&amp;quot;Pelvic exam result (visual)&amp;quot; = &amp;quot;Evidence of amniotic fluid&amp;quot;)\n AND (&amp;quot;Gestational age&amp;quot; &amp;lt; 37 weeks) <i>(Should Refer urgently to a hospital 4)</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n If no fetal heartbeat is observed, inform the woman that there might be a problem and that she needs to be referred to the hospital for further examination and next steps.\n\nProcedure:\n– Inform the woman that you cannot find the heartbeat and need to refer her to check if there's a problem\n– Refer to hospital<br/>\n \n <b>If:</b> <i>Applicability:</i> (&amp;quot;Fetal heartbeat present&amp;quot; = FALSE)\n AND (&amp;quot;Gestational age&amp;quot; ≥ 20 weeks) <i>(Should Refer to a hospital 3)</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n Fetal heart rate is abnormal after two readings: the woman should be referred to hospital<br/>\n \n <b>If:</b> <i>Applicability:</i> (100 bpm &amp;gt; &amp;quot;Second fetal heart rate&amp;quot; &amp;gt; 180 bpm)\n AND (&amp;quot;Gestational age&amp;quot; ≥ 20 weeks) <i>(Should Refer to a hospital 4)</i><br/>\n \n \n \n </td>\n </tr>\n \n </table>\n \n </td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n </table>\n</div>"
  },
  "url" : "http://fhir.org/guides/who/anc-cds/PlanDefinition/ANCDT06",
  "identifier" : [
    {
      "use" : "official",
      "value" : "ANC.DT.06"
    }
  ],
  "version" : "0.3.0",
  "name" : "ANCDT06",
  "title" : "ANC.DT.06 Physical symptoms and exam results requiring referral",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "eca-rule"
      }
    ]
  },
  "status" : "active",
  "experimental" : false,
  "date" : "2021-06-11T22:32:40-06:00",
  "publisher" : "World Health Organization (WHO)",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.who.int"
        }
      ]
    }
  ],
  "description" : "If the woman has any of the following physical exam results, refer to the hospital",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "task",
        "display" : "Workflow Task"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://fhir.org/guides/who/anc-cds/CodeSystem/activity-codes",
            "code" : "ANC.B8.",
            "display" : "Conduct physical exam"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001"
        }
      ]
    }
  ],
  "library" : [
    "http://fhir.org/guides/who/anc-cds/Library/ANCDT06"
  ],
  "action" : [
    {
      "title" : "ANC.DT.06 Physical symptoms and exam results requiring referral",
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "ANC.B8. Conduct physical exam"
        }
      ],
      "action" : [
        {
          "id" : "1",
          "title" : "Conduct further investigation and, if necessary, refer urgently if treatment not available at your facility ",
          "description" : "Conduct further investigation and, if necessary, refer urgently if treatment not available at your facility ",
          "textEquivalent" : "Woman has a fever – provide treatment and refer urgently to hospital!\nProcedure:\n– Insert an IV line\n– Give fluids slowly",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Managing complications guide (IMPAC) (2017): Section S-113 (5)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "(\"Body temperature\" ≥ 38°C)\n AND (\"Second body temperature\" ≥ 38°C)",
                "language" : "text/cql-identifier",
                "expression" : "Should Conduct further investigation and, if necessary, refer urgently if treatment not available at your facility "
              }
            }
          ]
        },
        {
          "id" : "2",
          "title" : "Refer to a hospital",
          "description" : "Refer to a hospital",
          "textEquivalent" : "Abnormal pulse rate – refer for further investigation\nProcedure:\n– Check for fever, infection, respiratory distress, arrhythmia\n– Refer for further investigation",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Managing complications guide (IMPAC) (2017): Section S-1 (5)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "60 bpm > \"Second pulse rate\" > 100 bpm",
                "language" : "text/cql-identifier",
                "expression" : "Should Refer to a hospital"
              }
            }
          ]
        },
        {
          "id" : "3",
          "title" : "Refer urgently to a hospital",
          "description" : "Refer urgently to a hospital",
          "textEquivalent" : "Woman has respiratory distress – refer urgently to the hospital!",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Managing complications in pregnancy and childbirth guide (IMPAC) (2017): Section S-149 (5)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "((((((\"Respiratory exam result\" = \"Dyspnoea\")\n OR (\"Respiratory exam result\" = \"Cough\"))\n OR (\"Respiratory exam result\" = \"Rapid breathing\"))\n OR (\"Respiratory exam result\" = \"Slow breathing\"))\n OR (\"Respiratory exam result\" = \"Wheezing\"))\n OR (\"Respiratory exam result\" = \"Rales\"))\n OR (\"Respiratory exam result\" = \"Other abnormal respiratory exam result (specify)\")",
                "language" : "text/cql-identifier",
                "expression" : "Should Refer urgently to a hospital"
              }
            }
          ]
        },
        {
          "id" : "4",
          "title" : "Refer urgently to a hospital",
          "description" : "Refer urgently to a hospital 2",
          "textEquivalent" : "Woman has low oximetry (<92%) – she should be referred urgently to the hospital",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Managing complications in pregnancy and childbirth guide (IMPAC) (2017): Section S-58 (5)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "\"Oximetry\" < 92%",
                "language" : "text/cql-identifier",
                "expression" : "Should Refer urgently to a hospital 2"
              }
            }
          ]
        },
        {
          "id" : "5",
          "title" : "Refer urgently to a hospital",
          "description" : "Refer urgently to a hospital 3",
          "textEquivalent" : "Woman's cardiac condition is abnormal and she should be referred urgently to the hospital",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Managing complications in pregnancy and childbirth guide (IMPAC) (2017): Section S-150 (5)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "(((((((\"Cardiac exam result\" = \"Heart murmur\")\n OR (\"Cardiac exam result\" = \"Weak pulse\"))\n OR (\"Cardiac exam result\" = \"Tachycardia\"))\n OR (\"Cardiac exam result\" = \"Bradycardia\"))\n OR (\"Cardiac exam result\" = \"Arrhythmia\"))\n OR (\"Cardiac exam result\" = \"Cyanosis\"))\n OR (\"Cardiac exam result\" = \"Cold sweats\"))\n OR (\"Cardiac exam result\" = \"Other abnormal cardiac exam result (specify)\")",
                "language" : "text/cql-identifier",
                "expression" : "Should Refer urgently to a hospital 3"
              }
            }
          ]
        },
        {
          "id" : "6",
          "title" : "Conduct further investigation and, if necessary, refer urgently to a hospital",
          "description" : "Conduct further investigation and, if necessary, refer urgently to a hospital",
          "textEquivalent" : "Woman's breast exam was abnormal and she should be referred to hospital for further investigation",
          "documentation" : [
            {
              "type" : "citation"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "((((((\"Breast exam result\" = \"Nodule\")\n OR (\"Breast exam result\" = \"Discharge\"))\n OR (\"Breast exam result\" = \"Flushing\"))\n OR (\"Breast exam result\" = \"Local pain\"))\n OR (\"Breast exam result\" = \"Bleeding\"))\n OR (\"Breast exam result\" = \"Increased temperature\"))\n OR (\"Breast exam result\" = \"Other breast exam result (specify)\")",
                "language" : "text/cql-identifier",
                "expression" : "Should Conduct further investigation and, if necessary, refer urgently to a hospital"
              }
            }
          ]
        },
        {
          "id" : "7",
          "title" : "Refer to a hospital",
          "description" : "Refer to a hospital 2",
          "textEquivalent" : "Woman's abdominal exam was abnormal and she should be referred or further evaluated",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "WHO ANC recommendations (2016): B2.2 (2)\nManaging complications in pregnancy and childbirth guide (IMPAC) (2017): Section S-139 (5)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "(((((((((((((((((\"Abdominal exam result\" = \"Mass/tumour\")\n OR (\"Abdominal exam result\" = \"Pain on superficial palpation\"))\n OR (\"Abdominal exam result\" = \"Pain on deep palpation\"))\n OR (\"Abdominal exam result\" = \"Painful decompression\"))\n OR (\"Abdominal exam result\" = \"Other abnormal abdominal exam result (specify)\"))\n OR (\"Pelvic exam result (visual)\" = \"Abnormal vaginal discharge\"))\n OR (\"Pelvic exam result (visual)\" = \"Evidence of amniotic fluid\"))\n OR (\"Pelvic exam result (visual)\" = \"Foul-smelling vaginal discharge\"))\n OR (\"Pelvic exam result (visual)\" = \"Clusters of erythematous papules\"))\n OR (\"Pelvic exam result (visual)\" = \"Vesicles\"))\n OR (\"Pelvic exam result (visual)\" = \"Genital ulcer\"))\n OR (\"Pelvic exam result (visual)\" = \"Genital pain\"))\n OR (\"Pelvic exam result (visual)\" = \"Tender bilateral inguinal and femoral lymphadenopathy\"))\n OR (\"Pelvic exam result (visual)\" = \"Cervical friability\"))\n OR (\"Pelvic exam result (visual)\" = \"Mucopurulent cervicitis\"))\n OR (\"Pelvic exam result (visual)\" = \"Tender unilateral lymphadenopathy\"))\n OR (\"Pelvic exam result (visual)\" = \"Curd-like vaginal discharge\"))\n OR (\"Pelvic exam result (visual)\" = \"Other abnormal pelvic exam (visual) result (specify)\")",
                "language" : "text/cql-identifier",
                "expression" : "Should Refer to a hospital 2"
              }
            }
          ]
        },
        {
          "id" : "8",
          "title" : "Refer urgently to a hospital",
          "description" : "Refer urgently to a hospital 4",
          "textEquivalent" : "Woman should be referred urgently if there is evidence of amniotic fluid, which could indicate the start of labour",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Managing complications in pregnancy and childbirth guide (IMPAC) (2017): Sections S-51, C-91 (5)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "(\"Pelvic exam result (visual)\" = \"Evidence of amniotic fluid\")\n AND (\"Gestational age\" < 37 weeks)",
                "language" : "text/cql-identifier",
                "expression" : "Should Refer urgently to a hospital 4"
              }
            }
          ]
        },
        {
          "id" : "9",
          "title" : "Refer to a hospital",
          "description" : "Refer to a hospital 3",
          "textEquivalent" : "If no fetal heartbeat is observed, inform the woman that there might be a problem and that she needs to be referred to the hospital for further examination and next steps.\n\nProcedure:\n– Inform the woman that you cannot find the heartbeat and need to refer her to check if there's a problem\n– Refer to hospital",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Pregnancy, childbirth, postpartum and newborn care guide (IMPAC) (2015): C7 (1)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "(\"Fetal heartbeat present\" = FALSE)\n AND (\"Gestational age\" ≥ 20 weeks)",
                "language" : "text/cql-identifier",
                "expression" : "Should Refer to a hospital 3"
              }
            }
          ]
        },
        {
          "id" : "10",
          "title" : "Refer to a hospital",
          "description" : "Refer to a hospital 4",
          "textEquivalent" : "Fetal heart rate is abnormal after two readings: the woman should be referred to hospital",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Pregnancy, childbirth, postpartum and newborn care guide (IMPAC) (2015): C7 (1)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "(100 bpm > \"Second fetal heart rate\" > 180 bpm)\n AND (\"Gestational age\" ≥ 20 weeks)",
                "language" : "text/cql-identifier",
                "expression" : "Should Refer to a hospital 4"
              }
            }
          ]
        }
      ]
    }
  ]
}

XIG built as of ??metadata-date??. Found ??metadata-resources?? resources in ??metadata-packages?? packages.