Dear Tom, I agree with your observations - especially about the variation in sizing description.
The snag, in use, is that a neonatal arm cuff works nicely on an adult finger, an adult thigh cuff equally nicely on a large adult arm, etc. So, in order to be sure that the clinical focus is adequately fulfilled, it may be necessary (perhaps only by exception) to drill back to operational data that provides, site of measurement, weight /age of patient at time of measurement, measurement technology used (oscillometric, doppler, auscultatory,...), etc. As someone else observed on this list a while back - you could spend (and I have) your life in this quagmire. The key thing seems to be getting enough (defined by use case / archetype) clinical information into the long-term record, whilst ensuring that the operational data is accessible and semantically comparable if required. That's where the SNOMED enterprise environment needs to have clean link (as being investigated in the IOTA work) to the more granular operational EN ISO/IEEE 11073 semantics of devices - and thence into clusters and archetypes? Oh, and then the different regulatory and 'ordering' semantics have to be accommodated... joy! Regards, Melvin. In mail of Fri, 4 Jan 2008 12:00:06, openehr-clinical-request at openehr.org wrote: >Send openEHR-clinical mailing list submissions to > openehr-clinical at openehr.org > >To subscribe or unsubscribe via the World Wide Web, visit > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical >or, via email, send a message with subject or body 'help' to > openehr-clinical-request at openehr.org > >You can reach the person managing the list at > openehr-clinical-owner at openehr.org > >When replying, please edit your Subject line so it is more specific >than "Re: Contents of openEHR-clinical digest..." >Today's Topics: > > 1. RE: BP cuff sizes (Tom Seabury (NHS Connecting for Health)) >From: "Tom Seabury \(NHS Connecting for Health\)" <tom.seabury at nhs.net> >Precedence: list >MIME-Version: 1.0 >To: "'For openEHR clinical discussions'" <openehr-clinical at openehr.org> >References: <006e01c81fcc$f5681e50$e0385af0$@leslie at >oceaninformatics.com><002601c82000$d60c5380$4001a8c0 at D15RBL0J> > <006901c82056$669b28e0$33d17aa0$@leslie at oceaninformatics.com> >In-Reply-To: <006901c82056$669b28e0$33d17aa0$@leslie at oceaninformatics.com> >Date: Fri, 4 Jan 2008 11:30:04 -0000 >Reply-To: tom.seabury at nhs.net, > For openEHR clinical discussions <openehr-clinical at openehr.org> >Message-ID: <016f01c84ec5$27392740$5392d20a at npfit.nhs.uk> >Content-Type: multipart/alternative; > boundary="----=_NextPart_000_0170_01C84EC5.27392740" >Subject: RE: BP cuff sizes >Message: 1 > >Hi Heather, >? >Just a (non clinician's) note on the cuff size issue. >? >The clinical focus for recording cuff sizes seems to be :- >- The clinical need to demonstrate the measurements were performed >appropriately, or not. >- The ability to replicate measurement methods >- Clinical audit >I suggest >1/ 'Adult' should not be use but rather 'Standard adult'. >2/ The addition of Extra Large adult?? (per previous communications) >? >? >Finally, its worth noting that the dimensional ranges which these >classes map to are different depending not least on the manufacturer >e.g >Classified Size Ranges: >Small adult (17-22)?or?Small adult 22-26 or Small adult (18-26) >Standard adult (22-32)??or Adult 27-34 or Medium adult (26-34) or Standard >adults (27.5-36.5) >Large adult (32-42)?or Large Adult 35-44 or Large adult (34-43) or >Large adults (35-46) >?.. etc. >Tom Seabury >? >From: openehr-clinical-bounces at openehr.org >[mailto:openehr-clinical-bounces at openehr.org] On Behalf Of Heather >Leslie >Sent: 06 November 2007 09:21 >To: 'For openEHR clinical discussions' >Subject: RE: BP cuff sizes >Thanks Ian and Jag ? clearly the Scots are experts on BP cuff sizes, or >just modelling similar things to me! > >? >Cheers >? >Heather >? > >From: openehr-clinical-bounces at openehr.org >[mailto:openehr-clinical-bounces at openehr.org] On Behalf Of Dr.S.Jagannathan >Sent: Monday, 5 November 2007 11:09 PM >To: 'For openEHR clinical discussions' >Subject: RE: BP cuff sizes >? >Hi Heather > >The attatched reference from The American Heart Association may be of >some help. >Hope you are well >Regards >Jag > > -----Original Message----- > From: openehr-clinical-bounces at openehr.org > [mailto:openehr-clinical-bounces at openehr.org] On Behalf Of Heather > Leslie > Sent: 05 November 2007 16:57 > To: openEHR clinical list > Subject: BP cuff sizes > Hi all, > ? > Advice from clever clinicians please: > ? > In OBSERVATION.blood_pressure.v1 BP cuff sizes are currently: > > ????????? Neonatal > > ????????? Paediatric > > ????????? Adult > > ????????? Wide adult > > ????????? Thigh > > ? > I?m wondering if they should be slightly different ie: > > ????????? neonatal, > > ????????? infant, > > ????????? child and/or paediatric, > > ????????? small adult, > ????????? adult, and > > ????????? large adult (or thigh) cuff > > ? > Can anyone clarify for me? > ? > Thanks > > ? > Heather > ? > _____________________________________________ > > Dr Heather Leslie > Director of Clinical Modeling > Ocean Informatics > > M +61 418 966 670 (in Australia) > M +44 7722 064 546 (in UK) > Skype - heatherleslie > ? > >__________ NOD32 2630 (20071031) Information __________ >This message was checked by NOD32 antivirus system. >http://www.eset.com > >********************************************************************** >This?message??may??contain??confidential??and??privileged?information. >If?you?are?not??the?intended??recipient?please??accept?our??apologies. >Please?do?not?disclose,?copy?or?distribute??information?in?this?e-mail >or?take?any??action?in?reliance?on?its??contents:?to?do?so?is?strictly >prohibited?and?may?be?unlawful.?Please?inform?us?that?this?message?has >gone??astray??before??deleting?it.??Thank??you?for??your?co-operation. >? >NHSmail?is?used?daily?by?over?100,000?staff?in?the?NHS.?Over?a?million >messages??are?sent?every?day?by?the?system.??To?find??out?why?more?and >more?NHS?personnel?are??switching?to??this?NHS??Connecting??for?Health >system?please?visit?www.connectingforhealth.nhs.uk/nhsmail >********************************************************************** >_______________________________________________ >openEHR-clinical mailing list >openEHR-clinical at openehr.org >http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical -- Melvin I REYNOLDS, Vice-Chair, CEN TC251: Health Informatics Co-Chair, IEEE EMBS 11073: Medical Device Communication Convenor, CEN TC251/WGIV: Health Informatics - Devices Convenor, ISO TC215/TG-PHI: Health Informatics - Personal Health Secretary, ISO TC215/WG 7: Health Informatics - Devices Organising Member: ITU/WHO eHealth Standards Co-ordination Group Member: ISO/IEC/ITU Health Technology Task Force, CEN: Advisory Board for Health Standards, BSI: IST35/-, -/1 and -/4, CH62/-, CH100/- HL7: -UK, -CBH SIG, -GAS SIG, -DEV SIG, IEC: SC62A -JWG6 and -JWG7, IHE: -UK, -PCD. ~ Setting Standards for Information, Management & Technology in Care ~ AMS Consulting ~ Ashcote ~ Walford Road ~ Ross-on-Wye ~ HR9 5PQ ~ UK email: melvinr at ams-consulting.co.uk . . . . fax: +44 (0)8700 547 303 phone: +44 (0)1989 763 120 . . . . . . mobile: +44 (0)7831 517 803 . . . . . . . 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