ARCHETYPE Pulse/Heart beat (openEHR-EHR-OBSERVATION.pulse.v1)

Name: Pulse/Heart beat
License: http://creativecommons.org/licenses/by-sa/3.0/

ARCHETYPE ID	openEHR-EHR-OBSERVATION.pulse.v1
Concept	Pulse/Heart beat
Description	Record details about the rate and associated attributes for a pulse or heart beat.
Use	Use to record the presence or absence of a pulse or heart beat. In practice, the terms 'heart rate' and 'pulse rate' are often used interchangeably, although they may be measured at different body sites. This archetype allows either term to be used when the measurement site is not specified, to suit clinician preferences. Use to record the measurement of the pulse rate, or heart rate, observations about the associated pattern and character, and clinical interpretation of the findings. Measurements such as the maximum pulse or heart rate over an interval of time can be recorded using 'Maximum' event. Others point-in-time or interval events may be specified within a template or at run-time. In development of this archetype, there has been some tension around representation of the regularity of the pulse or heart beat. This archetype represents the relevant data points separately: firstly establishing 'Regular' vs 'Irregular' and then, if 'Irregular', further options of 'Regularly irregular' and 'Irregularly irregular'. In practice, clinical systems could offer users a combination of the values from the 'Regular?' and 'Irregular type' - for example, 'Regular', 'Regularly irregular' and 'Irregularly irregular' drawn from these two data elements. Data could be recorded against both data elements with the assumption that if one of the irregular types are selected, then the 'Irregular' value in the 'Regular?' data element is also automatically selected. In certain situations it is important to be very specific so that a rate observed at a peripheral body site, such as the radial artery, can be differentiated from the rate of the heart. To record a pulse deficit, record the measurements of the mechanical heart rate and a peripheral pulse rate in two instances of this archetype - the difference between these measurments is the pulse deficit. The actual pulse deficit will be recorded in a separate OBSERVATION archetype.
Misuse	Not to be used to record the R-R rate in the context of an Electrocardiograph report - use the OBSERVATION.ecg archetypefor this purpose. Not to be used to record other details of the full cardiovascular examination or assessment. Other specific CLUSTER archetypes will be used to record characteristics such as apex beat, murmurs and bruits, or auscultatory findings. In particular, this archetype is not intended to record the assessment of peripheral vascular disease, which requires documentation of the presence and strength of each peripheral pulse. A specific CLUSTER archetype will be used to record the general findings on examination of peripheral pulses. Not to be used to record fetal heart rate - use the OBSERVATION.fetal_heart archetype for this purpose. Not to be used to record the pulse deficit - use a specific OBSERVATION archetype for this purpose. Concepts such as Target Heart Rate should be recorded in separate EVALUATION archetypes related to goals and exercise assessment.
Purpose	To record details about the rate and associated attributes for a pulse or heart beat.
References	Direct communication with clinicians.
Copyright	© openEHR Foundation
Authors	Author name: Sam Heard Organisation: Ocean Informatics Email: sam.heard@oceaninformatics.com Date originally authored: 2006-03-26
Other Details Language	Author name: Sam Heard Organisation: Ocean Informatics Email: sam.heard@oceaninformatics.com Date originally authored: 2006-03-26
Other Details (Language Independent)	Licence: This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/. Custodian Organisation: openEHR Foundation References: Direct communication with clinicians. Current Contact: Heather Leslie, Ocean Informatics, heather.leslie@oceaninformatics.com Original Namespace: org.openehr Original Publisher: openEHR Foundation Custodian Namespace: org.openehr MD5-CAM-1.0.1: C87914388FF3D5E7CA7EF78A4AD31358 Build Uid: 79d6cdb5-7a5a-45f8-89e1-387ff31846d6 Revision: 1.0.3
Keywords	rate, rhythm, beat, pulse, heart, vital, sign
Lifecycle	deprecated
UID	cb2268c5-b91e-48a0-992e-ac9777d94862
Language used	en
Citeable Identifier	1013.1.170
Revision Number	1.0.3
events
Any event	Any event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Maximum	Maximum: Maximum pulse rate or heart rate observed during a period of exertion. Math. function: Maximum
state
Position	Position: The body position of the subject during the observation. at1003::Standing/upright [The subject was standing, walking or running.] at1001::Sitting [The subject was sitting (for example on bed or chair).] at1002::Reclining [The subject was reclining at an approximate angle of 45 degrees, with the legs elevated to the level of the pelvis.] at1000::Lying [The subject was lying flat.] Assumed value: Sitting
Confounding factors	Confounding factors: Narrative description about any incidental factors that may affect interpretation of the physical findings. For example, presence of a pacemaker, level of anxiety; pain or fever etc.
Exertion	Exertion: Details about physical exertion being undertaken during the examination. Include: openEHR-EHR-CLUSTER.level_of_exertion.v1 and specialisations
data
(Presence)	(Presence): Presence of a pulse or heart beat. It can be implied that the pulse is present if Rate >0 beats/min. at1024::Present [A pulse or heart beat can be detected.] at1025::Not detected [A pulse or heart beat cannot be detected.] Runtime name constraint: at1045::Pulse presence [Presence of a pulse.] at1046::Heart beat presence [Presence of a heart beat.]
(Rate)	(Rate): The rate, measured in beats per minute. Run-time name constraints have been specified, in order to simplify the renaming of this data element to Pulse Rate or Heart Rate, as required. Property: Frequency Units: >=0.0 /min Limit decimal places: 0 Runtime name constraint: at1026::Pulse Rate [The pulse rate, measured in beats per minute.] at1027::Heart Rate [The heart rate, measured in beats per minute.]
Regular?	Regular?: Is the pulse or heart beat regular? at0006::Regular [The pattern is regular.] at1028::Irregular [The pattern is irregular.]
Irregular type	Irregular type: More specific pattern of an irregular pulse or heart beat. Selection of a value from this value set is only valid if 'Irregular' is selected from the 'Regularity' data element. at0007::Regularly Irregular [The pattern is irregular in a regular pattern,. For example, a dropped beat once every 'n' beats.] at0008::Irregularly Irregular [The pattern is irregular in a chaotic and unpredictable manner. For example, atrial fibrillation.]
Character	Character: Description of the character of the pulse or heart beat. Coding with a terminology is desired, where possible. For example: full, thready, bounding, slow rising, or collapsing. Multiple terms may be recorded.
Clinical description	Clinical description: Narrative description about the pulse or heart beat.
(Clinical interpretation)	(Clinical interpretation): Single word, phrase or brief description that represents the clinical meaning and significance of the pulse or heart beat findings, including the rhythm. Coding with a terminology is preferred, where possible. For example: Bradycardia, Extrasystoles or Sinus rhythm. Multiple statements are allowed. Runtime name constraint: at1057::Clinical interpretation [Generic label to allow for any or all statements about the pulse or heart beat.] at1058::Rhythm [Specific conclusion about the rhythm of the pulse or heartbeat, drawn from a combination of the heart rate, pattern and other characteristics observed on examination.]
Comment	Comment: Additional narrative about the pulse or heart beat findings not captured in other fields.
protocol
Method	Method: Method used to observe the pulse or heart beat. For example, auscultation or electronic monitoring. at1032::Palpation [The findings are observed by physical touch of the observer on the subject.] at1033::Auscultation [The findings are observed with the assistance of a device, such as a stethoscope.] at1034::Automatic, non-invasive [The findings are observed non-invasively using a device such as a pulse oximeter or a stethoscope.] at1050::Automatic, invasive [The findings are observed invasively using a device such as an arterial catheter.]
Body site	Body site: Body site where the pulse or heart beat were observed. Choice of: Coded Text at1038::Radial Artery - Left [The left radial artery.] at1039::Radial Artery - Right [The right radial artery.] at1040::Heart [The region of the heart.] at1041::Carotid Artery - Left [The left carotid artery.] at1042::Carotid Artery - Right [The right carotid artery.] at1043::Femoral Artery - Left [The left femoral artery.] at1044::Femoral Artery - Right [The right femoral artery.] at1049::Brachial artery - Right [The right brachial artery.] at1048::Brachial artery - Left [The left brachial artery.] at1047::Finger [An unspecified finger.] at1054::Toe [An unspecified toe.] at1051::Ear lobe [The lobe of an unspecified ear.] Text
Device	Device: Details about the device used to measure the pulse rate or heart rate. Include: openEHR-EHR-CLUSTER.device.v1 and specialisations Exclude: All not explicitly included archetypes
Extension	Extension: Additional information required to capture local content or to align with other reference models/formalisms. For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents. Include: All not explicitly excluded archetypes
Other contributors	Nadim Anani, Karolinska Institutet, Sweden Vebjoern Arntzen, Oslo university hospital, Norway Koray Atalag, University of Auckland, New Zealand Gustavo Bacelar-Silva, Healthcare Designs, Brazil (openEHR Editor) Silje Ljosland Bakke, Bergen Hospital Trust, Norway (openEHR Editor) Lars Bitsch-Larsen, Haukeland University hospital, Norway Diego Bosca, IBIME group, Spain Rong Chen, Cambio Healthcare Systems, Sweden Stephen Chu, Queensland Health, Australia Angela de Zwart, Orion Health, New Zealand Graham Denyer, Australian Antarctic Division, Australia Paul Donaldson, Nursing Informatics Australia, Australia Shahla Foozonkhah, Ocean Informatics, Australia Einar Fosse, National Centre for Integrated Care and Telemedicine, Norway Sebastian Garde, Ocean Informatics, Germany John George, HSCIC, United Kingdom Heather Grain, Llewelyn Grain Informatics, Australia Sam Heard, Ocean Informatics, Australia Evelyn Hovenga, EJSH Consulting, Australia Eugene Igras, IRIS Systems, Inc., Canada Lars Karlsen, DIPS ASA, Norway Athanasios Kleontas, Ergobyte Informatics, Greece Shinji Kobayashi, Kyoto University, Japan Robert Legan, NEHTA, Australia Heather Leslie, Ocean Informatics, Australia (openEHR Editor) Rohan Martin, Ambulance Victoria, Australia Ian McNicoll, freshEHR Clinical Informatics, United Kingdom (openEHR Editor) Jeroen Meintjens, Medisch Centrum Alkmaar, Netherlands Monica Merchat, Hospital Cardiac Electrophysiology, MS Health Informatics Student, former ICU nurse, former Anesthesia Technician, United States Bjoern Naess, DIPS ASA, Norway Andrej Orel, Marand d.o.o., Slovenia Arturo Romero, SESCAM, Spain Jussara Rotzsch, UNB, Brazil Micaela Thierley, Helse Bergen, Norway Soon Ghee Yap, Singapore General Hospital, Singapore
Translators	German: Jasmin Buck, Sebastian Garde, University of Heidelberg, Central Queensland University Russian: Vyacheslav Mavrin, JSC Comsoft Swedish: Erik Sundvall; Åsa Skagerhult, Kirsi Poikela, Region Östergötland, Tieto Sweden AB, asa.skagerhult@regionostergotland.se, ext.kirsi.poikela@tieto.com Finnish: Vesa Peltola, Tieto Finland, vesa.peltola@tieto.com Portuguese (Brazil): Osmeire Chamelette Sanzovo, Hospital Sírio Libanês - SP, osmeire.acsanzovo@hsl.org.br Arabic (Syria): Mona Saleh Spanish (Spain): Pablo Pazos, CaboLabs - Health Informatics, pablo.pazos@cabolabs.com Spanish (Colombia): Jose Florez-Arango, MD MS PhD