WHO Antenatal Care Guideline Implementation Guide
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WHO Antenatal Care Guideline Implementation Guide, published by World Health Organization (WHO). This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-anc/ and changes regularly. See the Directory of published versions

: ANC.DT.04 Conducting physical exams - JSON Representation

Active as of 2021-06-11

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{
  "resourceType" : "PlanDefinition",
  "id" : "ANCDT04",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n    <table class=\"grid dict\">\n        \n        <tr>\n            <th scope=\"row\"><b>Id: </b></th>\n            <td style=\"padding-left: 4px;\">ANCDT04</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\"><a href=\"PlanDefinition-ANCDT04.html\">ANC.DT.04 Conducting physical exams</a></td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Version: </b></th>\n            <td style=\"padding-left: 4px;\">0.3.0</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Identifier: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                \n                <p style=\"margin-bottom: 5px;\">\n                    <b>value: </b> <span>ANC.DT.04</span>\n                </p>\n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Name: </b></th>\n            <td style=\"padding-left: 4px;\">ANCDT04</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Title: </b></th>\n            <td style=\"padding-left: 4px;\">ANC.DT.04 Conducting physical exams</td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Status: </b></th>\n            <td style=\"padding-left: 4px;\">active</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Experimental: </b></th>\n            <td style=\"padding-left: 4px;\">false</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Type: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-plan-definition-type.html\">PlanDefinitionType</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>eca-rule</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Date: </b></th>\n            <td style=\"padding-left: 4px;\">2021-06-11 22:32:40-0600</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Publisher: </b></th>\n            <td style=\"padding-left: 4px;\">World Health Organization (WHO)</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Description: </b></th>\n            <td style=\"padding-left: 4px;\">Depending on the results of some physical exams, additional examinations or repeat measurements are required</td>\n        </tr>\n        \n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Use Context: </b></th>\n            <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>code</b></th><th><b>value</b></th><th><b>display</b></th></tr>\n                    \n                      <tr>\n                        <td>task</td>\n                        <td>ANC.B8</td>\n                        <td>Conduct physical exam</td>\n                      </tr>\n                    \n                </table>\n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Jurisdiction: </b></th>\n            <td style=\"padding-left: 4px;\">001</td>\n        </tr>\n        \n        \n        \n        \n        \n        \n        \n        \n\n        \n        <tr>\n          <th scope=\"row\"><b>Libraries: </b></th>\n          <td style=\"padding-left: 4px;\">\n            <table class=\"grid-dict\">\n              \n                <tr><td><a href=\"Library-ANCDT04.html\">ANC.DT.04 Conducting physical exams</a></td></tr>\n              \n            </table>\n          </td>\n        </tr>\n        \n\n        \n        <tr>\n          <th scope=\"row\"><b>Actions: </b></th>\n          <td style=\"padding-left: 4px;\">\n            <table class=\"grid-dict\">\n              \n                <tr>\n                  <td>\n                    <b> ANC.DT.04 Conducting physical exams:</b> <br/>\n                    <b>When:</b> <i>named-event:</i> ANC.B8 Conduct physical exam<br/>\n                    \n                    \n                      <b>Then:</b>\n                      <table class=\"grid-dict\">\n                        \n                          <tr>\n                            <td>\n                              Given high values (SBP ≥ 140 or DBP ≥ 90) upon first measure, blood pressure should be measured again<br/>\n                              \n                              <b>If:</b> <i>applicability:</i> (&amp;quot;Systolic blood pressure&amp;quot; ≥ 140 mmHg)\n  OR (&amp;quot;Diastolic blood pressure&amp;quot; ≥ 90 mmHg) <i>(Should Measure BP again after 10–15 minutes rest)</i><br/>\n                              \n                                \n                              \n                            </td>\n                          </tr>\n                        \n                          <tr>\n                            <td>\n                              The health worker should retake the woman's temperature if the first reading is over 38°C<br/>\n                              \n                              <b>If:</b> <i>applicability:</i> &amp;quot;Body temperature&amp;quot; ≥ 38°C <i>(Should Measure temperature again)</i><br/>\n                              \n                                \n                              \n                            </td>\n                          </tr>\n                        \n                          <tr>\n                            <td>\n                              The health worker should retake the woman's pulse rate if the first reading is lower than 60 or higher than 100 beats per minute<br/>\n                              \n                              <b>If:</b> <i>applicability:</i> 60 &amp;gt; Pulse rate &amp;gt; 100 <i>(Should Check again after 10 minutes rest)</i><br/>\n                              \n                                \n                              \n                            </td>\n                          </tr>\n                        \n                          <tr>\n                            <td>\n                              If the woman has an abnormal respiratory exam result or respiratory distress, conduct oximetry test<br/>\n                              \n                              <b>If:</b> <i>applicability:</i> ((((((&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Dyspnoea&amp;quot;)\n  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Cough&amp;quot;))\n  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Rapid breathing&amp;quot;))\n  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Slow breathing&amp;quot;))\n  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Wheezing&amp;quot;))\n  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Rales&amp;quot;))\n  OR (&amp;quot;Respiratory exam result&amp;quot; = &amp;quot;Other abnormal respiratory exam result (specify)&amp;quot;) <i>(Should Conduct oximetry test)</i><br/>\n                              \n                                \n                              \n                            </td>\n                          </tr>\n                        \n                          <tr>\n                            <td>\n                              Fetal heart rate out of normal range (100–180) – please have the woman lay on her left side for 15 minutes and check again<br/>\n                              \n                              <b>If:</b> <i>applicability:</i> 100 bpm &amp;gt; Fetal heart rate &amp;gt; 180 bpm <i>(Should Measure the fetal heart rate again)</i><br/>\n                              \n                                \n                              \n                            </td>\n                          </tr>\n                        \n                      </table>\n                    \n                  </td>\n                </tr>\n              \n            </table>\n          </td>\n        </tr>\n        \n    </table>\n</div>"
  },
  "url" : "http://fhir.org/guides/who/anc-cds/PlanDefinition/ANCDT04",
  "identifier" : [
    {
      "use" : "official",
      "value" : "ANC.DT.04"
    }
  ],
  "version" : "0.3.0",
  "name" : "ANCDT04",
  "title" : "ANC.DT.04 Conducting physical exams",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "eca-rule"
      }
    ]
  },
  "status" : "active",
  "experimental" : false,
  "date" : "2021-06-11T22:32:40-06:00",
  "publisher" : "World Health Organization (WHO)",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.who.int"
        }
      ]
    }
  ],
  "description" : "Depending on the results of some physical exams, additional examinations or repeat measurements are required",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "task",
        "display" : "Workflow Task"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://fhir.org/guides/who/anc-cds/CodeSystem/activity-codes",
            "code" : "ANC.B8",
            "display" : "Conduct physical exam"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001"
        }
      ]
    }
  ],
  "library" : [
    🔗 "http://fhir.org/guides/who/anc-cds/Library/ANCDT04"
  ],
  "action" : [
    {
      "title" : "ANC.DT.04 Conducting physical exams",
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "ANC.B8 Conduct physical exam"
        }
      ],
      "action" : [
        {
          "id" : "1",
          "title" : "Measure BP again after 10–15 minutes rest",
          "description" : "Measure BP again after 10–15 minutes rest",
          "textEquivalent" : "Given high values (SBP ≥ 140 or DBP ≥ 90) upon first measure, blood pressure should be measured again",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Managing complications guide (IMPAC) (2017): Section S-51 (5)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "(\"Systolic blood pressure\" ≥ 140 mmHg)\n  OR (\"Diastolic blood pressure\" ≥ 90 mmHg)",
                "language" : "text/cql-identifier",
                "expression" : "Should Measure BP again after 10–15 minutes rest"
              }
            }
          ]
        },
        {
          "id" : "2",
          "title" : "Measure temperature again",
          "description" : "Measure temperature again",
          "textEquivalent" : "The health worker should retake the woman's temperature if the first reading is over 38°C",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Managing complications guide (IMPAC) (2017): Section S-113 (5)"
            }
          ],
          "condition" : [
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              "kind" : "applicability",
              "expression" : {
                "description" : "\"Body temperature\" ≥ 38°C",
                "language" : "text/cql-identifier",
                "expression" : "Should Measure temperature again"
              }
            }
          ]
        },
        {
          "id" : "3",
          "title" : "Check again after 10 minutes rest",
          "description" : "Check again after 10 minutes rest",
          "textEquivalent" : "The health worker should retake the woman's pulse rate if the first reading is lower than 60 or higher than 100 beats per minute",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Managing complications guide (IMPAC) (2017): Section S-1 (5)"
            }
          ],
          "condition" : [
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              "kind" : "applicability",
              "expression" : {
                "description" : "60 > Pulse rate > 100",
                "language" : "text/cql-identifier",
                "expression" : "Should Check again after 10 minutes rest"
              }
            }
          ]
        },
        {
          "id" : "4",
          "title" : "Conduct oximetry test",
          "description" : "Conduct oximetry test",
          "textEquivalent" : "If the woman has an abnormal respiratory exam result or respiratory distress, conduct oximetry test",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Managing complications guide (IMPAC) (2017): Section S-149 (5)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "((((((\"Respiratory exam result\" = \"Dyspnoea\")\n  OR (\"Respiratory exam result\" = \"Cough\"))\n  OR (\"Respiratory exam result\" = \"Rapid breathing\"))\n  OR (\"Respiratory exam result\" = \"Slow breathing\"))\n  OR (\"Respiratory exam result\" = \"Wheezing\"))\n  OR (\"Respiratory exam result\" = \"Rales\"))\n  OR (\"Respiratory exam result\" = \"Other abnormal respiratory exam result (specify)\")",
                "language" : "text/cql-identifier",
                "expression" : "Should Conduct oximetry test"
              }
            }
          ]
        },
        {
          "id" : "5",
          "title" : "Measure the fetal heart rate again",
          "description" : "Measure the fetal heart rate again",
          "textEquivalent" : "Fetal heart rate out of normal range (100–180) – please have the woman lay on her left side for 15 minutes and check again",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Managing complications guide (IMPAC) (2017): C-89 (5)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "100 bpm > Fetal heart rate > 180 bpm",
                "language" : "text/cql-identifier",
                "expression" : "Should Measure the fetal heart rate again"
              }
            }
          ]
        }
      ]
    }
  ]
}