<?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 with Details</b></p><p><b>id</b>: 20minute-apgar-score</p><p><b>contained</b>: </p><p><b>status</b>: final</p><p><b>category</b>: Survey <span>(Details : {http://terminology.hl7.org/CodeSystem/observation-category code &#39;survey&#39; = &#39;Survey&#39;, given as &#39;Survey&#39;})</span></p><p><b>code</b>: 20 minute Apgar Score <span>(Details : {SNOMED CT code &#39;443849008&#39; = &#39;Apgar score at 20 minutes&#39;, given as &#39;Apgar score at 20 minutes&#39;})</span></p><p><b>subject</b>: id: newborn; 12345; active; Peter James Chalmers ; gender: male; birthDate: 18/05/2016</p><p><b>effective</b>: 18/05/2016 10:33:22 PM</p><p><b>performer</b>: <a>Practitioner/example</a></p><p><b>value</b>: 10 {score}<span> (Details: UCUM code {score} = &#39;{score}&#39;)</span></p><blockquote><p><b>component</b></p><p><b>code</b>: Apgar color score <span>(Details : {SNOMED CT code &#39;249227004&#39; = &#39;Apgar color score&#39;, given as &#39;Apgar color score&#39;})</span></p><p><b>value</b>: 2. Good color all over <span>(Details : {LOINC code &#39;LA6724-4&#39; = &#39;Good color all over&#39;, given as &#39;Good color all over&#39;}; {http:/acme.ped/apgarcolor code &#39;2&#39; = &#39;2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span>(Details : {SNOMED CT code &#39;249223000&#39; = &#39;Apgar heart rate score&#39;, given as &#39;Apgar heart rate score&#39;})</span></p><p><b>value</b>: 2. At least 100 beats per minute <span>(Details : {LOINC code &#39;LA6718-6&#39; = &#39;At least 100 beats per minute&#39;, given as &#39;At least 100 beats per minute&#39;}; {http:/acme.ped/apgarheartrate code &#39;2&#39; = &#39;2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar response to stimulus score <span>(Details : {SNOMED CT code &#39;249226008&#39; = &#39;Apgar response to stimulus score&#39;, given as &#39;Apgar response to stimulus score&#39;})</span></p><p><b>value</b>: 2. Grimace and pulling away, cough, or sneeze during suctioning <span>(Details : {LOINC code &#39;LA6721-0&#39; = &#39;Grimace and pulling away, cough, or sneeze during suctioning&#39;, given as &#39;Grimace and pulling away, cough, or sneeze during suctioning&#39;}; {http:/acme.ped/apgarreflexirritability code &#39;2&#39; = &#39;2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar muscle tone score <span>(Details : {SNOMED CT code &#39;249225007&#39; = &#39;Apgar muscle tone score&#39;, given as &#39;Apgar muscle tone score&#39;})</span></p><p><b>value</b>: 2. Active motion <span>(Details : {LOINC code &#39;LA6715-2&#39; = &#39;Active motion&#39;, given as &#39;Active motion &#39;}; {http:/acme.ped/apgarmuscletone code &#39;2&#39; = &#39;2)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: Apgar respiratory effort score <span>(Details : {SNOMED CT code &#39;249224006&#39; = &#39;Apgar respiratory effort score&#39;, given as &#39;Apgar respiratory effort score&#39;})</span></p><p><b>value</b>: 2. Good, strong cry; normal rate and effort of breathing <span>(Details : {LOINC code &#39;LA6727-7&#39; = &#39;Good, strong cry; normal rate and effort of breathing&#39;, given as &#39;Good, strong cry; normal rate and effort of breathing    &#39;}; {http:/acme.ped/apgarrespiratoryeffort code &#39;2&#39; = &#39;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/iso21090-ordinal-value">
					<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/iso21090-ordinal-value">
					<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/iso21090-ordinal-value">
					<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/iso21090-ordinal-value">
					<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/iso21090-ordinal-value">
					<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>