archetype (adl_version=1.4; uid=fa320afb-44f0-492d-8fb9-702da5938624)
	openEHR-EHR-OBSERVATION.avpu-and_confusion.v0
specialise
	openEHR-EHR-OBSERVATION.avpu.v0

concept
	[at0000.1]	-- ACVPU
language
	original_language = <[ISO_639-1::en]>
	translations = <
		["nb"] = <
			language = <[ISO_639-1::nb]>
			author = <
				["name"] = <"Silje Ljosland Bakke">
				["organisation"] = <"Helse Bergen HF">
			>
		>
		["pt-br"] = <
			language = <[ISO_639-1::pt-br]>
			author = <
				["name"] = <"Vladimir Pizzo">
				["organisation"] = <"Hospital Sirio Libanes, Brazil">
				["email"] = <"vladimir.pizzo@hsl.org.br">
			>
		>
	>
description
	original_author = <
		["name"] = <"Hildegard Franke">
		["organisation"] = <"freshEHR Clinical Informatics Ltd.">
		["email"] = <"hildi@freshehr.com">
		["date"] = <"2018-02-01">
	>
	details = <
		["nb"] = <
			language = <[ISO_639-1::nb]>
			purpose = <"Brukes for å vurdere et individs bevissthetsnivå.">
			use = <"For raskt og enkel vurdering av et individs bevissthetsnivå, særlig egnet til vurdering i akutte situasjoner.">
			keywords = <"AVPU", "alert", "voice", "pain", "unresponsive", "våken", "tale", "smerte", "bevisstløs", "stemme", "bevissthet", "verbal", "verbalrespons", "semikomatøs", "bevisst", "bevissthetsnivå", "komatøs">
			misuse = <"">
			copyright = <"© Clinical Models UK">
		>
		["pt-br"] = <
			language = <[ISO_639-1::pt-br]>
			purpose = <"Registrar a responsividade de um paciente, como uma indicação do seu nível de consciência.">
			use = <"Usar para registrar, como parte de uma avaliação de rastreamento da responsividade de um paciente, como uma indicação do seu nível de consicência.">
			keywords = <"avda", "alerta", "voz", "dor", "arresponsivo">
			misuse = <"">
			copyright = <"© Clinical Models UK">
		>
		["en"] = <
			language = <[ISO_639-1::en]>
			purpose = <"To record an individual's level of consciousness.">
			use = <"Use to record a quick and simple assessment of an individual's level of consciousness, especially in an emergency situation.">
			keywords = <"avpu", "alert", "voice", "pain", "unresponsive", "awake", "speech", "pain", "unconscious", "voice", "consciousness", "verbal", "verbal response", "semicomatose", "conscious", "level of consciousness", "comatose", "confusion", "acvpu">
			misuse = <"">
			copyright = <"© Clinical Models UK">
		>
	>
	lifecycle_state = <"in_development">
	other_contributors = <>
	other_details = <
		["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/.">
		["custodian_organisation"] = <"UK Clinical Models">
		["references"] = <"https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2 cited 01-Feb-2018">
		["current_contact"] = <"Hildegard Franke, freshEHR Clinical Informatics Ltd.<hildi@freshehr.com>">
		["original_namespace"] = <"uk.org.clinicalmodels">
		["original_publisher"] = <"UK Clinical Models">
		["custodian_namespace"] = <"uk.org.clinicalmodels">
		["MD5-CAM-1.0.1"] = <"8F9AF5C0FF535EFC45C111EEDB60484D">
		["build_uid"] = <"d8a017c6-7c72-4f15-b0f1-86727166b10a">
		["revision"] = <"0.0.1-alpha">
	>

definition
	OBSERVATION[at0000.1] matches {	-- ACVPU
		data matches {
			HISTORY[at0001] matches {	-- Event Series
				events cardinality matches {1..*; unordered} matches {
					EVENT[at0002] occurrences matches {0..*} matches {	-- Any event
						data matches {
							ITEM_TREE[at0003] matches {	-- Tree
								items cardinality matches {0..*; unordered} matches {
									ELEMENT[at0004.1] occurrences matches {0..1} matches {	-- Observation
										value matches {
											DV_CODED_TEXT matches {
												defining_code matches {
													[local::
													at0005, 	-- Alert
													at0.15, 	-- Confusion
													at0006, 	-- Voice
													at0007, 	-- Pain
													at0008]	-- Unresponsive
												}
											}
										}
									}
									ELEMENT[at0012] occurrences matches {0..1} matches {	-- Comment
										value matches {
											DV_TEXT matches {*}
										}
									}
								}
							}
						}
						state matches {
							ITEM_TREE[at0013] matches {	-- Tree
								items cardinality matches {0..*; unordered} matches {
									ELEMENT[at0014] occurrences matches {0..1} matches {	-- Confounding factors
										value matches {
											DV_TEXT matches {*}
										}
									}
								}
							}
						}
					}
				}
			}
		}
		protocol matches {
			ITEM_TREE[at0009] matches {	-- Tree
				items cardinality matches {0..*; unordered} matches {
					ELEMENT[at0010] occurrences matches {0..1} matches {	-- Pain stimulus
						value matches {
							DV_TEXT matches {*}
						}
					}
					allow_archetype CLUSTER[at0011] occurrences matches {0..*} matches {	-- Extension
						include
							archetype_id/value matches {/.*/}
					}
				}
			}
		}
	}


ontology
	term_definitions = <
		["en"] = <
			items = <
				["at0.15"] = <
					text = <"Confusion">
					description = <"The patient has new-onset confusion, disorientation and/or agitation, where previously their mental state was normal.">
				>
				["at0000"] = <
					text = <"AVPU">
					description = <"Simple scale used as part of an assessment to measure and record an individual's level of consciousness. AVPU is an acronym for 'Alert', 'Voice', 'Pain', 'Unresponsive'.">
				>
				["at0000.1"] = <
					text = <"ACVPU">
					description = <"Simple scale used as part of an assessment to measure and record an individual's level of consciousness. ACVPU is an acronym for 'Alert', 'Confusion', 'Voice', 'Pain', 'Unresponsive'.!">
				>
				["at0001"] = <
					text = <"Event Series">
					description = <"@ internal @">
				>
				["at0002"] = <
					text = <"Any event">
					description = <"Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time.">
				>
				["at0003"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0004"] = <
					text = <"Observation">
					description = <"The observation of the patient's level of consciousness.">
				>
				["at0004.1"] = <
					text = <"Observation">
					description = <"The observation of the patient's level of consciousness.">
				>
				["at0005"] = <
					text = <"Alert">
					description = <"Eyes open spontaneously, oriented speech, obeys commands.">
				>
				["at0006"] = <
					text = <"Voice">
					description = <"Any verbal, motor or eye response to a voice stimulus.">
				>
				["at0007"] = <
					text = <"Pain">
					description = <"Any verbal, motor or eye response to a pain stimulus, such as pressing the nail root, but not to voice stimulus.">
				>
				["at0008"] = <
					text = <"Unresponsive">
					description = <"No response to voice or pain stimuli.">
				>
				["at0009"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0010"] = <
					text = <"Pain stimulus">
					description = <"Description of the type of pain stimulus used to elicit the observation.">
					comment = <"This element should be coded with a terminology, where possible. For example: pressing the nail root or the sternum.">
				>
				["at0011"] = <
					text = <"Extension">
					description = <"Additional information required to capture local content or to align with other reference models/formalisms.">
					comment = <"e.g. Local information requirements or additional metadata to align with FHIR or CIMI equivalents.">
				>
				["at0012"] = <
					text = <"Comment">
					description = <"Additional narrative about the observation, not captured in other fields.">
				>
				["at0013"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0014"] = <
					text = <"Confounding factors">
					description = <"Narrative description of any issues or factors that may impact on the observation.">
				>
			>
		>
		["nb"] = <
			items = <
				["at0.15"] = <
					text = <"*Confusion(en)">
					description = <"*The patient has new-onset confusion, disorientation and/or agitation, where previously their mental state was normal.(en)">
				>
				["at0000"] = <
					text = <"AVPU">
					description = <"En enkel skala for å vurdere et individs bevissthetsnivå. AVPU er en forkortelse for engelsk \"Alert\", \"Voice\", \"Pain\" og \"Unresponsive\", på norsk \"Våken\", \"Tiltale\", \"Smerte\" og \"Reagerer ikke\".">
				>
				["at0000.1"] = <
					text = <"*AVPU!(en)">
					description = <"*Simple scale used as part of an assessment to measure and record an individual's level of consciousness. AVPU is an acronym for 'Alert', 'Voice', 'Pain', 'Unresponsive'.!(en)">
				>
				["at0001"] = <
					text = <"Event Series">
					description = <"@ internal @">
				>
				["at0002"] = <
					text = <"Uspesifikk hendelse.">
					description = <"Standard, uspesifisert tidspunkt eller tidsintervall som kan defineres mer eksplisitt i en template eller i en applikasjon.">
				>
				["at0003"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0004"] = <
					text = <"AVPU-observasjon">
					description = <"Observasjonen av individets bevissthetsnivå.">
				>
				["at0004.1"] = <
					text = <"*! - Observation(en)">
					description = <"*The observation of the patient's level of consciousness.(en)">
				>
				["at0005"] = <
					text = <"Våken">
					description = <"Øynene åpnes spontant, orientert tale, adlyder kommandoer (A).">
				>
				["at0006"] = <
					text = <"Tiltale">
					description = <"Hvilken som helst verbal, motorisk eller øye-respons på verbal tiltale (rop høyt eller rist forsiktig) (V).">
				>
				["at0007"] = <
					text = <"Smerte">
					description = <"En hvilken som helst verbal, motorisk eller øye-respons på smertestimuli (eksempelvis press på neglerot), men ikke på verbal tiltale (P).">
				>
				["at0008"] = <
					text = <"Reagerer ikke">
					description = <"Ingen respons på tale- eller smertestimuli (U).">
				>
				["at0009"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0010"] = <
					text = <"Smertestimuli">
					description = <"Beskrivelse av type smertestimuli. Bør kodes ved hjelp av kodeverk eller terminologi.">
					comment = <"Eksempler: Trykk på neglerot og press mot sternum.">
				>
				["at0011"] = <
					text = <"Tilleggsinformasjon">
					description = <"Ytterligere informasjon som trengs for å kunne registrere lokalt definert innhold eller for å tilpasse til andre referansemodeller/formalismer.">
					comment = <"For eksempel lokale informasjonsbehov eller ytterligere metadata for å kunne tilpasse til tilsvarende konsepter i FHIR eller CIMI.">
				>
				["at0012"] = <
					text = <"Comment">
					description = <"Ytterligere fritekst om observasjonen som ikke passer inn i andre elementer.">
				>
				["at0013"] = <
					text = <"*Tree(en)">
					description = <"*@ internal @(en)">
				>
				["at0014"] = <
					text = <"Konfunderende faktorer">
					description = <"Fritekstbeskrivelse av problemer eller faktorer som kan ha påvirkning på observasjonen.">
				>
			>
		>
		["pt-br"] = <
			items = <
				["at0.15"] = <
					text = <"*Confusion(en)">
					description = <"*The patient has new-onset confusion, disorientation and/or agitation, where previously their mental state was normal.(en)">
				>
				["at0000"] = <
					text = <"AVDA">
					description = <"Escala simples utilizada como parte de uma medida de avaliação e registro da responsividade de um paciente, indicando o seu nível de consciência. AVDA é um acrônimo para 'Alerta', 'Voz', 'Dor' e \"Arresponsivo'">
				>
				["at0000.1"] = <
					text = <"*AVPU!(en)">
					description = <"*Simple scale used as part of an assessment to measure and record an individual's level of consciousness. AVPU is an acronym for 'Alert', 'Voice', 'Pain', 'Unresponsive'.!(en)">
				>
				["at0001"] = <
					text = <"Event Series">
					description = <"@ internal @">
				>
				["at0002"] = <
					text = <"Qualquer evento">
					description = <"Padrão, evento ponto no tempo ou intervalo não especificado que pode ser definido explicitamente num template ou no tempo corrente.">
				>
				["at0003"] = <
					text = <"Tree">
					description = <"@ internal @">
				>
				["at0004"] = <
					text = <"Observação AVDA">
					description = <"A observação da responsividade do paciente.">
				>
				["at0004.1"] = <
					text = <"*! - Observation(en)">
					description = <"*The observation of the patient's level of consciousness.(en)">
				>
				["at0005"] = <
					text = <"Alerta">
					description = <"O paciente está completamente acordado e alerta.">
				>
				["at0006"] = <
					text = <"Voz">
					description = <"O paciente responde de alguma forma a um estímulo vocal.">
				>
				["at0007"] = <
					text = <"Dor">
					description = <"O paciente responde de alguma forma a um estímulo doloroso.">
				>
				["at0008"] = <
					text = <"Arresponsivo">
					description = <"O paciente não responde de forma alguma a um estímulo vocal ou doloroso.">
				>
				["at0009"] = <
					text = <"*Tree(en)">
					description = <"*@ internal @(en)">
				>
				["at0010"] = <
					text = <"*Pain stimulus(en)">
					description = <"*Description of the type of pain stimulus used to elicit the observation.(en)">
					comment = <"* This element should be coded with a terminology, where possible. For example: pressing the nail root or the sternum.(en)">
				>
				["at0011"] = <
					text = <"*Extension(en)">
					description = <"*Additional information required to capture local content or to align with other reference models/formalisms.(en)">
					comment = <"*e.g. Local information requirements or additional metadata to align with FHIR or CIMI equivalents.(en)">
				>
				["at0012"] = <
					text = <"*Comment(en)">
					description = <"*Additional narrative about the observation, not captured in other fields.(en)">
				>
				["at0013"] = <
					text = <"*Tree(en)">
					description = <"*@ internal @(en)">
				>
				["at0014"] = <
					text = <"*Confounding factors(en)">
					description = <"*Narrative descripiton of any issues or factors that may impact on the observation.(en)">
				>
			>
		>
	>