description: 'This profile is for submitting the response scores of the Glasgow Coma Scale (GCS) measurement with the lowest total score during the first 24 hours of admission.\r\nThis includes: \r\n- Lowest eye response\r\n- Lowest motor response\r\n- Lowest verbal response'
package_name: niceprofiling.v23q1
derivation: constraint
name: NICE-GlasgowComaScale
type: Observation
elements:
  value:
    mustSupport: false
    choices: []
    index: 10
  related: {mustSupport: true, index: 12}
  component:
    mustSupport: true
    index: 13
    slicing:
      rules: open
      description: There are three aspects of behaviour that are independently measured as part of an assessment of a patient’s GCS – motor responsiveness, verbal performance and eye-opening.  The highest response from each category elicited by the healthcare professional is scored on the chart.
      min: null
      max: 1
      slices:
        gcsEyes:
          match: {}
          schema:
            mustSupport: true
            index: 14
            elements:
              code:
                elements:
                  coding:
                    elements:
                      system:
                        pattern: {type: Uri, value: 'http://loinc.org'}
                        index: 15
                      code:
                        pattern: {type: Code, value: 9267-6}
                        index: 16
              valueQuantity:
                type: Quantity
                index: 17
                slicing:
                  slices:
                    valueQuantity:
                      match: {}
                      schema:
                        type: Quantity
                        index: 17
                        elements:
                          value:
                            constraint:
                              valueRange: {human: The eyesight Glasgow Coma Scale ranges from 1 to 4, severity: error, expression: gcsEyes.valueQuantity.value >= 1.0 and gcsEyes.valueQuantity.value <= 4.0}
                            maxValueDecimal: 4.0
                            minValueDecimal: 1.0
                            index: 18
        gcsVerbal:
          match: {}
          schema:
            mustSupport: true
            index: 19
            elements:
              code:
                elements:
                  coding:
                    elements:
                      system:
                        pattern: {type: Uri, value: 'http://loinc.org'}
                        index: 20
                      code:
                        pattern: {type: Code, value: 9270-0}
                        index: 21
              valueQuantity:
                type: Quantity
                index: 22
                slicing:
                  slices:
                    valueQuantity:
                      match: {}
                      schema:
                        type: Quantity
                        index: 22
                        elements:
                          value:
                            constraint:
                              valueRange: {human: The verbal Glasgow Coma Scale ranges from 1 to 5, severity: error, expression: gcsVerbal.valueQuantity.value >= 1.0 and gcsVerbal.valueQuantity.value <= 5.0}
                            maxValueDecimal: 5.0
                            minValueDecimal: 1.0
                            index: 23
        gcsMotor:
          match: {}
          schema:
            mustSupport: true
            index: 24
            elements:
              code:
                elements:
                  coding:
                    elements:
                      system:
                        pattern: {type: Uri, value: 'http://loinc.org'}
                        index: 25
                      code:
                        pattern: {type: Code, value: 9268-4}
                        index: 26
              valueQuantity:
                type: Quantity
                index: 27
                slicing:
                  slices:
                    valueQuantity:
                      match: {}
                      schema:
                        type: Quantity
                        index: 27
                        elements:
                          value:
                            constraint:
                              valueRange: {human: The motor Glasgow Coma Scale ranges from 1 to 4, severity: error, expression: gcsMotor.valueQuantity.value >= 1.0 and gcsMotor.valueQuantity.value <= 6.0}
                            maxValueDecimal: 6.0
                            minValueDecimal: 1.0
                            index: 28
        gcsTotal:
          match: {}
          schema:
            mustSupport: false
            index: 29
            elements:
              valueQuantity:
                type: Quantity
                index: 30
                slicing:
                  slices:
                    valueQuantity:
                      match: {}
                      schema:
                        type: Quantity
                        index: 30
                        elements:
                          value:
                            constraint:
                              valueRange: {human: The total Glasgow Coma Scale ranges from 0.0 to 15.0, severity: error, expression: gcsTotal.valueQuantity.value >= 0.0 and gcsTotal.valueQuantity.value <= 15.0}
                            maxValueDecimal: 15.0
                            minValueDecimal: 0.0
                            index: 31
  extension:
    index: 0
    slicing:
      rules: open
      discriminator:
      - {path: url, type: value}
      min: 1
      slices:
        Verified:
          match: {url: null}
          schema: {type: Extension, short: 'Is the instance validated by a medical professional?', url: h, index: 1}
          min: 1
          max: 1
  effectiveDateTime:
    type: dateTime
    mustSupport: true
    index: 8
    slicing:
      slices:
        effectiveDateTime:
          match: {}
          schema: {type: dateTime, mustSupport: true, _required: true, index: 8}
          min: 1
  status:
    short: Validated (final)
    pattern: {type: Code, value: final}
    mustSupport: true
    index: 2
  code:
    mustSupport: true
    index: 3
    elements:
      coding:
        elements:
          system:
            pattern: {type: Uri, value: 'http://loinc.org'}
            index: 4
          code:
            pattern: {type: Code, value: 9269-2}
            index: 5
  context:
    type: Reference
    mustSupport: true
    refers: ['https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Encounter-2022Q1']
    index: 7
  subject:
    type: Reference
    mustSupport: true
    refers: ['https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Patient-2022Q1']
    index: 6
  dataAbsentReason: {mustSupport: true, index: 11}
package_version: 0.2.0
extensions:
  Verified: {url: h, min: 1, max: 1, type: Extension, short: 'Is the instance validated by a medical professional?', index: 1}
class: profile
kind: resource
url: https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-GlasgowComaScale-2022Q1
base: http://hl7.org/fhir/StructureDefinition/Observation
version: '1'
required: [effectiveDateTime, extension]