TEMPLATE Infant clinical context - JM (Infant clinical context - JM)

Name: Infant clinical context - JM
License: http://creativecommons.org/licenses/by-sa/4.0/

TEMPLATE ID	Infant clinical context - JM
Concept	Infant clinical context - JM
Description	Not Specified
Purpose	Not Specified
References
Authors	date: 2023-07-25
Other Details Language	date: 2023-07-25
Other Details (Language Independent)	Licence: This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/. Custodian Organisation: openEHR Foundation Original Namespace: org.openehr Original Publisher: openEHR Foundation Custodian Namespace: org.openehr MD5-CAM-1.0.1: 7ba5fec5f91e66aee1b4707e2bb6dd86 Sem Ver: 10.0.0 PARENT:MD5-CAM-1.0.1: 8FE80F3E80C594AAF99D3BA540A53D73 Original Language: ISO_639-1::en
Language used	en
Citeable Identifier	1013.26.939
Root archetype id	openEHR-EHR-SECTION.adhoc.v1
Infant clinical context	Infant clinical context: A generic section header which should be renamed in a template to suit a specific clinical context.
Birth summary	Birth summary: Overview or summary record of the pregnancy and birth of an individual.
Data
Birth detail	Birth detail: A subset of persistent or summary information about the pregnancy and birth of an infant, selected for utility of use within both the maternal and infant health records.
Birth outcome	Birth outcome: Outcome of the pregnancy for the identified infant or fetus. Live birth Still birth
Gestational age	Gestational age: The length of the pregnancy at the time of delivery of the infant. The value for this data element will usually, but not always, be identical to the 'Pregnancy duration' data element within the EVALUATION.pregnancy_summary in the maternal record. It may also be derived using the 'Agreed date' data element within the EVALUATION.estimated_date_delivery archetype in the maternal record. Usually estimated by Naegele's rule or by ultrasound scan. P0W..P52W Week
Gestational maturity	Gestational maturity: The estimated gestational maturity of the newborn at, or very near, birth. Usually estimated by physical examination and/or neuromuscular assessment of the newborn. P0W..P52W Week
Birth category by gestation	Birth category by gestation: Category of birth based on the duration of the pregnancy at birth. Pre-term Term Post-term
Adjusted age	Adjusted age: A statement about the age of an individual at a point in time.
Data
Point in time event	Point in time event: Default, unspecified point in time event which may be explicitly defined in a template or at run-time.
Data
Adjusted age	Adjusted age: The age of a premature infant, calculated from their expected due date rather than their actual date of birth. Also known as 'Corrected age'. In most use cases the DV_DURATION data type is used to record the Adjusted age. The DV_QUANTITY data type is used for recording a decimal age in years or mean Julian years (365.25 days), and the DV_TEXT data type is used for recording a textual representation of the individual's age. For example: 'P3M2W', '0,2884615384615385 a_j' or '3 months 2 weeks'. Duration>-P1Y Quantity-1..10; -1..10 Units: yr (UCUM: a) a_j Text
Infant measurements	Infant measurements: A generic section header which should be renamed in a template to suit a specific clinical context.
Body weight	Body weight: Measurement of the body weight of an individual.
Data
Any event	Any event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Data
Weight	Weight: The weight of the individual. 0..1000; 0..2000; 0..1000000 Units: kg lbm (UCUM: [lb_av]) g
Birth	Birth: Usually the first weight, measured soon after birth. This event will only be used once per health record .
Data
Weight	Weight: The weight of the individual. 0..1000; 0..2000; 0..1000000 Units: kg lbm (UCUM: [lb_av]) g
Comment	Comment: Additional narrative about the measurement of Body weight, not captured in other fields.
Data
Weight	Weight: The weight of the individual. 0..1000; 0..2000; 0..1000000 Units: kg lbm (UCUM: [lb_av]) g
Comment	Comment: Additional narrative about the measurement of Body weight, not captured in other fields.
State
State of dress	State of dress: Description of the state of dress of the person at the time of weighing. Naked Nappy/diaper Lightly clothed/underwear Fully clothed, without shoes Fully clothed, including shoes
Confounding factors	Confounding factors: Record any issues or factors that may impact on the measurement of body weight eg timing in menstrual cycle, timing of recent bowel motion or noting of amputation.
State
State of dress	State of dress: Description of the state of dress of the person at the time of weighing. Naked Nappy/diaper Lightly clothed/underwear Fully clothed, without shoes Fully clothed, including shoes
Confounding factors	Confounding factors: Record any issues or factors that may impact on the measurement of body weight eg timing in menstrual cycle, timing of recent bowel motion or noting of amputation.
Body weight for age	Body weight for age: Details about parameters plotted on a growth chart to allow monitoring of a child's growth over time, relative to a reference population.
Data
Any event	Any event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Data
Growth indicator	Growth indicator: The name of the growth parameter. Weight-for-age
Z-score category	Z-score category: The category or grouping of the Z score. For example: a choice between <-3, <-2, or Normal.
Protocol
Growth reference chart	Growth reference chart: Specifies the standard or syndrome-specific reference charts used to calculate the growth indicator data. For example, for a typical height assessment, 'WHO' might be used, whereas for children diagnosed with Turner Syndrome, the 'Turner' standard would be applicable (see the Royal College of Paediatrics and Child Health API (https://growth.rcpch.ac.uk/).
Length	Length: Height, or body length, is measured from crown of head to sole of foot. Height is measured with the individual in a standing position and body length in a recumbent position.
Data
Any event	Any event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Data
Length	Length: The length of the body from crown of head to sole of foot. 0..1000; 0..250 Units: cm in (UCUM: [in_i])
Birth	Birth: Usually the first length measurement, recorded soon after birth. This event will only be used once per health record .
Data
Height/Length	Height/Length: The length of the body from crown of head to sole of foot. 0..1000; 0..250 Units: cm in (UCUM: [in_i])
Comment	Comment: Additional narrative about the measurement, not captured in other fields.
Data
Height/Length	Height/Length: The length of the body from crown of head to sole of foot. 0..1000; 0..250 Units: cm in (UCUM: [in_i])
Comment	Comment: Additional narrative about the measurement, not captured in other fields.
State
Position	Position: Position of individual when measured. Standing Lying Assumed value: Standing
Confounding factors	Confounding factors: Narrative description of any issues or factors that may impact on the measurement. For example: noting of amputation.
State
Position	Position: Position of individual when measured. Standing Lying Assumed value: Standing
Confounding factors	Confounding factors: Narrative description of any issues or factors that may impact on the measurement. For example: noting of amputation.
Body length for age	Body length for age: Details about parameters plotted on a growth chart to allow monitoring of a child's growth over time, relative to a reference population.
Data
Any event	Any event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Data
Growth indicator	Growth indicator: The name of the growth parameter. Length/height-for-age
Z-score category	Z-score category: The category or grouping of the Z score. For example: a choice between <-3, <-2, or Normal.
Head circumference	Head circumference: The measurement of the longest distance around the head.
Data
Any event	Any event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Data
Head circumference	Head circumference: The measurement of the longest distance around the head. 0..100; 0..40 Units: cm in (UCUM: [in_i])
Birth	Birth: The first measurement of head circumference that is recorded soon after birth. This event should only be used once per record.
Data
Head circumference	Head circumference: The measurement of the longest distance around the head. 0..100; 0..40 Units: cm in (UCUM: [in_i])
Comment	Comment: Additional narrative about the head circumference not captured in other fields.
Data
Head circumference	Head circumference: The measurement of the longest distance around the head. 0..100; 0..40 Units: cm in (UCUM: [in_i])
Comment	Comment: Additional narrative about the head circumference not captured in other fields.
State
Confounding factors	Confounding factors: Narrative descripiton of any issues or factors that may impact on the measurement. For example: 'uncooperative child','caput & moulding post birth' and 'haematoma'.
State
Confounding factors	Confounding factors: Narrative descripiton of any issues or factors that may impact on the measurement. For example: 'uncooperative child','caput & moulding post birth' and 'haematoma'.
Head circumference for age	Head circumference for age: Details about parameters plotted on a growth chart to allow monitoring of a child's growth over time, relative to a reference population.
Data
Any event	Any event: Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.
Data
Growth indicator	Growth indicator: The name of the growth parameter. Head circumference-for-age
Z-score category	Z-score category: The category or grouping of the Z score. For example: a choice between <-3, <-2, or Normal.