Allergyintolerance-example.xml

A typical Food Allergy (id = "example")

<AllergyIntolerance xmlns="http://hl7.org/fhir">
  <id value="example"/>

  <!--    an identifier used for this allergic propensity (adverse reaction risk)    -->
  <text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: example</p><p><b>identifier</b>: 49476534</p><p><b>status</b>: confirmed</p><p><b>type</b>: allergy</p><p><b>category</b>: food</p><p><b>criticality</b>: high</p><p><b>substance</b>: Cashew nuts <span>(Details : {SNOMED CT code '227493005' = 'Cashew nut (substance)', given as 'Cashew nuts'})</span></p><p><b>patient</b>: <a>Patient/example</a></p><p><b>recordedDate</b>: 09/10/2014 2:58:00 PM</p><p><b>recorder</b>: <a>Practitioner/example</a></p><p><b>reporter</b>: <a>Patient/example</a></p><p><b>onset</b>: 01/01/2004</p><p><b>lastOccurence</b>: 01/06/2012</p><p><b>note</b>: The criticality is high becasue of the observed anaphylactic reaction when challenged
         with cashew extract.</p><blockquote><p><b>reaction</b></p><p><b>substance</b>: cashew nut allergenic extract Injectable Product <span>(Details : {RxNorm code 'C3214954' = '??', given as 'cashew nut allergenic extract Injectable
             Product'})</span></p><p><b>certainty</b>: confirmed</p><p><b>manifestation</b>: Anaphylactic reaction <span>(Details : {SNOMED CT code '39579001' = 'Anaphylaxis (disorder)', given as 'Anaphylactic
             reaction'})</span></p><p><b>description</b>: Challenge Protocol. Severe reaction to subcutaneous cashew extract. Epinephrine administered</p><p><b>onset</b>: 12/06/2012</p><p><b>severity</b>: severe</p><p><b>exposureRoute</b>: Subcutaneous route <span>(Details : {SNOMED CT code '34206005' = 'Subcutaneous route (qualifier value)', given
             as 'Subcutaneous route'})</span></p></blockquote><blockquote><p><b>reaction</b></p><p><b>certainty</b>: likely</p><p><b>manifestation</b>: Urticaria <span>(Details : {SNOMED CT code '64305001' = 'Urticaria (morphologic abnormality)', given as
             'Urticaria'})</span></p><p><b>onset</b>: 01/01/2004</p><p><b>severity</b>: moderate</p><p><b>note</b>: The patient reports that the onset of urticaria was within 15 minutes of eating cashews.</p></blockquote></div></text><identifier>
    <system value="http://acme.com/ids/patients/risks"/>
    <value value="49476534"/>
  </identifier>

  <!--    this individual has had several reactions    --> 
  <status value="confirmed"/>

  <!--    note: it's often unknown whether an allergy is mediated by an immune response, and
   not as significant as once thought    -->
  <type value="allergy"/>
  
  <!--    this categorisation is implied by "cashew nut" and therefore basically 
    redundant, but many systems collect this field anyway, since it's either 
    useful when the substance is not coded, or it's quicker to sort/filter on
    than using terminology based reasoning    -->
  <category value="food"/>
  
  <!--    there is no question that the allergy is real and serious    --> 
  <criticality value="high"/>
  
  <!--    substance - either coded, or text. A few times, 
    there's a full description of a complex substance - in these caes, use the
    extension [url] to refer to a Substance resource    -->
  <substance>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="227493005"/>
      <display value="Cashew nuts"/>
    </coding>
  </substance>
 
  <!--    the patient that actually has the risk of adverse reaction    -->
  <patient>
    <reference value="Patient/example"/>
  </patient>

  <!--    the date that this entry was recorded    -->  
  <recordedDate value="2014-10-09T14:58:00+11:00"/>
  
  <!--    who made the record / last updated it    -->
  <recorder>
    <reference value="Practitioner/example"/>
  </recorder>
  
  <!--    the patient is the reporter in this case    -->
  <reporter>
    <reference value="Patient/example"/>
  </reporter>

  <!--    when the allergy was first noted (in this case the same as reaction.onset of the first
   occurrence)    --> 
  <onset value="2004"/>

  <!--    last happened June 2012. Typically, systems either track lastOccurence,
     or a list of events.    -->
  <lastOccurence value="2012-06"/>
  
  <!--    an additional note about the allergy propensity by the recorder    -->
  <note>
    <text value="The criticality is high becasue of the observed anaphylactic reaction when challenged
     with cashew extract."/>
  </note>  
  
  <!--    past events. There's no claim that this is all the events, and 
     that should not be assumed    -->
  <reaction> 
    <!--    
      It's possible to list specific things to which the patient responded,
      e.g. chocolate (that happened to contain cashew nuts). This event has
      such a specific substance. Note that systems should ensure that what
      goes in here does not conflict with the substance above, and systems
      processing the data can be sure that what is here does not contravene
      the substance above
       -->
    <substance>
      <coding>
        <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
        <code value="C3214954"/>
        <display value="cashew nut allergenic extract Injectable Product"/>
      </coding>  
    </substance>
    <certainty value="confirmed"/>
    <manifestation>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="39579001"/>
        <display value="Anaphylactic reaction"/>
      </coding>
    </manifestation>
    <description value="Challenge Protocol. Severe reaction to subcutaneous cashew extract. Epinephrine administered"/>
    <onset value="2012-06-12"/>
    <severity value="severe"/>
    <exposureRoute>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="34206005"/>
        <display value="Subcutaneous route"/>
      </coding>
    </exposureRoute>
  </reaction>

  <!--    this was the first occurrence    -->
  <reaction> 
    <certainty value="likely"/>
    <manifestation>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="64305001"/>
        <display value="Urticaria"/>
      </coding>
    </manifestation>
    <onset value="2004"/>
    <severity value="moderate"/>
    <!--    an additional note about the reaction by the recorder    -->
    <note>
      <text value="The patient reports that the onset of urticaria was within 15 minutes of eating cashews."/>
    </note>  
  </reaction>
  
</AllergyIntolerance>