WHO FHIR Implementation Guide (IG): Integrated Management of Childhood Illness (IMCI) in emergencies
0.1.0 - release

WHO FHIR Implementation Guide (IG): Integrated Management of Childhood Illness (IMCI) in emergencies, published by World Health Organization (WHO). This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-emcare/tree/feature/update-canonical and changes regularly. See the Directory of published versions

## Questionnaire: Ccc.B22.AssessmentsTests

Branch:

Profile: SDCBaseQuestionnaire

Structure

LinkID | Text | Cardinality | Type | Flags | Description & Constraints
--- | --- | --- | --- | --- | ---
Ccc.B22.AssessmentsTests |  |  | Questionnaire |  | https://smart.who.int/ccc/Questionnaire/Ccc.b22.assessmentstests#0.1.0
force-collection | null | 0..1 | boolean |  | Value Set:
AgeInMonths | null | 0..1 | integer |  | Value Set:
AgeInDays | null | 0..1 | integer |  | Value Set:
a-BreastFeedingTest | applicability-BreastFeedingTest | 0..1 | boolean |  | Value Set:
a-RespiratoryRate | applicability-RespiratoryRate | 0..1 | boolean |  | Value Set:
a-BronchodilatorTest | applicability-BronchodilatorTest | 0..1 | boolean |  | Value Set:
a-Hemoglobin | applicability-Hemoglobin | 0..1 | boolean |  | Value Set:
a-SecondTemperature | applicability-SecondTemperature | 0..1 | boolean |  | Value Set:
a-FluidTest | applicability-FluidTest | 0..1 | boolean |  | Value Set:
Ccc.B22.RespiratoryRate | null | 0..1 | group |  | Value Set:
Ccc.B22.DE01 | Respiratory Rate (breaths per minute) | 1..1 | quantity |  | Value Set:
Ccc.B22.DE01-help | <b>Count the number of breaths the child takes per minute</b> to determine if fast breathing is present.<br /> It is <b>very important that the child is calm</b> and still. If the child is moving or crying, you will not be able to get an accurate count of breaths. <br /> <b>To count the breaths per minute,</b> use a watch with a second hand or a digital watch. Look for the breathing movement anywhere on the child’s chest or abdomen. <br /> The number of breaths for <b>‘fast breathing’ depends on the child’s age.</b></p> <ul> <li>Under 2 months: More than 60 breaths per minute*</li> <li>2 to 11 months: More than 50 breaths per minute</li> <li>12 to 59 months: More than 40 breaths per minute</li> </ul> <p>*In young infants, a second measurement should be taken to confirm, unless there is already another sign of possible serious bacterial infection | 0..1 | display |  | Value Set:
Ccc.B22.DE02 | null | 0..* | choice |  | Value Set: Options: 1 option
second | null | 0..1 | group |  | Value Set:
Ccc.B22.DE04 | Respiratory Rate Second Count (breaths per minute) | 0..1 | quantity |  | Value Set:
Ccc.B22.DE04-help | <b>Count the number of breaths the child takes per minute</b> to determine if fast breathing is present.<br /> It is <b>very important that the child is calm</b> and still. If the child is moving or crying, you will not be able to get an accurate count of breaths. <br /> <b>To count the breaths per minute,</b> use a watch with a second hand or a digital watch. Look for the breathing movement anywhere on the child’s chest or abdomen. <br /> The number of breaths for <b>‘fast breathing’ depends on the child’s age.</b></p> <ul> <li>Under 2 months: More than 60 breaths per minute*</li> <li>2 to 11 months: More than 50 breaths per minute</li> <li>12 to 59 months: More than 40 breaths per minute</li> </ul> <p>*In young infants, a second measurement should be taken to confirm, unless there is already another sign of possible serious bacterial infection | 0..1 | display |  | Value Set:
Ccc.B22.DE05 | null | 0..* | choice |  | Value Set: Options: 1 option
Ccc.B22.DE07 | Fast Breathing | 0..1 | boolean |  | Value Set:
Ccc.B22.DE07-help | The number of breaths for <b>‘fast breathing’ depends on the child’s age.</b> * Under 2 months: More than 60 breaths per minute* * 2 to 11 months: More than 50 breaths per minute * 12 to 59 months: More than 40 breaths per minute *In young infants, a second measurement should be taken to confirm, unless there is already another sign of possible serious bacterial infection | 0..1 | display |  | Value Set:
Ccc.B22.FluidTest | null | 0..1 | group |  | Value Set:
Ccc.B22.DE08 | Oral Fluid Test Results | 1..1 | choice |  | Value Set: Options: 5 options
Ccc.B22.DE08-help | If a child is unconscious do not try to carry out an oral fluid test (Exact wording <span class="caps">TBC</span>) &#8211; Pop Up</p> <p>If a breastfeeding assessment and an Oral Fluid test is recommended for a child that is only breastfed then a pop up is required to ensure that the health care worker observes the signs for both and provides results for both tests. </p> <p>Oral Fluid Test<br /> If it is not possible to perform an oral fluid test, the health care worker should assume that the child is vomiting everything<br /> For a child under 6 months the health care worker can offer for the mother to breastfeed instead of receiving fluids</p> <p>Caution: Do not force fluids into an unconscious child , it can be dangerous. The fluid can cause them to choke or the fluid can go into their lungs. </p> <p>Pop up box to be made available with instructions on how to carry out an oral fluid test.<br /> Additional information <span class="caps">TBC</span> | 0..1 | display |  | Value Set:
Ccc.B22.DE14 | null | 1..* | choice |  | Value Set: Options: 1 option
Ccc.B22.DE14a | Completely Unable to Drink or Vomits Immediately / Everything | 0..1 | boolean |  | Value Set:
Ccc.B22.DE15 | Has the Child had anything to drink today? | 0..1 | boolean |  | Value Set:
Ccc.B22.DE16 | How did the child last drink | 0..1 | choice |  | Value Set: Options: 5 options
Ccc.B22.BronchodilatorTest | null | 0..1 | group |  | Value Set:
Ccc.B22.DE17 | Inhaled Bronchodilator Trial Results | 0..* | choice |  | Value Set: Options: 5 options
Ccc.B22.DE17-help | Provide information on how to conduct an Inhaled Bronchodilator Trial as per <span class="caps">IMCI</span> training &#8211; <span class="caps">TBC</span> | 0..1 | display |  | Value Set:
Ccc.B22.DE22 | null | 0..* | choice |  | Value Set: Options: 1 option
Ccc.B22.DE21 | No Fast Breathing and No Chest Indrawing (post Inhaled Bronchodilator Trial) | 0..1 | boolean |  | Value Set:
Ccc.B22.BreastFeeding | null | 0..1 | group |  | Value Set:
Ccc.B22.DE27 | Breastfeeding Assessment | 0..1 | display |  | Value Set:
Ccc.B22.DE27-help | If a breastfeeding assessment and an Oral Fluid test is recommended for a child that is only breastfed then a pop up is required to ensure that the health care worker observes the signs for both and provides results for both tests. | 0..1 | display |  | Value Set:
Ccc.B22.DE41 | null | 0..* | choice |  | Value Set: Options: 1 option
Ccc.B22.DE28 | Breastfed in the previous hour | 1..1 | boolean |  | Value Set:
Ccc.B22.DE29 | Mother able to wait until young infant is willing to breastfeed again | 0..1 | boolean |  | Value Set:
Ccc.B22.DE30 | Mother reports difficulty breastfeeding | 1..1 | boolean |  | Value Set:
Ccc.B22.DE30-help | Provide information on what difficulty breastfeeding may include, such as: the infant feeds too often, doesn&#8217;t feed often enough, she does not have enough milk, her nipples are sore, or she has flat or inverted nipples. After feeds, the infant may be restless, cry or try to suckle again, or continue to breastfeed for a long time. | 0..1 | display |  | Value Set:
Ccc.B22.DE31 | Chin Touching Breast | 1..1 | boolean |  | Value Set:
Ccc.B22.DE32 | Mouth Wide Open | 1..1 | boolean |  | Value Set:
Ccc.B22.DE33 | Lower Lip Turned Outwards | 1..1 | boolean |  | Value Set:
Ccc.B22.DE34 | More Areola Visible above than below the Mouth | 1..1 | boolean |  | Value Set:
Ccc.B22.DE35 | Slow Deep Sucks, Sometimes Pausing | 1..1 | boolean |  | Value Set:
Ccc.B22.DE36 | Breastfeeding Assessment Results | 1..1 | string |  | Value Set:
Ccc.B22.DE37 | Not well Attached to Breast | 0..1 | boolean |  | Value Set:
Ccc.B22.DE38 | Good Attachment | 0..1 | boolean |  | Value Set:
Ccc.B22.DE39 | Not Sucking Effectively | 0..1 | boolean |  | Value Set:
Ccc.B22.DE40 | Sucking Effectively | 0..1 | boolean |  | Value Set:
Ccc.B22.DE42 | Difficulty Breastfeeding Reported | 0..1 | boolean |  | Value Set:
Ccc.B22.DE44 | Difficulty Breastfeeding Observed | 0..1 | boolean |  | Value Set:
Ccc.B22.Hemoglobin | null | 0..1 | group |  | Value Set:
Ccc.B22.DE81 | Hemoglobin (Hb) g/dL | 1..1 | quantity |  | Value Set:
Ccc.B22.DE82 | null | 1..* | choice |  | Value Set: Options: 1 option
Ccc.B22.SecondTemperature | null | 0..1 | group |  | Value Set:
Ccc.B22.DE47 | Axillary Temperature (second measurement) | 0..1 | quantity |  | Value Set:
Ccc.B22.DE47-help | The client&#8217;s axillary temperature in degrees Celcius (temperature taken under the armpit)<br /> Warning/error if above 45 and below 32 degrees Celcius. | 0..1 | display |  | Value Set:
Ccc.B22.DE46 | null | 0..* | choice |  | Value Set: Options: 1 option
Ccc.B22.DE50 | Measured Temperature (second measurement) | 0..1 | string |  | Value Set:
notesttodo | No assessments / tests to do | 0..1 | display |  | Value Set:
Respiratory Rate profile | null | 0..1 | quantity |  | Value Set:
Respiratory Rate Second Count Profile | null | 0..1 | quantity |  | Value Set:
Fast Breathing profile | null | 0..1 | boolean |  | Value Set:
DS | Danger Signs | 0..1 | boolean |  | Value Set:
Ccc.B7.DE09 | Not able to drink or breastfeed | 0..1 | boolean |  | Value Set:
Ccc.B7.DE10 | Vomiting Everything | 0..1 | boolean |  | Value Set:
timestamp | null | 0..1 | dateTime |  | Value Set:
Documentation for this format

Options Sets

Answer options for Ccc.B22.DE02

- null#Ccc.B22.DE02 ("Unable to perform Respiratory Rate at this time")

Answer options for Ccc.B22.DE05

- null#Ccc.B22.DE05 ("Respiratory Rate Second Count Not Possible")

Answer options for Ccc.B22.DE08

- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE09 ("Completely Unable to Drink")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE10 ("Vomits Immediately / Everything")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE11 ("Drinks Poorly")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE12 ("Drinks Eagerly / Thirstily")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE13 ("Drinks Normally")

Answer options for Ccc.B22.DE14

- null#Ccc.B22.DE14 ("Unable to Perform Oral Fluid Test")

Answer options for Ccc.B22.DE16

- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE09 ("Completely Unable to Drink")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE10 ("Vomits Immediately / Everything")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE11 ("Drinks Poorly")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE12 ("Drinks Eagerly / Thirstily")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE13 ("Drinks Normally")

Answer options for Ccc.B22.DE17

- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE18 ("Chest Indrawing (post inhaled bronchodilator trial)")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE19 ("Respiratory Rate (post inhaled bronchodilator trial)")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE20 ("Fast Breathing (post inhaled bronchodilator trial)")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE21 ("No Fast Breathing and No Chest Indrawing (post Inhaled Bronchodilator Trial)")
- https://smart.who.int/ccc/CodeSystem/Ccc-custom-codes#Ccc.B22.DE22 ("Inhaled Bronchodilator Trial Not Feasible or Available")

Answer options for Ccc.B22.DE22

- null#Ccc.B22.DE22 ("Inhaled Bronchodilator Trial Not Feasible or Available")

Answer options for Ccc.B22.DE41

- null#Ccc.B22.DE41 ("Breastfeeding Assessment Not Possible")

Answer options for Ccc.B22.DE82

- null#Ccc.B22.DE82 ("Hemoglobin Test Not Available")

Answer options for Ccc.B22.DE46

- null#Ccc.B22.DE46 ("Second Temperature Measurement Not Feasible")