| ARCHETYPE ID | openEHR-EHR-OBSERVATION.indirect_oximetry.v1 |
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| Concept | Indirect oximetry |
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| Description | Method of monitoring blood gas measurements such as Spo2 and pTCO2 by indirect, currently non-invasive, means. |
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| Use | Used to record indirect blood gas measurement, currently by non-invasive techniques. New indirect blood gas measurements should be added to this archetype.
Where the recording device also provides another type of measurement, such as pulse rate, this should be recorded in a separate archetype, appropriate for that particular measurement e.g. the OBSERVATION.heart_rate-pulse archetype, to allow consistent querying.
The aim is to consistently model a clinical concept, rather than to model device output ; devices are increasingly multi-functional and provide overlapping measurements which may need to be recorded using a number of discrete archetypes.
Waveforms should be recorded here when used to document quality of the blood gas measurement. In contrast, if used for primary diagnostic purposes e.g. of cardiac output, plesmythography should be recorded in the key associated clinical archetype - OBSERVATION.heart_rate-pulse. |
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| Misuse | Any blood gas measurement that involves direct contact with blood, and measuring PaO2, PaCO2 should not be recorded using this archetype - Use OBSERVATION.lab_test-blood_gases archetype. New direct blood gas measurements should be added to OBSERVATION.lab_test-blood_gases.v1.
NOT to be used to record direct blood gas measurement e.g arterial (SaO2), venous (SvO2) oxygen saturation or Oxygen content (CaOC) usually determined by invasive methods e.g. lab blood gases or vascular catheter devices. These should be recorded within the OBSERVATION.lab_test-blood_gases archetype. |
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| Purpose | To record indirect, currently non-invasive, blood gas measurements, such as Spo2 and pTCO2, via pulse oximetry, transcutaneous oximetry or other methods.
It is likely that this archetype will be used primarily to record oxygenation estimations, but other gas measurements may be included, or added over time. |
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| References | AARC Clinical Practice Guideline - Pulse Oximetry. Respir Care 1992;37(8):891–897,[cited 2010 Jan 31 ]
Available from http://www.rcjournal.com/cpgs/pulsecpg.html
Jubran A. Pulse oximetry [Internet]. Critical Care 1999;3(2):R11-R17.[cited 2009 Oct 29 ]
Available from: http://ccforum.com
Hanning CD, Alexander-Williams JM. Fortnightly Review: Pulse oximetry: a practical review [Internet]. BMJ 1995 Aug;311(7001):367-370.[cited 2009 Nov 9 ]
Available from: http://www.bmj.com/cgi/content/abstract/311/7001/367
Baldwin KM. Transcutaneous Oximetry and Skin Surface Temperature as Objective Measures of Pressure Ulcer Risk [Internet]. Advances in Skin & Wound Care 2001;14(1) [cited 2010 Jan 31 ]
Available from: http://journals.lww.com/aswcjournal/Fulltext/2001/01000/Transcutaneous_Oximetry_and_Skin_Surface.14.aspx
Barker SJ, Badal JJ. The measurement of dyshemoglobins and total hemoglobin by pulse oximetry [Internet]. Current Opinion in Anaesthesiology 2008;21(6):805-810.[cited 2010 Jan 12 ]
Available from: http://journals.lww.com/co-anesthesiology/Abstract/2008/12000/The_measurement_of_dyshemoglobins_and_total.20.aspx |
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| Copyright | copyright (c) 2010 openEHR foundation |
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| Authors | Author name: Ian McNicoll
Organisation: Ocean Informatics, UK
Email: Ian.mcnicoll@oceaninformatics.com
Date originally authored: 26/01/2010
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| Other Details Language | Author name: Ian McNicoll
Organisation: Ocean Informatics, UK
Email: Ian.mcnicoll@oceaninformatics.com
Date originally authored: 26/01/2010
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| Other Details (Language Independent) | - References: AARC Clinical Practice Guideline - Pulse Oximetry. Respir Care 1992;37(8):891–897,[cited 2010 Jan 31 ]
Available from http://www.rcjournal.com/cpgs/pulsecpg.html
Jubran A. Pulse oximetry [Internet]. Critical Care 1999;3(2):R11-R17.[cited 2009 Oct 29 ]
Available from: http://ccforum.com
Hanning CD, Alexander-Williams JM. Fortnightly Review: Pulse oximetry: a practical review [Internet]. BMJ 1995 Aug;311(7001):367-370.[cited 2009 Nov 9 ]
Available from: http://www.bmj.com/cgi/content/abstract/311/7001/367
Baldwin KM. Transcutaneous Oximetry and Skin Surface Temperature as Objective Measures of Pressure Ulcer Risk [Internet]. Advances in Skin & Wound Care 2001;14(1) [cited 2010 Jan 31 ]
Available from: http://journals.lww.com/aswcjournal/Fulltext/2001/01000/Transcutaneous_Oximetry_and_Skin_Surface.14.aspx
Barker SJ, Badal JJ. The measurement of dyshemoglobins and total hemoglobin by pulse oximetry [Internet]. Current Opinion in Anaesthesiology 2008;21(6):805-810.[cited 2010 Jan 12 ]
Available from: http://journals.lww.com/co-anesthesiology/Abstract/2008/12000/The_measurement_of_dyshemoglobins_and_total.20.aspx
- MD5-CAM-1.0.1: 20011847A5995DE4BEE632C7C59EDF8D
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| Keywords | oxygen, oxygenation, saturation, SpO2, ptcCO2, ptcO2, spMet, spCO, spOC, carboxyhaemoglobin, methaemoglobin, transcutaneous, pulse, oximeter, oximetry, concentration, partial, pressure, non-invasive, vital, O2, CO2, carbon dioxide |
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| Lifecycle | Published |
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| Language used | en |
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| Citeable Identifier | 1013.1.188 |
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| state | |
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| Exertion | Exertion: Details about physical activity undertaken at the time of measurement.
Include:
openEHR-EHR-CLUSTER.level_of_exertion.v1 and specialisations |
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| Ambient oxygen | Ambient oxygen: Details of the amount of oxygen available to the subject at the time of observation. Assumed values of 21% oxygen concentration, Fi02 of 0.21 and oxygen flow rate of 0 l/min or 0 ml/min.
Include:
openEHR-EHR-CLUSTER.ambient_oxygen.v1 and specialisations |
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| Confounding factors | Confounding factors: Comment on and record other incidental factors that may be affect interpretation of the observation. For example, motion, pain, poor perfusion, infant feeding. |
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| events | |
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| Any event | Any event: Timing event. |
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| protocol | |
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| Sensor site | Sensor site: The site of the measurement sensor. |
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| Sensor type | Sensor type: The type of measurement sensor used e.g. transmittal, reflective, clamp or strip, electrode.
Choice of:
 Coded Text
- at0048::Transmittal [A pulse oximetry transmittal sensor was applied.]
- at0049::Reflective [A pulse oximetry reflective sensor was applied.]
- at0050::Clamp [A pulse oximetry clamp sensor was applied.]
- at0051::Strip [A pulse oximetry strip sensor was applied.]
- at0052::Electrode [A transcutaneous electrode sensor was applied.]
 Text
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| Electrode operating temperature | Electrode operating temperature: The operating temperature of a transcutaneous oximeter electrode.
Property: Temperature
Units: 0.0..100.0 °C
Limit decimal places: 1 |
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| Time of sensor application | Time of sensor application: The date and time at which the sensor was applied. Significant for transcutaneous oximetry. |
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| Device | Device: Details of the non-invasive oximetry device used.
Include:
openEHR-EHR-CLUSTER.device.v1 and specialisations |
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| data | |
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| SpO2 | SpO2: Measured via pulse oximetry, the saturation of oxygen in the peripheral blood.
SpO2 is defined as the ratio of oxyhaemoglobin (HbO2) to the total concentration of haemoglobin (HbO2 + deoxyhaemoglobin).
Numerator: 0.0..100.0
Denominator: 100.0..100.0
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| spOC | spOC: Measured via pulse CO-oximetry, the oxygen content of the peripheral blood.
Property: Concentration
Units: >=0.0 ml/ml |
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| spCO | spCO: Measured via pulse CO-oximetry, the saturation of carboxyhaemoglobin in the perpiheral blood.
Numerator: 0.0..100.0
Denominator: 100.0..100.0
Assumed value: false
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| spMet | spMet: Measured via pulse CO-oximetry, the saturation of methoxyhaemoglobin in the peripheral blood.
Numerator: 0.0..100.0
Denominator: 100.0..100.0
Assumed value: false
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| ptcO2 | ptcO2: Measured via transcutaneous electrode oximetry, the partial pressure of oxygen in the peripheral blood.
Numerator: 0.0..100.0
Denominator: 100.0..100.0
Assumed value: false
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| ptcCO2 | ptcCO2: Measured via transcutaneous electrode oximetry, the partial pressure of carbon dioxide in the peripheral blood.
Numerator: 0.0..100.0
Denominator: 100.0..100.0
Assumed value: false
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| Waveform | Waveform: A waveform reading associated with the oximetry measurement.
Include:
openEHR-EHR-CLUSTER.waveform.v1 and specialisations |
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| Multimedia image | Multimedia image: Details of a series of oximetry readings, other than waveforms, expressed as a multimedia image or series of images. Waveforms should be recorded using the Waveform slot and associated cluster archetype. |
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| Comment | Comment: A text comment about the indirect oximetry result. |
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| Other contributors | Marja Buur, Medisch Centrum Alkmaar, Netherlands
Sergio Carmona, Chile
Stephen Chu, NeHTA, Australia
Tamsin Cockayne, Australia
Ed Conley, Cardiff University
Graham Denyer, Australian Antarctic Division, Australia
Paul Donaldson, Nursing Informatics Australia, Australia
Shahla Foozonkhah, Ocean Informatics, Australia
Sebastian Garde, Ocean Informatics, Germany (Editor)
Sam Heard, Ocean Informatics, Australia
Karsten Heusser, Hannover Medical School, Germany
Omer Hotomaroglu, Turkey (Editor)
Evelyn Hovenga, EJSH Consulting, Australia
Pieter Hummel, Medisch Centrum Alkmaar, Netherlands
Eugene Igras, IRIS Systems, Inc., Canada
Sundaresan Jagannathan, Scottish NHS, United Kingdom
Gorazd Kalan, University Medical Centre Ljubljana, Slovenia
Heather Leslie, Ocean Informatics, Australia (Editor)
Rikard Lovstrom, Swedish Medical Association, Sweden
Ian McNicoll, Ocean Informatics, United Kingdom (Editor)
Jeroen Meintjens, Medisch Centrum Alkmaar, Netherlands
Udo Müller, CompuGROUP Software, Germany
Andrej Orel, Marand d.o.o., Slovenia
Arturo Romero, SESCAM, Spain
Tony Shannon, NHS, United Kingdom |
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| Translators | German: Jasmin Buck, Sebastian Garde, University of Heidelberg, Central Queensland University
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