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 - XML Representation

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<Observation xmlns="http://hl7.org/fhir">
  <id value="em-ed-high-risk-signs-example"/>
  <meta>
    <profile
             value="https://fhir.dha.go.ke/ig/emergency/StructureDefinition/em-high-risk-signs-observation"/>
  </meta>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <status value="final"/>
  <category>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/observation-category"/>
      <code value="survey"/>
    </coding>
  </category>
  <code>
    <coding>
      <system
              value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-observation-code"/>
      <code value="high-risk-signs-assessment"/>
    </coding>
  </code>
  <subject>🔗 
    <reference value="Patient/pat-0712345678"/>
  </subject>
  <encounter>🔗 
    <reference value="Encounter/em-ed-encounter-example"/>
  </encounter>
  <effectiveDateTime value="2026-06-29T12:41:00+03:00"/>
  <performer>🔗 
    <reference value="Practitioner/em-ed-nurse-example"/>
  </performer>
  <valueBoolean value="true"/>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign"/>
        <code value="abnormal-heart-rate"/>
      </coding>
    </code>
    <valueBoolean value="false"/>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign"/>
        <code value="abnormal-respiratory-rate"/>
      </coding>
    </code>
    <valueBoolean value="false"/>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign"/>
        <code value="low-spo2"/>
      </coding>
    </code>
    <valueBoolean value="false"/>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign"/>
        <code value="not-alert"/>
      </coding>
    </code>
    <valueBoolean value="false"/>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign"/>
        <code value="stridor-or-swallow-difficulty"/>
      </coding>
    </code>
    <valueBoolean value="false"/>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign"/>
        <code value="respiratory-distress"/>
      </coding>
    </code>
    <valueBoolean value="false"/>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign"/>
        <code value="poor-perfusion"/>
      </coding>
    </code>
    <valueBoolean value="true"/>
  </component>
  <component>
    <code>
      <coding>
        <system
                value="https://fhir.dha.go.ke/ig/emergency/CodeSystem/em-high-risk-sign"/>
        <code value="cannot-eat-or-drink"/>
      </coding>
    </code>
    <valueBoolean value="false"/>
  </component>
</Observation>