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 - High-Risk Signs at Triage - JSON Representation

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{
  "resourceType" : "Observation",
  "id" : "em-ed-high-risk-signs-example",
  "meta" : {
    "profile" : [
      🔗 "https://fhir.dha.go.ke/ig/emergency/StructureDefinition/em-high-risk-signs-observation"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Observation em-ed-high-risk-signs-example</b></p><a name=\"em-ed-high-risk-signs-example\"> </a><a name=\"hcem-ed-high-risk-signs-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-high-risk-signs-observation.html\">Observation - Emergency High-Risk Signs</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/observation-category survey}\">Survey</span></p><p><b>code</b>: <span title=\"Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-observation-code high-risk-signs-assessment}\">High-risk signs assessment</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 12:41:00+0300</p><p><b>performer</b>: <a href=\"Practitioner-em-ed-nurse-example.html\">Practitioner Grace Wanjiru </a></p><p><b>value</b>: true</p><blockquote><p><b>component</b></p><p><b>code</b>: <span title=\"Codes:{https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign abnormal-heart-rate}\">Heart rate &lt;60 or &gt;130</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-high-risk-sign abnormal-respiratory-rate}\">Respiratory rate &lt;10 or &gt;30</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-high-risk-sign low-spo2}\">SpO2 &lt;92% on room air</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-high-risk-sign not-alert}\">Not alert (AVPU)</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-high-risk-sign stridor-or-swallow-difficulty}\">Stridor, voice change, or unable to swallow</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-high-risk-sign respiratory-distress}\">Respiratory distress (grunting in child, retractions, cyanosis)</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-high-risk-sign poor-perfusion}\">Poor perfusion, weak pulse, capillary refill &gt;3 sec, MAP &lt;65mmHg</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-high-risk-sign cannot-eat-or-drink}\">Vomits everything, cannot eat or drink</span></p><p><b>value</b>: false</p></blockquote></div>"
  },
  "status" : "final",
  "category" : [
    {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
          "code" : "survey"
        }
      ]
    }
  ],
  "code" : {
    "coding" : [
      {
        "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-observation-code",
        "code" : "high-risk-signs-assessment"
      }
    ]
  },
  "subject" : {
    🔗 "reference" : "Patient/pat-0712345678"
  },
  "encounter" : {
    🔗 "reference" : "Encounter/em-ed-encounter-example"
  },
  "effectiveDateTime" : "2026-06-29T12:41:00+03:00",
  "performer" : [
    {
      🔗 "reference" : "Practitioner/em-ed-nurse-example"
    }
  ],
  "valueBoolean" : true,
  "component" : [
    {
      "code" : {
        "coding" : [
          {
            "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign",
            "code" : "abnormal-heart-rate"
          }
        ]
      },
      "valueBoolean" : false
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign",
            "code" : "abnormal-respiratory-rate"
          }
        ]
      },
      "valueBoolean" : false
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign",
            "code" : "low-spo2"
          }
        ]
      },
      "valueBoolean" : false
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign",
            "code" : "not-alert"
          }
        ]
      },
      "valueBoolean" : false
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign",
            "code" : "stridor-or-swallow-difficulty"
          }
        ]
      },
      "valueBoolean" : false
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign",
            "code" : "respiratory-distress"
          }
        ]
      },
      "valueBoolean" : false
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign",
            "code" : "poor-perfusion"
          }
        ]
      },
      "valueBoolean" : true
    },
    {
      "code" : {
        "coding" : [
          {
            "system" : "https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign",
            "code" : "cannot-eat-or-drink"
          }
        ]
      },
      "valueBoolean" : false
    }
  ]
}