archetype (adl_version=1.4; uid=fef2df95-cf31-4318-87d5-4210c1791da2) openEHR-EHR-CLUSTER.relative_body_surface_area_assessment-burn.v0 specialise openEHR-EHR-CLUSTER.relative_body_surface_area_assessment.v0 concept [at0000.1] -- Relative body surface area burnt language original_language = <[ISO_639-1::en]> description original_author = < ["name"] = <"Erik Sundvall"> ["organisation"] = <"Region Östergötland & Linköping University"> ["email"] = <"erik.sundvall@regionostergotland.se & erik.sundvall@liu.se"> ["date"] = <"2020-07-30"> > details = < ["en"] = < language = <[ISO_639-1::en]> purpose = <"For recording percentage of total body area affected by burns."> use = <"Use in 'Examination findings' slots of other archetypes, for example CLUSTER.exam, CLUSTER.exam-skin, CLUSTER.exam_burn and specialisations of those. These scales/rules ar often displayed to end users in tabular form with e.g. burn depth as columns and body parts/areas as rows. Systems should preferably not store anything (e.g. not store 0%) for body part sections and burn depth levels within them that are not injured."> keywords = <"surface area, burns, burn assessment, Lund-Browder, skin area, rule of nines, palmar method, TBSA, TBSA%", ...> misuse = <"Do not use 'Comment' or extensions for detailed descriptions, cause and etiology of injuries and diseases; instead use suitable fields in archetypes like CLUSTER.exam, CLUSTER.exam-skin, CLUSTER.exam_burn or EVALUATION.problem_diagnosis that this surface area assessment is likely nested within when used in EHRs."> > > lifecycle_state = <"in_development"> other_contributors = <> other_details = < ["licence"] = <"This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/."> ["custodian_organisation"] = <"openEHR Foundation"> ["references"] = <"Hettiaratchy S, Papini R. Initial management of a major burn: II--assessment and resuscitation. BMJ. 2004;329(7457):101-103. doi:10.1136/bmj.329.7457.101 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC449823/ Lund-Browder Charts https://www.remm.nlm.gov/burns.htm & https://www.remm.nlm.gov/LundBrowder.pdf https://www.rch.org.au/burns/clinical_information/#lund-and-browder-chart https://en.wikipedia.org/wiki/Lund_and_Browder_chart https://en.wikipedia.org/wiki/Total_body_surface_area Rhodes J, Clay C, Phillips M. The surface area of the hand and the palm for estimating percentage of total body surface area: results of a meta-analysis. Br J Dermatol. 2013;169(1):76-84. doi:10.1111/bjd.12290 Scarisbrick JJ, Morris S. How big is your hand and should you use it to score skin in cutaneous T-cell lymphoma?. Br J Dermatol. 2013;169(2):260-265. doi:10.1111/bjd.12403 Available from: https://pubmed.ncbi.nlm.nih.gov/23621659/ https://www.vicburns.org.au/wp-content/uploads/2016/06/poster4-paediatric-burns-assessment-ruler.pdf"> ["original_namespace"] = <"org.openehr"> ["original_publisher"] = <"openEHR Foundation"> ["custodian_namespace"] = <"org.openehr"> ["MD5-CAM-1.0.1"] = <"8C084F46711958ACC882C09FF6E9CD4F"> ["build_uid"] = <"f231cb22-296d-4cfe-9eda-c4ddab0cc393"> ["ip_acknowledgements"] = <"This artefact includes content from SNOMED Clinical Terms® (SNOMED CT®) which is copyrighted material of the International Health Terminology Standards Development Organisation (IHTSDO). Where an implementation of this artefact makes use of SNOMED CT content, the implementer must have the appropriate SNOMED CT Affiliate license - for more information contact http://www.snomed.org/snomed-ct/get-snomedct or info@snomed.org."> ["revision"] = <"0.0.1-alpha"> > definition CLUSTER[at0000.1] matches { -- Relative body surface area burnt items cardinality matches {1..*; unordered} matches { ELEMENT[at0001] occurrences matches {0..1} matches { -- Estimation method value matches { DV_CODED_TEXT matches { defining_code matches { [local:: at0002, -- Lund-Browder Chart at0003, -- Wallace Rule of nines at0004, -- Modified Rule of nines for pediatric use at0005, -- Hand surface area (HSA) at0006, -- Palm surface area (PSA) at0007, -- Image analysis at0008] -- Rule of five } } } } ELEMENT[at0009] occurrences matches {0..1} matches { -- Age interval or category used value matches { DV_INTERVAL matches { lower matches { C_DV_QUANTITY < list = < ["1"] = < units = <"a"> magnitude = <|>=0.0|> > > > } upper matches { C_DV_QUANTITY < list = < ["1"] = < units = <"a"> > > > } } DV_CODED_TEXT matches { defining_code matches { [local:: at0010, -- 0-1 years at0011, -- 1-4 years at0012, -- 5-9 years at0013, -- 10-14 years at0014, -- 15 years at0015, -- Adult at0016, -- 10-15 years at0017, -- Child at0018] -- Adult, obese } } } } ELEMENT[at0019] occurrences matches {0..1} matches { -- Comment value matches { DV_TEXT matches {*} } } CLUSTER[at0020.1] occurrences matches {0..*} matches { -- Partial skin area items cardinality matches {1..*; unordered} matches { ELEMENT[at0021] occurrences matches {0..1} matches { -- Area name value matches { DV_CODED_TEXT matches { defining_code matches { [local:: at0022, -- Head at0023, -- Head and neck at0024, -- Neck at0025, -- Trunk at0026, -- Trunk, frontside (anterior trunk) at0027, -- Back, (posterior trunk) at0028, -- Genitalia at0029, -- Buttock at0030, -- Arm (including shoulder and hand) at0031, -- Upper arm at0032, -- Lower arm at0033, -- Hand and wrist at0034, -- Leg (including hip and foot) at0035, -- Hip and thigh at0036, -- Lower leg at0037] -- Foot } } } } ELEMENT[at0038] occurrences matches {0..1} matches { -- Laterality value matches { DV_CODED_TEXT matches { defining_code matches { [local:: at0039, -- Left at0040, -- Right at0041] -- Bilateral (right and left) } } } } ELEMENT[at0042] occurrences matches {0..1} matches { -- Relative area (% of total body area) value matches { DV_PROPORTION matches { type matches {2} } } } allow_archetype CLUSTER[at0054] occurrences matches {0..*} matches { -- Extension per area include archetype_id/value matches {/.*/} } CLUSTER[at0.1] occurrences matches {0..*} matches { -- Burns per depth items cardinality matches {1..*; unordered} matches { ELEMENT[at0005.1] occurrences matches {0..1} matches { -- Depth value matches { DV_CODED_TEXT matches { defining_code matches { [local:: at0.2, -- Epidermal burn at0.3, -- Partial thickness burn at0.4, -- Superficial partial thickness burn at0.5, -- Deep partial thickness burn at0.6, -- Full thickness burn at0.7] -- Deep full thickness burn } } } } ELEMENT[at0006.1] occurrences matches {0..1} matches { -- Burnt area, precentage of full body value matches { DV_PROPORTION matches { type matches {2} } } } } } ELEMENT[at0.10] occurrences matches {0..1} matches { -- Sum of burnt area on this part value matches { DV_PROPORTION matches {*} } } } } CLUSTER[at0055] occurrences matches {0..1} matches { -- Sum of areas items cardinality matches {1..*; unordered} matches { ELEMENT[at0056.1] occurrences matches {0..1} matches { -- TBSA%, total burnt body surface area value matches { DV_PROPORTION matches { type matches {2} } } } allow_archetype CLUSTER[at0059] occurrences matches {0..*} matches { -- Sum extension include archetype_id/value matches {/.*/} } CLUSTER[at0.8] occurrences matches {0..*} matches { -- Burns per depth category items cardinality matches {1..*; unordered} matches { use_node ELEMENT occurrences matches {0..1} /items[at0020.1]/items[at0.1]/items[at0005.1] ELEMENT[at0023.1] occurrences matches {0..1} matches { -- Total burnt area of this depth category value matches { DV_PROPORTION matches { type matches {2} } } } } } } } allow_archetype CLUSTER[at0060] occurrences matches {0..*} matches { -- Extension include archetype_id/value matches {/.*/} } } } ontology terminologies_available = <"SNOMED-CT", ...> term_definitions = < ["en"] = < items = < ["at0000.1"] = < text = <"Relative body surface area burnt"> description = <"Assessment of relative body surface area affected by burns, estimated using methods like Lund-Browder chart, Wallace rule of nines, etc. "> > ["at0.1"] = < text = <"Burns per depth"> description = <"Repeat once for each depth category used in template."> > ["at0.2"] = < text = <"Epidermal burn"> description = <"First degree burn, Superficial epidermal burn (For example sunburn) Not included in TBSA%"> > ["at0.3"] = < text = <"Partial thickness burn"> description = <"Second degree burn (old deprecated description)"> > ["at0.4"] = < text = <"Superficial partial thickness burn"> description = <"Superficial second degree burn, SPSL - Superficial partial skin loss burn"> > ["at0.5"] = < text = <"Deep partial thickness burn"> description = <"Deep second degree burn / Deep dermal burn"> > ["at0.6"] = < text = <"Full thickness burn"> description = <"Third degree burn"> > ["at0.7"] = < text = <"Deep full thickness burn"> description = <"Fourth degree burn"> > ["at0005.1"] = < text = <"Depth"> description = <"The burn depth category used for the estimation."> comment = <"Some applications of e.g. the Lund-Browder chart only discern Partial v.s. Full thickness burns, but others use more granular levels like 'deep partial thickness burn' Corresponding codes are available in SNOMED CT"> > ["at0006.1"] = < text = <"Burnt area, precentage of full body"> description = <""> > ["at0056.1"] = < text = <"TBSA%, total burnt body surface area"> description = <"Sum of affected/burnt area of whole body"> comment = <"Summing up all 'Sum of burnt area on this part' for all body parts should equal summing up all 'Total burnt area of this depth category' Note that Epiderminal (first degree) burns are usually _not_ included in the TBSA% calculation."> > ["at0.8"] = < text = <"Burns per depth category"> description = <""> > ["at0023.1"] = < text = <"Total burnt area of this depth category"> description = <"Total burnt area of this depth category, precentage of full body"> > ["at0020.1"] = < text = <"Partial skin area"> description = <"To be repeated and configured in template, if the predefined body parts/areas in available templates or archetype specializations do not fit the use case."> comment = <"Example: In some use cases upper arm and lower arm are recorded separately and in some other use cases recorded together as arm. Remember to remove (0..0) old overlapping parts if new ones are introduced, to avoid possibility of double registration."> > ["at0.10"] = < text = <"Sum of burnt area on this part"> description = <"Sum of the areas of different depth categories"> comment = <"Note that Epiderminal (first degree) burns are usually _not_ included in these partial sums (since they may be used for TBSA% calculation)."> > ["at0000"] = < text = <"Relative body surface area assessment"> description = <"Assessment of relative body surface area affected by conditions, injuries,, diseases etc, estimated using methods like Lund-Browder chart, Wallace rule of nines, etc. "> > ["at0001"] = < text = <"Estimation method"> description = <""> > ["at0002"] = < text = <"Lund-Browder Chart"> description = <"Chart of body parts' relateive area, using age category dependent values for head and legs"> > ["at0003"] = < text = <"Wallace Rule of nines"> description = <"Divides body roughly into fractions of multiples of 9%, (Not accurate for children)"> > ["at0004"] = < text = <"Modified Rule of nines for pediatric use"> description = <""> > ["at0005"] = < text = <"Hand surface area (HSA)"> description = <"Based on that the patient's hand (palm + fingers) is approximately 1% of total body surface area"> > ["at0006"] = < text = <"Palm surface area (PSA)"> description = <"Based on that the patient's palm (fingers excluded) is approximately 0.5% of total body surface area"> > ["at0007"] = < text = <"Image analysis"> description = <"Algorithm (software) based analysis of data obtained by imaging methods"> > ["at0008"] = < text = <"Rule of five"> description = <"Used for obese patients etc. TODO: add reference/name"> > ["at0009"] = < text = <"Age interval or category used"> description = <"Age category interval used for area estimation in the method, if any."> > ["at0010"] = < text = <"0-1 years"> description = <"Scale for infants and children less than 1 year old"> > ["at0011"] = < text = <"1-4 years"> description = <"Scale for children 1-4 years old"> > ["at0012"] = < text = <"5-9 years"> description = <"Scale for children 5-9 years old"> > ["at0013"] = < text = <"10-14 years"> description = <"Scale for children 10-14 years old"> > ["at0014"] = < text = <"15 years"> description = <"Scale for adolescents approximately 15 years old"> > ["at0015"] = < text = <"Adult"> description = <"Scale for adults"> > ["at0016"] = < text = <"10-15 years"> description = <"Scale for children 10-15 years old"> > ["at0017"] = < text = <"Child"> description = <"Scale for children"> > ["at0018"] = < text = <"Adult, obese"> description = <"Scale for obese aduts >80 kg"> > ["at0019"] = < text = <"Comment"> description = <"Information about the estimation that could not captured in other fields."> > ["at0020"] = < text = <"Partial skin area"> description = <"To be repeated and configured in template,or at runtime to fit the use case and selected method, age interval etc."> comment = <"Example: In some use cases upper arm and lower arm are recorded separately and in some other use cases recorded together as arm. "> > ["at0021"] = < text = <"Area name"> description = <"Name of skin area, preferably coded with terminology like Snomed CT."> > ["at0022"] = < text = <"Head"> description = <"Entire skin of head (excluding neck)"> > ["at0023"] = < text = <"Head and neck"> description = <"Entire skin of head and neck"> > ["at0024"] = < text = <"Neck"> description = <"Entire skin of neck (Neck/throat, front and back)"> > ["at0025"] = < text = <"Trunk"> description = <"Entire skin of trunk (front and back)"> > ["at0026"] = < text = <"Trunk, frontside (anterior trunk)"> description = <"Skin of anterior trunk (TODO: report missing SNOMED CT code for \"entire skin of...\")"> > ["at0027"] = < text = <"Back, (posterior trunk)"> description = <"Entire skin of back"> > ["at0028"] = < text = <"Genitalia"> description = <"Entire skin of external genitalia"> > ["at0029"] = < text = <"Buttock"> description = <"Entire skin of buttock"> > ["at0030"] = < text = <"Arm (including shoulder and hand)"> description = <"Entire skin of upper extremity (record separately for each arm, use laterality to specify side)"> > ["at0031"] = < text = <"Upper arm"> description = <""> > ["at0032"] = < text = <"Lower arm"> description = <""> > ["at0033"] = < text = <"Hand and wrist"> description = <""> > ["at0034"] = < text = <"Leg (including hip and foot)"> description = <"Entire skin of lower extremity (record separately for each arm, use laterality to specify side)"> > ["at0035"] = < text = <"Hip and thigh"> description = <"Entire skin of hip and thigh"> > ["at0036"] = < text = <"Lower leg"> description = <"Entire skin of lower leg"> > ["at0037"] = < text = <"Foot"> description = <""> > ["at0038"] = < text = <"Laterality"> description = <"Side of body, for skin regions involving arms, legs, buttocks etc."> comment = <"Example: In some use cases buttocks (right and left) are added and recorded as one field and in other use cases they are recorded separately."> > ["at0039"] = < text = <"Left"> description = <""> > ["at0040"] = < text = <"Right"> description = <""> > ["at0041"] = < text = <"Bilateral (right and left)"> description = <""> > ["at0042"] = < text = <"Relative area (% of total body area)"> description = <"The age-category-dependent relative area (percentage of full body area) that the estimation method (e.g. 'Lund-Browder chart' or 'rule of nines') assigns to this body part. "> comment = <"When 'Estimation Method' and 'Age category...' have been selected, this number could be automatically filled by the system. The 'Total burns on this part' for this partial area should never exceed this number. All the "> > ["at0054"] = < text = <"Extension per area"> description = <""> > ["at0055"] = < text = <"Sum of areas"> description = <""> > ["at0056"] = < text = <"TBSA%, total affected body surface area"> description = <"Sum of affected/burnt area of whole body"> comment = <"Summing up all 'Sum of burnt area on this part' for all body parts should equal summing up all 'Total burnt area of this depth category' Note that Epiderminal (first degree) burns are usually _not_ included in the TBSA% calculation."> > ["at0059"] = < text = <"Sum extension"> description = <""> > ["at0060"] = < text = <"Extension"> description = <""> > > > > term_bindings = < ["SNOMED-CT"] = < items = < ["at0023"] = <[SNOMED-CT::361355005]> ["at0022"] = <[SNOMED-CT::181484006]> ["at0024"] = <[SNOMED-CT::361705004]> ["at0025"] = <[SNOMED-CT::181489001]> ["at0026"] = <[SNOMED-CT::181491009]> ["at0027"] = <[SNOMED-CT::181492002]> ["at0028"] = <[SNOMED-CT::367701003]> ["at0038"] = <[SNOMED-CT::272741003]> ["at0029"] = <[SNOMED-CT::181493007]> > > >