I am impressed by Tom's dedictaiton to detail!! but I'm not sure that, at least in GP-land, such considerations of variations in cuff-size definition amount to very much when set against the huge number of other confounding variables such as patient anxiety/anger, doctors rounding down to the nearest 10mmHg, constricting clothing etc,etc,etc
I am happy with the broad defs of cuff sizes and don't feel we need to be, or indeed can be, overly precise in this area. Ian On Jan 4, 2008 6:34 PM, Melvin Reynolds <melvin_r at amsc.demon.co.uk> wrote: > 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)orSmall 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 > > > >********************************************************************** > >Thismessagemaycontainconfidentialandprivilegedinformation. > >Ifyouarenottheintendedrecipientpleaseacceptourapologies. > >Pleasedonotdisclose,copyordistributeinformationinthise-mail > >ortakeanyactioninrelianceonitscontents:todosoisstrictly > >prohibitedandmaybeunlawful.Pleaseinformusthatthismessagehas > >goneastraybeforedeletingit.Thankyouforyourco-operation. > > > >NHSmailisuseddailybyover100,000staffintheNHS.Overamillion > >messagesaresenteverydaybythesystem.Tofindoutwhymoreand > >moreNHSpersonnelareswitchingtothisNHSConnectingforHealth > >systempleasevisitwww.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 > . . . . . . . VOIP - skypeID: melvinreynolds . . . . . . > ----------------------------------------------------------------------- > The information contained in this e-mail may be confidential and / or > copyright, and intended only for named recipient(s). If you have > received it indirectly or in error please do not copy, distribute, > take any action on, or rely on, the content; check authority for use > with postmaster at ams-consulting.co.uk > > _______________________________________________ > openEHR-clinical mailing list > openEHR-clinical at openehr.org > http://lists.chime.ucl.ac.uk/mailman/listinfo/openehr-clinical > -- Dr Ian McNicoll office +44(0)141 560 4657 fax +44(0)141 560 4657 mobile +44 (0)775 209 7859 skype ianmcnicoll Consultant - Ocean Informatics ian.mcnicoll at oceaninformatics.com Consultant - IRIS GP Accounts Member of BCS Primary Health Care Specialist Group ? http://www.phcsg.org -------------- next part -------------- An HTML attachment was scrubbed... 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