Kenya Emergency Care Implementation Guide
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Kenya Emergency Care Implementation Guide, published by Digital Health Agency (DHA), Kenya. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IntelliSOFT-Consulting/Kenya-Emergency-FHIR-IG/ and changes regularly. See the Directory of published versions

: Observation - ABCDE Circulation Assessment - XML Representation

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<Observation xmlns="http://hl7.org/fhir">
  <id value="em-ed-abcde-circulation-example"/>
  <meta>
    <profile
             value="https://fhir.dha.go.ke/ig/emergency/StructureDefinition/em-abcde-assessment-observation"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Observation em-ed-abcde-circulation-example</b></p><a name="em-ed-abcde-circulation-example"> </a><a name="hcem-ed-abcde-circulation-example"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-em-abcde-assessment-observation.html">Observation - Emergency ABCDE Assessment</a></p></div><p><b>Emergency No Findings On Exam</b>: false</p><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category exam}">Exam</span></p><p><b>code</b>: <span title="Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-component circulation}">Circulation</span></p><p><b>subject</b>: <a href="Patient-pat-0712345678.html">Amina Atieno Female, DoB: 1992-05-16 ( http://hie.go.ke/fhir/identifier/patient-official-id#33445566)</a></p><p><b>encounter</b>: <a href="Encounter-em-ed-encounter-example.html">Encounter: extension = Government insurance,Ambulance,Non-ambulatory,Acute,false,,; identifier = http://hie.go.ke/fhir/identifier/hospital-registration-number#KNH-ED-2026-004417; status = finished; class = emergency (ActCode#EMER); priority = Orange - Very urgent; period = 2026-06-29 12:40:00+0300 --&gt; 2026-06-29 14:10:00+0300</a></p><p><b>effective</b>: 2026-06-29 12:46:00+0300</p><p><b>performer</b>: <a href="Practitioner-em-practitioner-example.html">Practitioner Sarah Njoroge </a></p><p><b>value</b>: <span title="Codes:">Delayed capillary refill, cool peripheries</span></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field capillary-refill-seconds}">Circulation - capillary refill time</span></p><p><b>value</b>: 4 seconds<span style="background: LightGoldenRodYellow"> (Details: UCUM  codes = 's')</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field skin-findings}">Circulation - skin findings</span></p><p><b>value</b>: <span title="Codes:">Cool, pale</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field jvd}">Circulation - jugular venous distension</span></p><p><b>value</b>: false</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field pulses}">Circulation - pulse quality/asymmetry</span></p><p><b>value</b>: <span title="Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-vital-qualitative-state weak}">Weak</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field fluids-given-volume}">Circulation - IV fluids given (volume)</span></p><p><b>value</b>: 500 mL<span style="background: LightGoldenRodYellow"> (Details: UCUM  codemL = 'mL')</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field fluids-type}">Circulation - IV fluids given (type)</span></p><p><b>value</b>: <span title="Codes:">Normal saline</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field blood-ordered}">Circulation - blood ordered</span></p><p><b>value</b>: true</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field ecg-done}">Circulation - ECG done</span></p><p><b>value</b>: true</p></blockquote></div>
  </text>
  <extension
             url="https://fhir.dha.go.ke/ig/emergency/StructureDefinition/em-no-findings-on-exam">
    <valueBoolean value="false"/>
  </extension>
  <status value="final"/>
  <category>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/observation-category"/>
      <code value="exam"/>
    </coding>
  </category>
  <code>
    <coding>
      <system
              value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-component"/>
      <code value="circulation"/>
      <display value="Circulation"/>
    </coding>
  </code>
  <subject>🔗 
    <reference value="Patient/pat-0712345678"/>
  </subject>
  <encounter>🔗 
    <reference value="Encounter/em-ed-encounter-example"/>
  </encounter>
  <effectiveDateTime value="2026-06-29T12:46:00+03:00"/>
  <performer>🔗 
    <reference value="Practitioner/em-practitioner-example"/>
  </performer>
  <valueCodeableConcept>
    <text value="Delayed capillary refill, cool peripheries"/>
  </valueCodeableConcept>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field"/>
        <code value="capillary-refill-seconds"/>
      </coding>
    </code>
    <valueQuantity>
      <value value="4"/>
      <unit value="seconds"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="s"/>
    </valueQuantity>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field"/>
        <code value="skin-findings"/>
      </coding>
    </code>
    <valueCodeableConcept>
      <text value="Cool, pale"/>
    </valueCodeableConcept>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field"/>
        <code value="jvd"/>
      </coding>
    </code>
    <valueBoolean value="false"/>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field"/>
        <code value="pulses"/>
      </coding>
    </code>
    <valueCodeableConcept>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-vital-qualitative-state"/>
        <code value="weak"/>
        <display value="Weak"/>
      </coding>
    </valueCodeableConcept>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field"/>
        <code value="fluids-given-volume"/>
      </coding>
    </code>
    <valueQuantity>
      <value value="500"/>
      <unit value="mL"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="mL"/>
    </valueQuantity>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field"/>
        <code value="fluids-type"/>
      </coding>
    </code>
    <valueCodeableConcept>
      <text value="Normal saline"/>
    </valueCodeableConcept>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field"/>
        <code value="blood-ordered"/>
      </coding>
    </code>
    <valueBoolean value="true"/>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-abcde-field"/>
        <code value="ecg-done"/>
      </coding>
    </code>
    <valueBoolean value="true"/>
  </component>
</Observation>