<?xml version="1.0" encoding="UTF-8"?><Observation xmlns="http://hl7.org/fhir">
  <id value="20minute-apgar-score"/>
      <!--  	Using a contained patient for the purposes of this example Observation.  Typically the reference would be to an external resource    -->
  <text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Observation</b><a name="20minute-apgar-score"> </a></p><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">Resource Observation &quot;20minute-apgar-score&quot; </p></div><p><b>status</b>: final</p><p><b>category</b>: Survey <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.1.0/CodeSystem-observation-category.html">Observation Category Codes</a>#survey)</span></p><p><b>code</b>: 20 minute Apgar Score <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#443849008 &quot;Apgar score at 20 minutes&quot;)</span></p><p><b>subject</b>: <a name="newborn"> </a></p><blockquote><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;"><b>Peter James Chalmers </b> male, DoB: 2016-05-18 ( id: 12345)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td colspan="3">true</td></tr></table></blockquote><p><b>effective</b>: 2016-05-18T22:33:22Z</p><p><b>performer</b>: <a href="practitioner-example.html">Practitioner/example</a> &quot;Adam CAREFUL&quot;</p><p><b>value</b>: 10 {score}<span style="background: LightGoldenRodYellow"> (Details: UCUM code {score} = '{score}')</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Apgar color score <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#249227004)</span></p><p><b>value</b>: 2. Good color all over <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6724-4 &quot;Good color all over&quot;; apgarcolor#2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#249223000 &quot;Apgar heart rate score&quot;)</span></p><p><b>value</b>: 2. At least 100 beats per minute <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6718-6 &quot;At least 100 beats per minute&quot;; apgarheartrate#2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar response to stimulus score <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#249226008)</span></p><p><b>value</b>: 2. Grimace and pulling away, cough, or sneeze during suctioning <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6721-0 &quot;Grimace and pulling away, cough, or sneeze during suctioning&quot;; apgarreflexirritability#2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar muscle tone score <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#249225007)</span></p><p><b>value</b>: 2. Active motion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6715-2 &quot;Active motion&quot;; apgarmuscletone#2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#249224006)</span></p><p><b>value</b>: 2. Good, strong cry; normal rate and effort of breathing <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#LA6727-7 &quot;Good, strong cry; normal rate and effort of breathing&quot;; apgarrespiratoryeffort#2)</span></p></blockquote></div></text><contained>
    <Patient>
      <id value="newborn"/>
          <!--     MRN assigned by ACME healthcare on     -->
      <identifier>
        <system value="http://acmehealthcare/org/mrns"/>
        <value value="12345"/>
      </identifier>
      <active value="true"/>
          <!--     Peter James Chalmers     -->
      <name>
        <family value="Chalmers"/>
        <given value="Peter"/>
        <given value="James"/>
      </name>
          <!--     use FHIR code system for male / female     -->
      <gender value="male"/>
      <birthDate value="2016-05-18">
        <extension url="http://hl7.org/fhir/StructureDefinition/patient-birthTime">
          <valueDateTime value="2016-05-18T10:28:45Z"/>
        </extension>
      </birthDate>
    </Patient>
  </contained>
  <status value="final"/>
  <category>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
      <code value="survey"/>
      <display value="Survey"/>
    </coding>
    <text value="Survey"/>
  </category>
  <code>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="443849008"/>
      <display value="Apgar score at 20 minutes"/>
    </coding>
    <text value="20 minute Apgar Score"/>
  </code>
  <subject>
    <reference value="#newborn"/>
  </subject>
  <effectiveDateTime value="2016-05-18T22:33:22Z"/>
  <performer>
    <reference value="Practitioner/example"/>
  </performer>
  <valueQuantity>
    <value value="10"/>
    <system value="http://unitsofmeasure.org"/>
    <code value="{score}"/>
  </valueQuantity>
  <component>
    <code>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="249227004"/>
        <display value="Apgar color score"/>
      </coding>
      <text value="Apgar color score"/>
    </code>
    <valueCodeableConcept>
      <coding>
            <!--  this  extension  maps a numeric score to the code this may already be known and unecessary  -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
          <valueDecimal value="2"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6724-4"/>
        <display value="Good color all over"/>
      </coding>
      <coding>
        <system value="http://acme.ped/apgarcolor"/>
        <code value="2"/>
      </coding>
      <text value="2. Good color all over"/>
    </valueCodeableConcept>
  </component>
  <component>
    <code>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="249223000"/>
        <display value="Apgar heart rate score"/>
      </coding>
      <text value="Apgar respiratory effort score"/>
    </code>
    <valueCodeableConcept>
      <coding>
            <!--  this  extension  maps a numeric score to the code this may already be known and unecessary  -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
          <valueDecimal value="2"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6718-6"/>
        <display value="At least 100 beats per minute"/>
      </coding>
      <coding>
        <system value="http://acme.ped/apgarheartrate"/>
        <code value="2"/>
      </coding>
      <text value="2. At least 100 beats per minute"/>
    </valueCodeableConcept>
  </component>
  <component>
    <code>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="249226008"/>
        <display value="Apgar response to stimulus score"/>
      </coding>
      <text value="Apgar response to stimulus score"/>
    </code>
    <valueCodeableConcept>
      <coding>
            <!--  this  extension  maps a numeric score to the code this may already be known and unecessary  -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
          <valueDecimal value="2"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6721-0"/>
        <display value="Grimace and pulling away, cough, or sneeze during suctioning"/>
      </coding>
      <coding>
        <system value="http://acme.ped/apgarreflexirritability"/>
        <code value="2"/>
      </coding>
      <text value="2. Grimace and pulling away, cough, or sneeze during suctioning"/>
    </valueCodeableConcept>
  </component>
  <component>
    <code>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="249225007"/>
        <display value="Apgar muscle tone score"/>
      </coding>
      <text value="Apgar muscle tone score"/>
    </code>
    <valueCodeableConcept>
      <coding>
            <!--  this  extension  maps a numeric score to the code this may already be known and unecessary  -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
          <valueDecimal value="2"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6715-2"/>
        <display value="Active motion"/>
      </coding>
      <coding>
        <system value="http://acme.ped/apgarmuscletone"/>
        <code value="2"/>
      </coding>
      <text value="2. Active motion"/>
    </valueCodeableConcept>
  </component>
  <component>
    <code>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="249224006"/>
        <display value="Apgar respiratory effort score"/>
      </coding>
      <text value="Apgar respiratory effort score"/>
    </code>
    <valueCodeableConcept>
      <coding>
            <!--  this  extension  maps a numeric score to the code this may already be known and unecessary  -->
        <extension url="http://hl7.org/fhir/StructureDefinition/itemWeight">
          <valueDecimal value="2"/>
        </extension>
        <system value="http://loinc.org"/>
        <code value="LA6727-7"/>
        <display value="Good, strong cry; normal rate and effort of breathing"/>
      </coding>
      <coding>
        <system value="http://acme.ped/apgarrespiratoryeffort"/>
        <code value="2"/>
      </coding>
      <text value="2. Good, strong cry; normal rate and effort of breathing"/>
    </valueCodeableConcept>
  </component>
</Observation>