{
"description": "Questionnaire Instanz für das Erfassen von Intensivscores SAPS II und TISS",
"_filename": "examples/Questionnaire-Intensivscores.json",
"package_name": "basisprofil.tiplu.de.r4.dev",
"subjectType": [ "Patient" ],
"date": null,
"publisher": null,
"name": "Intensivscores_SAPS_TISS",
"item": [ {
"item": [ {
"text": "Datum",
"type": "date",
"linkId": "Datum",
"required": true
}, {
"text": "ID",
"type": "string",
"linkId": "Id"
}, {
"item": [ {
"item": [ {
"text": "Herzfrequenz",
"type": "choice",
"linkId": "Herzfrequenz_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "2",
"display": "2"
}
}, {
"valueCoding": {
"code": "4",
"display": "4"
}
}, {
"valueCoding": {
"code": "7",
"display": "7"
}
}, {
"valueCoding": {
"code": "11",
"display": "11"
}
} ]
}, {
"text": "Systolischer Blutdruck",
"type": "choice",
"linkId": "Systolischer_Blutdruck_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "2",
"display": "2"
}
}, {
"valueCoding": {
"code": "5",
"display": "5"
}
}, {
"valueCoding": {
"code": "13",
"display": "13"
}
} ]
}, {
"text": "Körpertemperatur",
"type": "choice",
"linkId": "Koerpertemperatur_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "3",
"display": "3"
}
} ]
}, {
"text": "PaO2/FiO2",
"type": "choice",
"linkId": "PaO2_FiO2_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "6",
"display": "6"
}
}, {
"valueCoding": {
"code": "9",
"display": "9"
}
}, {
"valueCoding": {
"code": "11",
"display": "11"
}
} ]
}, {
"text": "Ausfuhr Urin",
"type": "choice",
"linkId": "Ausfuhr_Urin_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "4",
"display": "4"
}
}, {
"valueCoding": {
"code": "11",
"display": "11"
}
} ]
}, {
"text": "Harnstoff im Serum",
"type": "choice",
"linkId": "Harnstoff_im_Serum_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "6",
"display": "6"
}
}, {
"valueCoding": {
"code": "10",
"display": "10"
}
} ]
}, {
"text": "Leukozyten",
"type": "choice",
"linkId": "Leukozyten_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "3",
"display": "3"
}
}, {
"valueCoding": {
"code": "12",
"display": "12"
}
} ]
}, {
"text": "Kalium im Serum",
"type": "choice",
"linkId": "Kalium_im_Serum_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "3",
"display": "3"
}
} ]
}, {
"text": "Natrium im Serum",
"type": "choice",
"linkId": "Natrium_im_Serum_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "1",
"display": "1"
}
}, {
"valueCoding": {
"code": "5",
"display": "5"
}
} ]
}, {
"text": "Bicarbonat im Serum",
"type": "choice",
"linkId": "Bicarbonat_im_Serum_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "3",
"display": "3"
}
}, {
"valueCoding": {
"code": "6",
"display": "6"
}
} ]
}, {
"text": "Bilirubin im Serum",
"type": "choice",
"linkId": "Bilirubin_im_Serum_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "4",
"display": "4"
}
}, {
"valueCoding": {
"code": "9",
"display": "9"
}
} ]
} ],
"text": "SAPS II: Für die medizinischen Messwerte jeweils zu vergebende Punkte",
"type": "group",
"linkId": "SAPS_Messwerte"
}, {
"item": [ {
"text": "Chronische Leiden",
"type": "choice",
"linkId": "ChronischeLeiden_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "9",
"display": "9"
}
}, {
"valueCoding": {
"code": "10",
"display": "10"
}
}, {
"valueCoding": {
"code": "17",
"display": "17"
}
} ]
}, {
"text": "Aufnahmestatus",
"type": "choice",
"linkId": "Aufnahmestatus_Punkte",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "6",
"display": "6"
}
}, {
"valueCoding": {
"code": "8",
"display": "8"
}
} ]
} ],
"text": "SAPS II: Für die Kriterien Chronische Leiden und Aufnahmestatus zu vergebende Punkte",
"type": "group",
"linkId": "SAPS_ChronischeLeiden"
}, {
"item": [ {
"text": "SAPS II: Für das Alter zu vergebende Punkte",
"type": "choice",
"linkId": "PunkteFuerAlter",
"initial": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
} ],
"answerOption": [ {
"valueCoding": {
"code": "0",
"display": "0"
}
}, {
"valueCoding": {
"code": "7",
"display": "7"
}
}, {
"valueCoding": {
"code": "12",
"display": "12"
}
}, {
"valueCoding": {
"code": "15",
"display": "15"
}
}, {
"valueCoding": {
"code": "16",
"display": "16"
}
}, {
"valueCoding": {
"code": "18",
"display": "18"
}
} ]
} ],
"text": "Weitere Kriterien",
"type": "group",
"linkId": "weitere_Punkte"
} ],
"text": "SAPS II",
"type": "group",
"linkId": "SAPS"
}, {
"item": [ {
"text": "Apparative Beatmung",
"type": "boolean",
"linkId": "Apparative_Beatmung",
"initial": [ {
"valueBoolean": false
} ]
}, {
"text": "Infusion multipler Katecholamine",
"type": "boolean",
"linkId": "Infusion_multipler_Katecholamine",
"initial": [ {
"valueBoolean": false
} ]
}, {
"text": "Flüssigkeitsersatz in hohen Mengen",
"type": "boolean",
"linkId": "Fluessigkeitsersatz_in_hohen_Mengen",
"initial": [ {
"valueBoolean": false
} ]
}, {
"text": "Peripherer arterieller Katheter",
"type": "boolean",
"linkId": "Peripherer_arterieller_Katheter",
"initial": [ {
"valueBoolean": false
} ]
}, {
"text": "Linksvorhof-Katheter/Pulmonalis-Katheter",
"type": "boolean",
"linkId": "Linksvorhof_Katheter_Pulmonalis_Katheter",
"initial": [ {
"valueBoolean": false
} ]
}, {
"text": "Hämofiltration/Dialyse",
"type": "boolean",
"linkId": "Haemofiltration_Dialyse",
"initial": [ {
"valueBoolean": false
} ]
}, {
"text": "Intrakranielle Druckmessung",
"type": "boolean",
"linkId": "Intrakranielle_Druckmessung",
"initial": [ {
"valueBoolean": false
} ]
}, {
"text": "Behandlung einer metabolischen Azidose/Alkalose",
"type": "boolean",
"linkId": "Behandlung_einer_metabolischen_Azidose_Alkalose",
"initial": [ {
"valueBoolean": false
} ]
}, {
"text": "Spezielle Interventionen auf der ITS (z.B. Tracheotomie, Kardioversion)",
"type": "boolean",
"linkId": "Spezielle_Interventionen_auf_der_ITS",
"initial": [ {
"valueBoolean": false
} ]
}, {
"text": "Aktionen außerhalb der Station (Diagnostik / Operation)",
"type": "boolean",
"linkId": "Aktionen_ausserhalb_der_Station",
"initial": [ {
"valueBoolean": false
} ]
} ],
"text": "TISS: Punkte pro Tag für die täglich zu erfassenden 10 aufwendigsten Leistungen",
"type": "group",
"linkId": "TISS"
} ],
"text": "Berechnung der Aufwandspunkte für die Intensivmedizinische Komplexbehandlung bei Erwachsenen (SAPS, TISS)",
"type": "group",
"linkId": "Intensivscores"
} ],
"type": null,
"experimental": null,
"resourceType": "Questionnaire",
"title": "Intensivscores (SAPS/TISS)",
"package_version": "1.0.0",
"status": "active",
"id": "e507b805-0dd3-4521-b91d-7101e71cf744",
"kind": null,
"url": "https://tiplu.de/fhir/Questionnaire/intensiv-scores",
"version": "1.0.0"
}