Guia de Implementação do Registro de Atendimento Clínico (RAC) da RNDS
1.0.0 - CI Build BR

!!Guia de Implementação do Registro de Atendimento Clínico (RAC) da RNDS - Compilação de desenvolvimento local (v1.0.0) construída pelas ferramentas de compilação FHIR (HL7® FHIR® Standard). Veja o Diretório de versões publicadas

Resource Profile: BRAlergiaReacaoAdversa - Detailed Descriptions

Page standards status: Informative Maturity Level: 1

Definitions for the BRAlergiaReacaoAdversa-1.0 resource profile.

Instruções sobre como interpretar o conteúdo desta tabela podem ser encontradashere

0. AllergyIntolerance
Definição

Reatividade alterada a um antígeno pode resultar em reações patológicas consequentes à exposição subsequente àquele antígeno particular.


Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.

CurtoAlergia ou Reação AdversaAllergy or Intolerance (generally: Risk of adverse reaction to a substance)
Comentários

Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.

Controlo0..*
É modificadorfalse
Deve apoiartrue
Resumofalse
Nomes alternativosAllergy, Intolerance, Adverse Reaction
Invariantesait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. (verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists())
ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty())
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
dom-6: A resource should have narrative for robust management (text.`div`.exists())
ait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. (verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists())
ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty())
2. AllergyIntolerance.implicitRules
Definição

A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

CurtoA set of rules under which this content was created
Comentários

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

Controlo0..1
Tipouri
É modificadortrue porque This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
4. AllergyIntolerance.contained
Definição

These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

CurtoContained, inline Resources
Comentários

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

Controlo0..0*
TipoResource
É modificadorfalse
Resumofalse
Nomes alternativosinline resources, anonymous resources, contained resources
6. AllergyIntolerance.modifierExtension
Definição

May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

CurtoExtensions that cannot be ignored
Comentários

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Controlo0..*
TipoExtension
É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
Resumofalse
Requisitos

Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

Nomes alternativosextensions, user content
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
8. AllergyIntolerance.identifier
Definição

Business identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

CurtoExternal ids for this item
Comentários

This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
Controlo0..0*
TipoIdentifier
É modificadorfalse
Resumotrue
Requisitos

Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
10. AllergyIntolerance.clinicalStatus
Definição

The clinical status of the allergy or intolerance.

Curtoactive | inactive | resolved
Comentários

Refer to discussion if clincalStatus is missing data. The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

Controlo0..1
Este elemento é afetado pelas seguintes invariantes: ait-1, ait-2
VínculoOs códigos DEVERÃO ser retirados de AllergyIntoleranceClinicalStatusCodeshttp://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1
(required to http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1)

The clinical status of the allergy or intolerance.

TipoCodeableConcept
É modificadortrue porque This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as no longer active.
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
12. AllergyIntolerance.verificationStatus
Definição

Indica o grau de certeza que se possui ao avaliar uma alergia ou reação adversa.


Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).

CurtoGrau de Certezaunconfirmed | confirmed | refuted | entered-in-error
Comentários

The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

Controlo0..1
Este elemento é afetado pelas seguintes invariantes: ait-1, ait-2
VínculoOs códigos DEVERÃO ser retirados de Grau de Certeza de Alergias e Reações Adversashttp://hl7.org/fhir/ValueSet/allergyintolerance-verification|4.0.1
(required to http://www.saude.gov.br/fhir/r4/ValueSet/BRGrauCertezaAlergiasReacoesAdversas-1.0)

Grau de Certeza de Alergias e Reações Adversas


Assertion about certainty associated with a propensity, or potential risk, of a reaction to the identified substance.

TipoCodeableConcept
É modificadortrue porque This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.
Deve apoiartrue
Resumotrue
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
14. AllergyIntolerance.verificationStatus.coding
Definição

A reference to a code defined by a terminology system.

CurtoCode defined by a terminology system
Comentários

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Controlo10..1*
TipoCoding
É modificadorfalse
Resumotrue
Requisitos

Allows for alternative encodings within a code system, and translations to other code systems.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
16. AllergyIntolerance.verificationStatus.coding.system
Definição

The identification of the code system that defines the meaning of the symbol in the code.

CurtoIdentity of the terminology system
Comentários

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Controlo10..1
Tipouri
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

Need to be unambiguous about the source of the definition of the symbol.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
18. AllergyIntolerance.verificationStatus.coding.code
Definição

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

CurtoSymbol in syntax defined by the system
Controlo10..1
Tipocode
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

Need to refer to a particular code in the system.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
20. AllergyIntolerance.verificationStatus.coding.display
Definição

A representation of the meaning of the code in the system, following the rules of the system.

CurtoRepresentation defined by the system
Controlo0..01
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
22. AllergyIntolerance.verificationStatus.coding.userSelected
Definição

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

CurtoIf this coding was chosen directly by the user
Comentários

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Controlo0..01
Tipoboolean
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
24. AllergyIntolerance.verificationStatus.text
Definição

A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

CurtoPlain text representation of the concept
Comentários

Very often the text is the same as a displayName of one of the codings.

Controlo0..01
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
26. AllergyIntolerance.type
Definição

Tipo de mecanismos fisiológico subjacente à reação. allergy: alergia intolerance: intolerância


Identification of the underlying physiological mechanism for the reaction risk.

CurtoTipo de Reaçãoallergy | intolerance - Underlying mechanism (if known)
Comentários

Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.

Controlo0..1
VínculoOs códigos DEVERÃO ser retirados de AllergyIntoleranceTypehttp://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1
(required to http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1)

Identification of the underlying physiological mechanism for a Reaction Risk.

Tipocode
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Deve apoiartrue
Resumotrue
Nomes alternativosCategory, Class
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
28. AllergyIntolerance.category
Definição

Categoriza a substância responsável por causar uma alergia ou reação adversa.


Category of the identified substance.

CurtoCategoria do Agente Causadorfood | medication | environment | biologic
Comentários

This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender.

Controlo10..1*
VínculoOs códigos DEVERÃO ser retirados de Categoria do Agente da Alergia ou Reação Adversahttp://hl7.org/fhir/ValueSet/allergy-intolerance-category|4.0.1
(required to http://www.saude.gov.br/fhir/r4/ValueSet/BRCategoriaAgenteAlergiasReacoesAdversas-1.0)

Categoria do Agente da Alergia ou Reação Adversa


Category of an identified substance associated with allergies or intolerances.

Tipocode
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Deve apoiartrue
Resumotrue
Nomes alternativosCategory, Type, Reaction Type, Class
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
30. AllergyIntolerance.criticality
Definição

Estimativa da criticidade do dano clínico ou gravidade da reação a uma substância identificada.


Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.

CurtoCriticidadelow | high | unable-to-assess
Comentários

The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.

Controlo0..1
VínculoOs códigos DEVERÃO ser retirados de Criticidade de Alergias e Reações Adversashttp://hl7.org/fhir/ValueSet/allergy-intolerance-criticality|4.0.1
(required to http://www.saude.gov.br/fhir/r4/ValueSet/BRCriticidadeAlergiasReacoesAdversas-1.0)

Criticidade


Estimate of the potential clinical harm, or seriousness, of a reaction to an identified substance.

Tipocode
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Deve apoiartrue
Resumotrue
Nomes alternativosSeverity, Seriousness, Contra-indication, Risk
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
32. AllergyIntolerance.code
Definição

Agente ou substância específica responsável pela alergia ou reação adversa.


Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies"). Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance.

CurtoAgente ou SubstânciaCode that identifies the allergy or intolerance
Comentários

It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.

When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship.

The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.

Controlo10..1
VínculoOs códigos DEVERÃO ser retirados de Para exemplos de códigos, ver Alérgenoshttp://hl7.org/fhir/ValueSet/allergyintolerance-code
(required to http://www.saude.gov.br/fhir/r4/ValueSet/BRAlergenos-1.0)

Alérgenos


Type of the substance/product, allergy or intolerance condition, or negation/exclusion codes for reporting no known allergies.

TipoCodeableConcept
É modificadorfalse
Deve apoiartrue
Resumotrue
Requisitos

Pode utilizar a descrição em texto livre, no elemento text, ou texto codificado utilizando o Catálogo Brasileiro de Alergias e Reações Adversas - CBARA (preferencial).

Nomes alternativosCode
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
34. AllergyIntolerance.code.coding
Definição

Texto codificado do agente ou substância causador da alergia ou reação adversa.


A reference to a code defined by a terminology system.

CurtoAgente ou Substância CodificadaCode defined by a terminology system
Comentários

Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

Controlo0..1*
TipoCoding
É modificadorfalse
Deve apoiartrue
Resumotrue
Requisitos

Allows for alternative encodings within a code system, and translations to other code systems.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
36. AllergyIntolerance.code.coding.system
Definição

The identification of the code system that defines the meaning of the symbol in the code.

CurtoIdentity of the terminology system
Comentários

The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

Controlo10..1
Tipouri
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

Need to be unambiguous about the source of the definition of the symbol.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
38. AllergyIntolerance.code.coding.code
Definição

A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

CurtoSymbol in syntax defined by the system
Controlo10..1
Tipocode
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

Need to refer to a particular code in the system.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
40. AllergyIntolerance.code.coding.display
Definição

A representation of the meaning of the code in the system, following the rules of the system.

CurtoRepresentation defined by the system
Controlo0..01
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
42. AllergyIntolerance.code.coding.userSelected
Definição

Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

CurtoIf this coding was chosen directly by the user
Comentários

Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

Controlo0..01
Tipoboolean
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Resumotrue
Requisitos

This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
44. AllergyIntolerance.code.text
Definição

Descrição em texto livre do agente ou substância causador da alergia ou reação adversa.


A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

CurtoAgente ou Substância em Texto LivrePlain text representation of the concept
Comentários

Very often the text is the same as a displayName of one of the codings.

Controlo0..1
Tipostring
É modificadorfalse
Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
Deve apoiartrue
Resumotrue
Requisitos

Um e somente um agente ou substância deve ser informado em cada recurso de AllergyIntolerance que compor um documento. Ou seja, na hipótese de se informar mais de um agente ou substância, deve ser enviado um recurso AllergyIntolerance para cada um deles no documento.


The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
46. AllergyIntolerance.patient
Definição

Indivíduo que possui a alergia ou reação adversa.


The patient who has the allergy or intolerance.

CurtoIndivíduoWho the sensitivity is for
Controlo1..1
TipoReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0, Patient)
É modificadorfalse
Deve apoiartrue
Resumotrue
Nomes alternativosPatient
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
48. AllergyIntolerance.patient.extension
Definição

An Extension


May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

CurtoExtensionAdditional content defined by implementations
Comentários

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Controlo0..*
TipoExtension
É modificadorfalse
Resumofalse
Nomes alternativosextensions, user content
Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.patient.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
  • value @ url
  • 50. AllergyIntolerance.patient.extension:unidentifiedPatient
    Nome da fatiaunidentifiedPatient
    Definição

    Informações demográficas básicas e justificativa dos indivíduos que não podem ser identificados por razões clínicas ou sociais, conforme legislação brasileira, com finalidade estatística.

    CurtoDados do Indivíduo Não Identificado
    Controlo0..1
    TipoExtension(Informações Complementares de Indivíduos Não Identificados) (Extensão complexa)
    É modificadorfalse
    Deve apoiartrue
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    52. AllergyIntolerance.patient.extension:unidentifiedPatient.extension
    Definição

    An Extension


    May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

    CurtoExtensionAdditional content defined by implementations
    Comentários

    There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

    Controlo30..3*
    TipoExtension
    É modificadorfalse
    Resumofalse
    Nomes alternativosextensions, user content
    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
    SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.patient.extension.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
    • value @ url
    • 54. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:gender
      Nome da fatiagender
      Definição

      An Extension

      CurtoExtensionAdditional content defined by implementations
      Controlo10..1*
      TipoExtension
      É modificadorfalse
      Deve apoiartrue
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      56. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:gender.url
      Definição

      Source of the definition for the extension code - a logical name or a URL.

      Curtoidentifies the meaning of the extension
      Comentários

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Controlo1..1
      Tipouri
      É modificadorfalse
      Formato XMLNo formato XML, esta propriedade é representada como um atributo.
      Resumofalse
      Valor fixogender
      58. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:gender.value[x]
      Definição

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      CurtoValue of extension
      Controlo10..1
      Tipocode, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      60. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:birthYear
      Nome da fatiabirthYear
      Definição

      An Extension

      CurtoExtensionAdditional content defined by implementations
      Controlo10..1*
      TipoExtension
      É modificadorfalse
      Deve apoiartrue
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      62. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:birthYear.url
      Definição

      Source of the definition for the extension code - a logical name or a URL.

      Curtoidentifies the meaning of the extension
      Comentários

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Controlo1..1
      Tipouri
      É modificadorfalse
      Formato XMLNo formato XML, esta propriedade é representada como um atributo.
      Resumofalse
      Valor fixobirthYear
      64. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:birthYear.value[x]
      Definição

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      CurtoValue of extension
      Controlo10..1
      Tipodate, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, CodeableConcept, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      66. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:reason
      Nome da fatiareason
      Definição

      An Extension

      CurtoExtensionAdditional content defined by implementations
      Controlo10..1*
      TipoExtension
      É modificadorfalse
      Deve apoiartrue
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      68. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:reason.url
      Definição

      Source of the definition for the extension code - a logical name or a URL.

      Curtoidentifies the meaning of the extension
      Comentários

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Controlo1..1
      Tipouri
      É modificadorfalse
      Formato XMLNo formato XML, esta propriedade é representada como um atributo.
      Resumofalse
      Valor fixoreason
      70. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:reason.value[x]
      Definição

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      CurtoValue of extension
      Controlo10..1
      TipoCodeableConcept, date, Meta, Address, Attachment, integer, Count, DataRequirement, Dosage, uuid, Identifier, Coding, SampledData, id, positiveInt, Distance, Period, Duration, canonical, Range, RelatedArtifact, base64Binary, UsageContext, Timing, decimal, ParameterDefinition, dateTime, code, string, Contributor, oid, instant, ContactPoint, HumanName, Money, markdown, Ratio, Age, Reference, TriggerDefinition, Quantity, uri, url, Annotation, ContactDetail, boolean, Expression, Signature, unsignedInt, time
      [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
      É modificadorfalse
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      72. AllergyIntolerance.patient.extension:unidentifiedPatient.url
      Definição

      Source of the definition for the extension code - a logical name or a URL.

      Curtoidentifies the meaning of the extension
      Comentários

      The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

      Controlo1..1
      Tipouri
      É modificadorfalse
      Formato XMLNo formato XML, esta propriedade é representada como um atributo.
      Resumofalse
      Valor fixohttp://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuoNaoIdentificado-1.0
      74. AllergyIntolerance.patient.extension:unidentifiedPatient.value[x]
      Definição

      Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

      CurtoValue of extension
      Controlo0..01
      TipoEscolha de: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      76. AllergyIntolerance.patient.reference
      Definição

      A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

      CurtoLiteral reference, Relative, internal or absolute URL
      Comentários

      Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

      Controlo0..01
      Este elemento é afetado pelas seguintes invariantes: ref-1
      Tipostring
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      78. AllergyIntolerance.patient.type
      Definição

      The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

      The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

      CurtoType the reference refers to (e.g. "Patient")
      Comentários

      This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

      Controlo0..01
      VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de ResourceTypehttp://hl7.org/fhir/ValueSet/resource-types
      (extensible to http://hl7.org/fhir/ValueSet/resource-types)

      Aa resource (or, for logical models, the URI of the logical model).

      Tipouri
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      80. AllergyIntolerance.patient.identifier
      Definição

      An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

      CurtoLogical reference, when literal reference is not known
      Comentários

      When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

      When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

      Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

      Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

      NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
      Controlo10..1
      TipoIdentifier
      É modificadorfalse
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      82. AllergyIntolerance.patient.identifier.use
      Definição

      The purpose of this identifier.

      Curtousual | official | temp | secondary | old (If known)
      Comentários

      Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

      Controlo0..01
      VínculoOs códigos DEVERÃO ser retirados de IdentifierUsehttp://hl7.org/fhir/ValueSet/identifier-use|4.0.1
      (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

      Identifies the purpose for this identifier, if known .

      Tipocode
      É modificadortrue porque This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Requisitos

      Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      84. AllergyIntolerance.patient.identifier.type
      Definição

      A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

      CurtoDescription of identifier
      Comentários

      This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

      Controlo0..01
      VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de Identifier Type Codeshttp://hl7.org/fhir/ValueSet/identifier-type
      (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

      A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

      TipoCodeableConcept
      É modificadorfalse
      Resumotrue
      Requisitos

      Allows users to make use of identifiers when the identifier system is not known.

      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      86. AllergyIntolerance.patient.identifier.system
      Definição

      Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

      CurtoThe namespace for the identifier value
      Comentários

      Identifier.system is always case sensitive.

      Controlo10..1
      Tipouri
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Requisitos

      There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

      Exemplo<br/><b>General</b>:http://www.acme.com/identifiers/patient
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      88. AllergyIntolerance.patient.identifier.value
      Definição

      The portion of the identifier typically relevant to the user and which is unique within the context of the system.

      CurtoThe value that is unique
      Comentários

      If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

      Controlo10..1
      Tipostring
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Exemplo<br/><b>General</b>:123456
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      90. AllergyIntolerance.patient.identifier.period
      Definição

      Time period during which identifier is/was valid for use.

      CurtoTime period when id is/was valid for use
      Controlo0..01
      TipoPeriod
      É modificadorfalse
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      92. AllergyIntolerance.patient.identifier.assigner
      Definição

      Organization that issued/manages the identifier.

      CurtoOrganization that issued id (may be just text)
      Comentários

      The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

      Controlo0..01
      TipoReference(Organization)
      É modificadorfalse
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      94. AllergyIntolerance.patient.display
      Definição

      Plain text narrative that identifies the resource in addition to the resource reference.

      CurtoText alternative for the resource
      Comentários

      This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

      Controlo0..01
      Tipostring
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      96. AllergyIntolerance.encounter
      Definição

      The encounter when the allergy or intolerance was asserted.

      CurtoEncounter when the allergy or intolerance was asserted
      Controlo0..01
      TipoReference(Encounter)
      É modificadorfalse
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      98. AllergyIntolerance.onset[x]
      Definição

      Ano, mês e ano ou dia, mês e ano, podendo conter também a hora em que a alergia ou reação adversa foi conhecida.


      Estimated or actual date, date-time, or age when allergy or intolerance was identified.

      CurtoData da Instalação da Alergia ou Reação AdversaWhen allergy or intolerance was identified
      Controlo0..1
      TipodateTime, string, Period, Range, Age
      [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Deve apoiartrue
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      100. AllergyIntolerance.recordedDate
      Definição

      The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date.

      CurtoDate first version of the resource instance was recorded
      Controlo0..01
      TipodateTime
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      102. AllergyIntolerance.recorder
      Definição

      Individual who recorded the record and takes responsibility for its content.

      CurtoWho recorded the sensitivity
      Controlo0..01
      TipoReference(Practitioner, PractitionerRole, Patient, RelatedPerson)
      É modificadorfalse
      Resumofalse
      Nomes alternativosAuthor
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      104. AllergyIntolerance.asserter
      Definição

      The source of the information about the allergy that is recorded.

      CurtoSource of the information about the allergy
      Comentários

      The recorder takes responsibility for the content, but can reference the source from where they got it.

      Controlo0..01
      TipoReference(Patient, RelatedPerson, Practitioner, PractitionerRole)
      É modificadorfalse
      Resumotrue
      Nomes alternativosSource, Informant
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      106. AllergyIntolerance.lastOccurrence
      Definição

      Represents the date and/or time of the last known occurrence of a reaction event.

      CurtoDate(/time) of last known occurrence of a reaction
      Comentários

      This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.

      Controlo0..01
      TipodateTime
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      108. AllergyIntolerance.note
      Definição

      Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.

      CurtoEvolução da Alergia ou Reação AdversaAdditional text not captured in other fields
      Comentários

      For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.

      Controlo0..1*
      TipoAnnotation
      É modificadorfalse
      Deve apoiartrue
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      110. AllergyIntolerance.note.author[x]
      Definição

      The individual responsible for making the annotation.

      CurtoIndividual responsible for the annotation
      Comentários

      Organization is used when there's no need for specific attribution as to who made the comment.

      Controlo0..01
      TipoEscolha de: Reference(Practitioner, Patient, RelatedPerson, Organization), string
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      112. AllergyIntolerance.note.time
      Definição

      Indicates when this particular annotation was made.

      CurtoWhen the annotation was made
      Controlo0..01
      TipodateTime
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      114. AllergyIntolerance.note.text
      Definição

      The text of the annotation in markdown format.

      CurtoThe annotation - text content (as markdown)
      Controlo1..1
      Tipomarkdown
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      116. AllergyIntolerance.reaction
      Definição

      Details about each adverse reaction event linked to exposure to the identified substance.

      CurtoAdverse Reaction Events linked to exposure to substance
      Controlo0..1*
      TipoBackboneElement
      É modificadorfalse
      Deve apoiartrue
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      118. AllergyIntolerance.reaction.modifierExtension
      Definição

      May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

      Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

      CurtoExtensions that cannot be ignored even if unrecognized
      Comentários

      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

      Controlo0..*
      TipoExtension
      É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
      Resumotrue
      Requisitos

      Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

      Nomes alternativosextensions, user content, modifiers
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
      120. AllergyIntolerance.reaction.substance
      Definição

      Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance.

      CurtoSpecific substance or pharmaceutical product considered to be responsible for event
      Comentários

      Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.

      Controlo0..01
      VínculoPara exemplos de códigos, ver SubstanceCodehttp://hl7.org/fhir/ValueSet/substance-code
      (example to http://hl7.org/fhir/ValueSet/substance-code)

      Codes defining the type of the substance (including pharmaceutical products).

      TipoCodeableConcept
      É modificadorfalse
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      122. AllergyIntolerance.reaction.manifestation
      Definição

      Sinais e/ou sintomas clínicos observados ou associados ao evento de reação adversa.


      Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.

      CurtoSinais e sintomas clínicos associados ao eventoClinical symptoms/signs associated with the Event
      Comentários

      Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.

      Controlo1..1*
      VínculoOs códigos DEVERÃO ser retirados de Para exemplos de códigos, ver Reações Adversas da MedDRAhttp://hl7.org/fhir/ValueSet/clinical-findings
      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRReacoesAdversasMedDRA-1.0)

      Reações Adversas da MedDRA


      Clinical symptoms and/or signs that are observed or associated with an Adverse Reaction Event.

      TipoCodeableConcept
      É modificadorfalse
      Resumofalse
      Nomes alternativosSymptoms, Signs
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      124. AllergyIntolerance.reaction.manifestation.coding
      Definição

      A reference to a code defined by a terminology system.

      CurtoCode defined by a terminology system
      Comentários

      Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

      Controlo0..1*
      TipoCoding
      É modificadorfalse
      Resumotrue
      Requisitos

      Allows for alternative encodings within a code system, and translations to other code systems.

      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      126. AllergyIntolerance.reaction.manifestation.coding.system
      Definição

      The identification of the code system that defines the meaning of the symbol in the code.

      CurtoIdentity of the terminology system
      Comentários

      The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

      Controlo10..1
      Tipouri
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Requisitos

      Need to be unambiguous about the source of the definition of the symbol.

      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      128. AllergyIntolerance.reaction.manifestation.coding.code
      Definição

      A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

      CurtoSymbol in syntax defined by the system
      Controlo10..1
      Tipocode
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Requisitos

      Need to refer to a particular code in the system.

      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      130. AllergyIntolerance.reaction.manifestation.coding.display
      Definição

      A representation of the meaning of the code in the system, following the rules of the system.

      CurtoRepresentation defined by the system
      Controlo0..01
      Tipostring
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Requisitos

      Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      132. AllergyIntolerance.reaction.manifestation.coding.userSelected
      Definição

      Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

      CurtoIf this coding was chosen directly by the user
      Comentários

      Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

      Controlo0..01
      Tipoboolean
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumotrue
      Requisitos

      This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      134. AllergyIntolerance.reaction.description
      Definição

      Text description about the reaction as a whole, including details of the manifestation if required.

      CurtoDescription of the event as a whole
      Comentários

      Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.

      Controlo0..01
      Tipostring
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumofalse
      Nomes alternativosNarrative, Text
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      136. AllergyIntolerance.reaction.onset
      Definição

      Record of the date and/or time of the onset of the Reaction.

      CurtoDate(/time) when manifestations showed
      Controlo0..01
      TipodateTime
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      138. AllergyIntolerance.reaction.severity
      Definição

      Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.

      Curtomild | moderate | severe (of event as a whole)
      Comentários

      It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.

      Controlo0..01
      VínculoOs códigos DEVERÃO ser retirados de AllergyIntoleranceSeverityhttp://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1
      (required to http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1)

      Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

      Tipocode
      É modificadorfalse
      Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      140. AllergyIntolerance.reaction.exposureRoute
      Definição

      Identification of the route by which the subject was exposed to the substance.

      CurtoHow the subject was exposed to the substance
      Comentários

      Coding of the route of exposure with a terminology should be used wherever possible.

      Controlo0..01
      VínculoPara exemplos de códigos, ver SNOMEDCTRouteCodeshttp://hl7.org/fhir/ValueSet/route-codes
      (example to http://hl7.org/fhir/ValueSet/route-codes)

      A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

      TipoCodeableConcept
      É modificadorfalse
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
      142. AllergyIntolerance.reaction.note
      Definição

      Additional text about the adverse reaction event not captured in other fields.

      CurtoText about event not captured in other fields
      Comentários

      Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.

      Controlo0..0*
      TipoAnnotation
      É modificadorfalse
      Resumofalse
      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))

      Instruções sobre como interpretar o conteúdo desta tabela podem ser encontradashere

      0. AllergyIntolerance
      Definição

      Reatividade alterada a um antígeno pode resultar em reações patológicas consequentes à exposição subsequente àquele antígeno particular.

      CurtoAlergia ou Reação Adversa
      Deve apoiartrue
      2. AllergyIntolerance.contained
      Controlo0..0
      4. AllergyIntolerance.identifier
      NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
      Controlo0..0
      6. AllergyIntolerance.verificationStatus
      Definição

      Indica o grau de certeza que se possui ao avaliar uma alergia ou reação adversa.

      CurtoGrau de Certeza
      VínculoOs códigos DEVERÃO ser retirados de Grau de Certeza de Alergias e Reações Adversas
      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRGrauCertezaAlergiasReacoesAdversas-1.0)

      Grau de Certeza de Alergias e Reações Adversas

      Deve apoiartrue
      8. AllergyIntolerance.verificationStatus.coding
      Controlo1..1
      10. AllergyIntolerance.verificationStatus.coding.system
      Controlo1..?
      12. AllergyIntolerance.verificationStatus.coding.code
      Controlo1..?
      14. AllergyIntolerance.verificationStatus.coding.display
      Controlo0..0
      16. AllergyIntolerance.verificationStatus.coding.userSelected
      Controlo0..0
      18. AllergyIntolerance.verificationStatus.text
      Controlo0..0
      20. AllergyIntolerance.type
      Definição

      Tipo de mecanismos fisiológico subjacente à reação. allergy: alergia intolerance: intolerância

      CurtoTipo de Reação
      Deve apoiartrue
      22. AllergyIntolerance.category
      Definição

      Categoriza a substância responsável por causar uma alergia ou reação adversa.

      CurtoCategoria do Agente Causador
      Controlo1..1
      VínculoOs códigos DEVERÃO ser retirados de Categoria do Agente da Alergia ou Reação Adversa
      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRCategoriaAgenteAlergiasReacoesAdversas-1.0)

      Categoria do Agente da Alergia ou Reação Adversa

      Deve apoiartrue
      24. AllergyIntolerance.criticality
      Definição

      Estimativa da criticidade do dano clínico ou gravidade da reação a uma substância identificada.

      CurtoCriticidade
      VínculoOs códigos DEVERÃO ser retirados de Criticidade de Alergias e Reações Adversas
      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRCriticidadeAlergiasReacoesAdversas-1.0)

      Criticidade

      Deve apoiartrue
      26. AllergyIntolerance.code
      Definição

      Agente ou substância específica responsável pela alergia ou reação adversa.

      CurtoAgente ou Substância
      Controlo1..?
      VínculoOs códigos DEVERÃO ser retirados de Alérgenos
      (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRAlergenos-1.0)

      Alérgenos

      Deve apoiartrue
      Requisitos

      Pode utilizar a descrição em texto livre, no elemento text, ou texto codificado utilizando o Catálogo Brasileiro de Alergias e Reações Adversas - CBARA (preferencial).

      28. AllergyIntolerance.code.coding
      Definição

      Texto codificado do agente ou substância causador da alergia ou reação adversa.

      CurtoAgente ou Substância Codificada
      Controlo0..1
      Deve apoiartrue
      30. AllergyIntolerance.code.coding.system
      Controlo1..?
      32. AllergyIntolerance.code.coding.code
      Controlo1..?
      34. AllergyIntolerance.code.coding.display
      Controlo0..0
      36. AllergyIntolerance.code.coding.userSelected
      Controlo0..0
      38. AllergyIntolerance.code.text
      Definição

      Descrição em texto livre do agente ou substância causador da alergia ou reação adversa.

      CurtoAgente ou Substância em Texto Livre
      Deve apoiartrue
      Requisitos

      Um e somente um agente ou substância deve ser informado em cada recurso de AllergyIntolerance que compor um documento. Ou seja, na hipótese de se informar mais de um agente ou substância, deve ser enviado um recurso AllergyIntolerance para cada um deles no documento.

      40. AllergyIntolerance.patient
      Definição

      Indivíduo que possui a alergia ou reação adversa.

      CurtoIndivíduo
      TipoReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0)
      Deve apoiartrue
      42. AllergyIntolerance.patient.extension
      Controlo0..?
      SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.patient.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
      • value @ url
      • 44. AllergyIntolerance.patient.extension:unidentifiedPatient
        Nome da fatiaunidentifiedPatient
        CurtoDados do Indivíduo Não Identificado
        Controlo0..?
        TipoExtension(Informações Complementares de Indivíduos Não Identificados) (Extensão complexa)
        Deve apoiartrue
        46. AllergyIntolerance.patient.extension:unidentifiedPatient.extension
        Controlo3..?
        SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.patient.extension.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
        • value @ url
        • 48. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:gender
          Nome da fatiagender
          Controlo1..?
          Deve apoiartrue
          50. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:birthYear
          Nome da fatiabirthYear
          Controlo1..?
          Deve apoiartrue
          52. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:reason
          Nome da fatiareason
          Controlo1..?
          Deve apoiartrue
          54. AllergyIntolerance.patient.reference
          Controlo0..0
          56. AllergyIntolerance.patient.type
          Controlo0..0
          58. AllergyIntolerance.patient.identifier
          NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
          Controlo1..?
          60. AllergyIntolerance.patient.identifier.use
          Controlo0..0
          62. AllergyIntolerance.patient.identifier.type
          Controlo0..0
          64. AllergyIntolerance.patient.identifier.system
          Controlo1..?
          66. AllergyIntolerance.patient.identifier.value
          Controlo1..?
          68. AllergyIntolerance.patient.identifier.period
          Controlo0..0
          70. AllergyIntolerance.patient.identifier.assigner
          Controlo0..0
          72. AllergyIntolerance.patient.display
          Controlo0..0
          74. AllergyIntolerance.encounter
          Controlo0..0
          76. AllergyIntolerance.onset[x]
          Definição

          Ano, mês e ano ou dia, mês e ano, podendo conter também a hora em que a alergia ou reação adversa foi conhecida.

          CurtoData da Instalação da Alergia ou Reação Adversa
          TipodateTime, string, Period, Range, Age
          [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
          Deve apoiartrue
          78. AllergyIntolerance.recordedDate
          Controlo0..0
          80. AllergyIntolerance.recorder
          Controlo0..0
          82. AllergyIntolerance.asserter
          Controlo0..0
          84. AllergyIntolerance.lastOccurrence
          Controlo0..0
          86. AllergyIntolerance.note
          CurtoEvolução da Alergia ou Reação Adversa
          Controlo0..1
          Deve apoiartrue
          88. AllergyIntolerance.note.author[x]
          Controlo0..0
          90. AllergyIntolerance.note.time
          Controlo0..0
          92. AllergyIntolerance.reaction
          Controlo0..1
          Deve apoiartrue
          94. AllergyIntolerance.reaction.substance
          Controlo0..0
          96. AllergyIntolerance.reaction.manifestation
          Definição

          Sinais e/ou sintomas clínicos observados ou associados ao evento de reação adversa.

          CurtoSinais e sintomas clínicos associados ao evento
          Controlo0..1
          VínculoOs códigos DEVERÃO ser retirados de Reações Adversas da MedDRA
          (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRReacoesAdversasMedDRA-1.0)

          Reações Adversas da MedDRA

          98. AllergyIntolerance.reaction.manifestation.coding
          Controlo0..1
          100. AllergyIntolerance.reaction.manifestation.coding.system
          Controlo1..?
          102. AllergyIntolerance.reaction.manifestation.coding.code
          Controlo1..?
          104. AllergyIntolerance.reaction.manifestation.coding.display
          Controlo0..0
          106. AllergyIntolerance.reaction.manifestation.coding.userSelected
          Controlo0..0
          108. AllergyIntolerance.reaction.description
          Controlo0..0
          110. AllergyIntolerance.reaction.onset
          Controlo0..0
          112. AllergyIntolerance.reaction.severity
          Controlo0..0
          114. AllergyIntolerance.reaction.exposureRoute
          Controlo0..0
          116. AllergyIntolerance.reaction.note
          Controlo0..0

          Instruções sobre como interpretar o conteúdo desta tabela podem ser encontradashere

          0. AllergyIntolerance
          Definição

          Reatividade alterada a um antígeno pode resultar em reações patológicas consequentes à exposição subsequente àquele antígeno particular.

          CurtoAlergia ou Reação Adversa
          Comentários

          Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.

          Controlo0..*
          É modificadorfalse
          Deve apoiartrue
          Resumofalse
          Nomes alternativosAllergy, Intolerance, Adverse Reaction
          Invariantesait-1: AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. (verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists())
          ait-2: AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error (verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty())
          dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources (contained.contained.empty())
          dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource (contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty())
          dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated (contained.meta.versionId.empty() and contained.meta.lastUpdated.empty())
          dom-5: If a resource is contained in another resource, it SHALL NOT have a security label (contained.meta.security.empty())
          dom-6: A resource should have narrative for robust management (text.`div`.exists())
          2. AllergyIntolerance.id
          Definição

          The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.

          CurtoLogical id of this artifact
          Comentários

          The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

          Controlo0..1
          Tipoid
          É modificadorfalse
          Resumotrue
          4. AllergyIntolerance.meta
          Definição

          The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource.

          CurtoMetadata about the resource
          Controlo0..1
          TipoMeta
          É modificadorfalse
          Resumotrue
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          6. AllergyIntolerance.implicitRules
          Definição

          A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.

          CurtoA set of rules under which this content was created
          Comentários

          Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.

          Controlo0..1
          Tipouri
          É modificadortrue porque This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation
          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
          Resumotrue
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          8. AllergyIntolerance.language
          Definição

          The base language in which the resource is written.

          CurtoLanguage of the resource content
          Comentários

          Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

          Controlo0..1
          VínculoOs códigos DEVERÃO ser retirados de CommonLanguages
          (preferred to http://hl7.org/fhir/ValueSet/languages)

          A human language.

          Vínculos adicionaisObjetivo
          AllLanguagesVínculo máximo
          Tipocode
          É modificadorfalse
          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
          Resumofalse
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          10. AllergyIntolerance.text
          Definição

          A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.

          CurtoText summary of the resource, for human interpretation
          Comentários

          Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later.

          Controlo0..1
          TipoNarrative
          É modificadorfalse
          Resumofalse
          Nomes alternativosnarrative, html, xhtml, display
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          12. AllergyIntolerance.contained
          Definição

          These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.

          CurtoContained, inline Resources
          Comentários

          This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.

          Controlo0..0
          TipoResource
          É modificadorfalse
          Resumofalse
          Nomes alternativosinline resources, anonymous resources, contained resources
          14. AllergyIntolerance.extension
          Definição

          May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          CurtoAdditional content defined by implementations
          Comentários

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Controlo0..*
          TipoExtension
          É modificadorfalse
          Resumofalse
          Nomes alternativosextensions, user content
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          16. AllergyIntolerance.modifierExtension
          Definição

          May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

          Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

          CurtoExtensions that cannot be ignored
          Comentários

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Controlo0..*
          TipoExtension
          É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them
          Resumofalse
          Requisitos

          Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

          Nomes alternativosextensions, user content
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          18. AllergyIntolerance.identifier
          Definição

          Business identifiers assigned to this AllergyIntolerance by the performer or other systems which remain constant as the resource is updated and propagates from server to server.

          CurtoExternal ids for this item
          Comentários

          This is a business identifier, not a resource identifier (see discussion). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number.

          NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
          Controlo0..0
          TipoIdentifier
          É modificadorfalse
          Resumotrue
          Requisitos

          Allows identification of the AllergyIntolerance as it is known by various participating systems and in a way that remains consistent across servers.

          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          20. AllergyIntolerance.clinicalStatus
          Definição

          The clinical status of the allergy or intolerance.

          Curtoactive | inactive | resolved
          Comentários

          Refer to discussion if clincalStatus is missing data. The data type is CodeableConcept because clinicalStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

          Controlo0..1
          Este elemento é afetado pelas seguintes invariantes: ait-1, ait-2
          VínculoOs códigos DEVERÃO ser retirados de AllergyIntoleranceClinicalStatusCodes
          (required to http://hl7.org/fhir/ValueSet/allergyintolerance-clinical|4.0.1)

          The clinical status of the allergy or intolerance.

          TipoCodeableConcept
          É modificadortrue porque This element is labeled as a modifier because the status contains the codes inactive and resolved that mark the AllergyIntolerance as no longer active.
          Resumotrue
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          22. AllergyIntolerance.verificationStatus
          Definição

          Indica o grau de certeza que se possui ao avaliar uma alergia ou reação adversa.

          CurtoGrau de Certeza
          Comentários

          The data type is CodeableConcept because verificationStatus has some clinical judgment involved, such that there might need to be more specificity than the required FHIR value set allows. For example, a SNOMED coding might allow for additional specificity.

          Controlo0..1
          Este elemento é afetado pelas seguintes invariantes: ait-1, ait-2
          VínculoOs códigos DEVERÃO ser retirados de Grau de Certeza de Alergias e Reações Adversas
          (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRGrauCertezaAlergiasReacoesAdversas-1.0)

          Grau de Certeza de Alergias e Reações Adversas

          TipoCodeableConcept
          É modificadortrue porque This element is labeled as a modifier because the status contains the codes refuted and entered-in-error that mark the AllergyIntolerance as not currently valid.
          Deve apoiartrue
          Resumotrue
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          24. AllergyIntolerance.verificationStatus.id
          Definição

          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

          CurtoUnique id for inter-element referencing
          Controlo0..1
          Tipostring
          É modificadorfalse
          Formato XMLNo formato XML, esta propriedade é representada como um atributo.
          Resumofalse
          26. AllergyIntolerance.verificationStatus.extension
          Definição

          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

          CurtoAdditional content defined by implementations
          Comentários

          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

          Controlo0..*
          TipoExtension
          É modificadorfalse
          Resumofalse
          Nomes alternativosextensions, user content
          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
          SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.verificationStatus.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
          • value @ url
          • 28. AllergyIntolerance.verificationStatus.coding
            Definição

            A reference to a code defined by a terminology system.

            CurtoCode defined by a terminology system
            Comentários

            Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

            Controlo1..1
            TipoCoding
            É modificadorfalse
            Resumotrue
            Requisitos

            Allows for alternative encodings within a code system, and translations to other code systems.

            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            30. AllergyIntolerance.verificationStatus.coding.id
            Definição

            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

            CurtoUnique id for inter-element referencing
            Controlo0..1
            Tipostring
            É modificadorfalse
            Formato XMLNo formato XML, esta propriedade é representada como um atributo.
            Resumofalse
            32. AllergyIntolerance.verificationStatus.coding.extension
            Definição

            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

            CurtoAdditional content defined by implementations
            Comentários

            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

            Controlo0..*
            TipoExtension
            É modificadorfalse
            Resumofalse
            Nomes alternativosextensions, user content
            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
            SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.verificationStatus.coding.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
            • value @ url
            • 34. AllergyIntolerance.verificationStatus.coding.system
              Definição

              The identification of the code system that defines the meaning of the symbol in the code.

              CurtoIdentity of the terminology system
              Comentários

              The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

              Controlo1..1
              Tipouri
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Resumotrue
              Requisitos

              Need to be unambiguous about the source of the definition of the symbol.

              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              36. AllergyIntolerance.verificationStatus.coding.version
              Definição

              The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

              CurtoVersion of the system - if relevant
              Comentários

              Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

              NotaEste é um ID de versão comercial, não um ID de versão de recurso (ver discussão)
              Controlo0..1
              Tipostring
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Resumotrue
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              38. AllergyIntolerance.verificationStatus.coding.code
              Definição

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

              CurtoSymbol in syntax defined by the system
              Controlo1..1
              Tipocode
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Resumotrue
              Requisitos

              Need to refer to a particular code in the system.

              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              40. AllergyIntolerance.verificationStatus.coding.display
              Definição

              A representation of the meaning of the code in the system, following the rules of the system.

              CurtoRepresentation defined by the system
              Controlo0..0
              Tipostring
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Resumotrue
              Requisitos

              Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              42. AllergyIntolerance.verificationStatus.coding.userSelected
              Definição

              Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

              CurtoIf this coding was chosen directly by the user
              Comentários

              Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

              Controlo0..0
              Tipoboolean
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Resumotrue
              Requisitos

              This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              44. AllergyIntolerance.verificationStatus.text
              Definição

              A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

              CurtoPlain text representation of the concept
              Comentários

              Very often the text is the same as a displayName of one of the codings.

              Controlo0..0
              Tipostring
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Resumotrue
              Requisitos

              The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              46. AllergyIntolerance.type
              Definição

              Tipo de mecanismos fisiológico subjacente à reação. allergy: alergia intolerance: intolerância

              CurtoTipo de Reação
              Comentários

              Allergic (typically immune-mediated) reactions have been traditionally regarded as an indicator for potential escalation to significant future risk. Contemporary knowledge suggests that some reactions previously thought to be immune-mediated are, in fact, non-immune, but in some cases can still pose a life threatening risk. It is acknowledged that many clinicians might not be in a position to distinguish the mechanism of a particular reaction. Often the term "allergy" is used rather generically and may overlap with the use of "intolerance" - in practice the boundaries between these two concepts might not be well-defined or understood. This data element is included nevertheless, because many legacy systems have captured this attribute. Immunologic testing may provide supporting evidence for the basis of the reaction and the causative substance, but no tests are 100% sensitive or specific for sensitivity to a particular substance. If, as is commonly the case, it is unclear whether the reaction is due to an allergy or an intolerance, then the type element should be omitted from the resource.

              Controlo0..1
              VínculoOs códigos DEVERÃO ser retirados de AllergyIntoleranceType
              (required to http://hl7.org/fhir/ValueSet/allergy-intolerance-type|4.0.1)

              Identification of the underlying physiological mechanism for a Reaction Risk.

              Tipocode
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Deve apoiartrue
              Resumotrue
              Nomes alternativosCategory, Class
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              48. AllergyIntolerance.category
              Definição

              Categoriza a substância responsável por causar uma alergia ou reação adversa.

              CurtoCategoria do Agente Causador
              Comentários

              This data element has been included because it is currently being captured in some clinical systems. This data can be derived from the substance where coding systems are used, and is effectively redundant in that situation. When searching on category, consider the implications of AllergyIntolerance resources without a category. For example, when searching on category = medication, medication allergies that don't have a category valued will not be returned. Refer to search for more information on how to search category with a :missing modifier to get allergies that don't have a category. Additionally, category should be used with caution because category can be subjective based on the sender.

              Controlo1..1
              VínculoOs códigos DEVERÃO ser retirados de Categoria do Agente da Alergia ou Reação Adversa
              (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRCategoriaAgenteAlergiasReacoesAdversas-1.0)

              Categoria do Agente da Alergia ou Reação Adversa

              Tipocode
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Deve apoiartrue
              Resumotrue
              Nomes alternativosCategory, Type, Reaction Type, Class
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              50. AllergyIntolerance.criticality
              Definição

              Estimativa da criticidade do dano clínico ou gravidade da reação a uma substância identificada.

              CurtoCriticidade
              Comentários

              The default criticality value for any propensity to an adverse reaction should be 'Low Risk', indicating at the very least a relative contraindication to deliberate or voluntary exposure to the substance. 'High Risk' is flagged if the clinician has identified a propensity for a more serious or potentially life-threatening reaction, such as anaphylaxis, and implies an absolute contraindication to deliberate or voluntary exposure to the substance. If this element is missing, the criticality is unknown (though it may be known elsewhere). Systems that capture a severity at the condition level are actually representing the concept of criticality whereas the severity documented at the reaction level is representing the true reaction severity. Existing systems that are capturing both condition criticality and reaction severity may use the term "severity" to represent both. Criticality is the worst it could be in the future (i.e. situation-agnostic) whereas severity is situation-dependent.

              Controlo0..1
              VínculoOs códigos DEVERÃO ser retirados de Criticidade de Alergias e Reações Adversas
              (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRCriticidadeAlergiasReacoesAdversas-1.0)

              Criticidade

              Tipocode
              É modificadorfalse
              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
              Deve apoiartrue
              Resumotrue
              Nomes alternativosSeverity, Seriousness, Contra-indication, Risk
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              52. AllergyIntolerance.code
              Definição

              Agente ou substância específica responsável pela alergia ou reação adversa.

              CurtoAgente ou Substância
              Comentários

              It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNII, and ATC. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text.

              When a substance or product code is specified for the 'code' element, the "default" semantic context is that this is a positive statement of an allergy or intolerance (depending on the value of the 'type' element, if present) condition to the specified substance/product. In the corresponding SNOMED CT allergy model, the specified substance/product is the target (destination) of the "Causative agent" relationship.

              The 'substanceExposureRisk' extension is available as a structured and more flexible alternative to the 'code' element for making positive or negative allergy or intolerance statements. This extension provides the capability to make "no known allergy" (or "no risk of adverse reaction") statements regarding any coded substance/product (including cases when a pre-coordinated "no allergy to x" concept for that substance/product does not exist). If the 'substanceExposureRisk' extension is present, the AllergyIntolerance.code element SHALL be omitted.

              Controlo1..1
              VínculoOs códigos DEVERÃO ser retirados de Alérgenos
              (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRAlergenos-1.0)

              Alérgenos

              TipoCodeableConcept
              É modificadorfalse
              Deve apoiartrue
              Resumotrue
              Requisitos

              Pode utilizar a descrição em texto livre, no elemento text, ou texto codificado utilizando o Catálogo Brasileiro de Alergias e Reações Adversas - CBARA (preferencial).

              Nomes alternativosCode
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              54. AllergyIntolerance.code.id
              Definição

              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

              CurtoUnique id for inter-element referencing
              Controlo0..1
              Tipostring
              É modificadorfalse
              Formato XMLNo formato XML, esta propriedade é representada como um atributo.
              Resumofalse
              56. AllergyIntolerance.code.extension
              Definição

              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

              CurtoAdditional content defined by implementations
              Comentários

              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

              Controlo0..*
              TipoExtension
              É modificadorfalse
              Resumofalse
              Nomes alternativosextensions, user content
              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
              SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.code.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
              • value @ url
              • 58. AllergyIntolerance.code.coding
                Definição

                Texto codificado do agente ou substância causador da alergia ou reação adversa.

                CurtoAgente ou Substância Codificada
                Comentários

                Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                Controlo0..1
                TipoCoding
                É modificadorfalse
                Deve apoiartrue
                Resumotrue
                Requisitos

                Allows for alternative encodings within a code system, and translations to other code systems.

                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                60. AllergyIntolerance.code.coding.id
                Definição

                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                CurtoUnique id for inter-element referencing
                Controlo0..1
                Tipostring
                É modificadorfalse
                Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                Resumofalse
                62. AllergyIntolerance.code.coding.extension
                Definição

                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                CurtoAdditional content defined by implementations
                Comentários

                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                Controlo0..*
                TipoExtension
                É modificadorfalse
                Resumofalse
                Nomes alternativosextensions, user content
                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.code.coding.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                • value @ url
                • 64. AllergyIntolerance.code.coding.system
                  Definição

                  The identification of the code system that defines the meaning of the symbol in the code.

                  CurtoIdentity of the terminology system
                  Comentários

                  The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                  Controlo1..1
                  Tipouri
                  É modificadorfalse
                  Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                  Resumotrue
                  Requisitos

                  Need to be unambiguous about the source of the definition of the symbol.

                  Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  66. AllergyIntolerance.code.coding.version
                  Definição

                  The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                  CurtoVersion of the system - if relevant
                  Comentários

                  Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                  NotaEste é um ID de versão comercial, não um ID de versão de recurso (ver discussão)
                  Controlo0..1
                  Tipostring
                  É modificadorfalse
                  Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                  Resumotrue
                  Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  68. AllergyIntolerance.code.coding.code
                  Definição

                  A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                  CurtoSymbol in syntax defined by the system
                  Controlo1..1
                  Tipocode
                  É modificadorfalse
                  Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                  Resumotrue
                  Requisitos

                  Need to refer to a particular code in the system.

                  Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  70. AllergyIntolerance.code.coding.display
                  Definição

                  A representation of the meaning of the code in the system, following the rules of the system.

                  CurtoRepresentation defined by the system
                  Controlo0..0
                  Tipostring
                  É modificadorfalse
                  Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                  Resumotrue
                  Requisitos

                  Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                  Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  72. AllergyIntolerance.code.coding.userSelected
                  Definição

                  Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                  CurtoIf this coding was chosen directly by the user
                  Comentários

                  Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                  Controlo0..0
                  Tipoboolean
                  É modificadorfalse
                  Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                  Resumotrue
                  Requisitos

                  This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                  Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  74. AllergyIntolerance.code.text
                  Definição

                  Descrição em texto livre do agente ou substância causador da alergia ou reação adversa.

                  CurtoAgente ou Substância em Texto Livre
                  Comentários

                  Very often the text is the same as a displayName of one of the codings.

                  Controlo0..1
                  Tipostring
                  É modificadorfalse
                  Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                  Deve apoiartrue
                  Resumotrue
                  Requisitos

                  Um e somente um agente ou substância deve ser informado em cada recurso de AllergyIntolerance que compor um documento. Ou seja, na hipótese de se informar mais de um agente ou substância, deve ser enviado um recurso AllergyIntolerance para cada um deles no documento.

                  Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  76. AllergyIntolerance.patient
                  Definição

                  Indivíduo que possui a alergia ou reação adversa.

                  CurtoIndivíduo
                  Controlo1..1
                  TipoReference(http://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuo-1.0)
                  É modificadorfalse
                  Deve apoiartrue
                  Resumotrue
                  Nomes alternativosPatient
                  Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  78. AllergyIntolerance.patient.id
                  Definição

                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                  CurtoUnique id for inter-element referencing
                  Controlo0..1
                  Tipostring
                  É modificadorfalse
                  Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                  Resumofalse
                  80. AllergyIntolerance.patient.extension
                  Definição

                  An Extension

                  CurtoExtension
                  Controlo0..*
                  TipoExtension
                  É modificadorfalse
                  Resumofalse
                  Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                  SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.patient.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                  • value @ url
                  • 82. AllergyIntolerance.patient.extension:unidentifiedPatient
                    Nome da fatiaunidentifiedPatient
                    Definição

                    Informações demográficas básicas e justificativa dos indivíduos que não podem ser identificados por razões clínicas ou sociais, conforme legislação brasileira, com finalidade estatística.

                    CurtoDados do Indivíduo Não Identificado
                    Controlo0..1
                    TipoExtension(Informações Complementares de Indivíduos Não Identificados) (Extensão complexa)
                    É modificadorfalse
                    Deve apoiartrue
                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    84. AllergyIntolerance.patient.extension:unidentifiedPatient.id
                    Definição

                    Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                    CurtoUnique id for inter-element referencing
                    Controlo0..1
                    Tipostring
                    É modificadorfalse
                    Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                    Resumofalse
                    86. AllergyIntolerance.patient.extension:unidentifiedPatient.extension
                    Definição

                    An Extension

                    CurtoExtension
                    Controlo3..3
                    TipoExtension
                    É modificadorfalse
                    Resumofalse
                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                    ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                    SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.patient.extension.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                    • value @ url
                    • 88. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:gender
                      Nome da fatiagender
                      Definição

                      An Extension

                      CurtoExtension
                      Controlo1..1
                      TipoExtension
                      É modificadorfalse
                      Deve apoiartrue
                      Resumofalse
                      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      90. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:gender.id
                      Definição

                      Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                      CurtoUnique id for inter-element referencing
                      Controlo0..1
                      Tipostring
                      É modificadorfalse
                      Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                      Resumofalse
                      92. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:gender.extension
                      Definição

                      May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                      CurtoAdditional content defined by implementations
                      Comentários

                      There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                      Controlo0..*
                      TipoExtension
                      É modificadorfalse
                      Resumofalse
                      Nomes alternativosextensions, user content
                      Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                      ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                      SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.patient.extension.extension.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                      • value @ url
                      • 94. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:gender.url
                        Definição

                        Source of the definition for the extension code - a logical name or a URL.

                        Curtoidentifies the meaning of the extension
                        Comentários

                        The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                        Controlo1..1
                        Tipouri
                        É modificadorfalse
                        Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                        Resumofalse
                        Valor fixogender
                        96. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:gender.value[x]
                        Definição

                        Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                        CurtoValue of extension
                        Controlo1..1
                        Tipocode
                        [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
                        É modificadorfalse
                        Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                        Resumofalse
                        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        98. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:birthYear
                        Nome da fatiabirthYear
                        Definição

                        An Extension

                        CurtoExtension
                        Controlo1..1
                        TipoExtension
                        É modificadorfalse
                        Deve apoiartrue
                        Resumofalse
                        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        100. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:birthYear.id
                        Definição

                        Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                        CurtoUnique id for inter-element referencing
                        Controlo0..1
                        Tipostring
                        É modificadorfalse
                        Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                        Resumofalse
                        102. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:birthYear.extension
                        Definição

                        May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                        CurtoAdditional content defined by implementations
                        Comentários

                        There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                        Controlo0..*
                        TipoExtension
                        É modificadorfalse
                        Resumofalse
                        Nomes alternativosextensions, user content
                        Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                        ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                        SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.patient.extension.extension.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                        • value @ url
                        • 104. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:birthYear.url
                          Definição

                          Source of the definition for the extension code - a logical name or a URL.

                          Curtoidentifies the meaning of the extension
                          Comentários

                          The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                          Controlo1..1
                          Tipouri
                          É modificadorfalse
                          Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                          Resumofalse
                          Valor fixobirthYear
                          106. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:birthYear.value[x]
                          Definição

                          Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                          CurtoValue of extension
                          Controlo1..1
                          Tipodate
                          [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
                          É modificadorfalse
                          Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                          Resumofalse
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          108. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:reason
                          Nome da fatiareason
                          Definição

                          An Extension

                          CurtoExtension
                          Controlo1..1
                          TipoExtension
                          É modificadorfalse
                          Deve apoiartrue
                          Resumofalse
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          110. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:reason.id
                          Definição

                          Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                          CurtoUnique id for inter-element referencing
                          Controlo0..1
                          Tipostring
                          É modificadorfalse
                          Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                          Resumofalse
                          112. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:reason.extension
                          Definição

                          May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                          CurtoAdditional content defined by implementations
                          Comentários

                          There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                          Controlo0..*
                          TipoExtension
                          É modificadorfalse
                          Resumofalse
                          Nomes alternativosextensions, user content
                          Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                          ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                          SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.patient.extension.extension.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                          • value @ url
                          • 114. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:reason.url
                            Definição

                            Source of the definition for the extension code - a logical name or a URL.

                            Curtoidentifies the meaning of the extension
                            Comentários

                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                            Controlo1..1
                            Tipouri
                            É modificadorfalse
                            Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                            Resumofalse
                            Valor fixoreason
                            116. AllergyIntolerance.patient.extension:unidentifiedPatient.extension:reason.value[x]
                            Definição

                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                            CurtoValue of extension
                            Controlo1..1
                            TipoCodeableConcept
                            [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
                            É modificadorfalse
                            Resumofalse
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            118. AllergyIntolerance.patient.extension:unidentifiedPatient.url
                            Definição

                            Source of the definition for the extension code - a logical name or a URL.

                            Curtoidentifies the meaning of the extension
                            Comentários

                            The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

                            Controlo1..1
                            Tipouri
                            É modificadorfalse
                            Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                            Resumofalse
                            Valor fixohttp://www.saude.gov.br/fhir/r4/StructureDefinition/BRIndividuoNaoIdentificado-1.0
                            120. AllergyIntolerance.patient.extension:unidentifiedPatient.value[x]
                            Definição

                            Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

                            CurtoValue of extension
                            Controlo0..0
                            TipoEscolha de: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
                            É modificadorfalse
                            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                            Resumofalse
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            122. AllergyIntolerance.patient.reference
                            Definição

                            A reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources.

                            CurtoLiteral reference, Relative, internal or absolute URL
                            Comentários

                            Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.

                            Controlo0..0
                            Este elemento é afetado pelas seguintes invariantes: ref-1
                            Tipostring
                            É modificadorfalse
                            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                            Resumotrue
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            124. AllergyIntolerance.patient.type
                            Definição

                            The expected type of the target of the reference. If both Reference.type and Reference.reference are populated and Reference.reference is a FHIR URL, both SHALL be consistent.

                            The type is the Canonical URL of Resource Definition that is the type this reference refers to. References are URLs that are relative to http://hl7.org/fhir/StructureDefinition/ e.g. "Patient" is a reference to http://hl7.org/fhir/StructureDefinition/Patient. Absolute URLs are only allowed for logical models (and can only be used in references in logical models, not resources).

                            CurtoType the reference refers to (e.g. "Patient")
                            Comentários

                            This element is used to indicate the type of the target of the reference. This may be used which ever of the other elements are populated (or not). In some cases, the type of the target may be determined by inspection of the reference (e.g. a RESTful URL) or by resolving the target of the reference; if both the type and a reference is provided, the reference SHALL resolve to a resource of the same type as that specified.

                            Controlo0..0
                            VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de ResourceType
                            (extensible to http://hl7.org/fhir/ValueSet/resource-types)

                            Aa resource (or, for logical models, the URI of the logical model).

                            Tipouri
                            É modificadorfalse
                            Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                            Resumotrue
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            126. AllergyIntolerance.patient.identifier
                            Definição

                            An identifier for the target resource. This is used when there is no way to reference the other resource directly, either because the entity it represents is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference.

                            CurtoLogical reference, when literal reference is not known
                            Comentários

                            When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy.

                            When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference

                            Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.

                            Reference is intended to point to a structure that can potentially be expressed as a FHIR resource, though there is no need for it to exist as an actual FHIR resource instance - except in as much as an application wishes to actual find the target of the reference. The content referred to be the identifier must meet the logical constraints implied by any limitations on what resource types are permitted for the reference. For example, it would not be legitimate to send the identifier for a drug prescription if the type were Reference(Observation|DiagnosticReport). One of the use-cases for Reference.identifier is the situation where no FHIR representation exists (where the type is Reference (Any).

                            NotaTrata-se de um identificador de empresa e não de um identificador de recurso (ver discussão)
                            Controlo1..1
                            TipoIdentifier
                            É modificadorfalse
                            Resumotrue
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            128. AllergyIntolerance.patient.identifier.id
                            Definição

                            Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                            CurtoUnique id for inter-element referencing
                            Controlo0..1
                            Tipostring
                            É modificadorfalse
                            Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                            Resumofalse
                            130. AllergyIntolerance.patient.identifier.extension
                            Definição

                            May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                            CurtoAdditional content defined by implementations
                            Comentários

                            There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                            Controlo0..*
                            TipoExtension
                            É modificadorfalse
                            Resumofalse
                            Nomes alternativosextensions, user content
                            Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                            ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                            SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.patient.identifier.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                            • value @ url
                            • 132. AllergyIntolerance.patient.identifier.use
                              Definição

                              The purpose of this identifier.

                              Curtousual | official | temp | secondary | old (If known)
                              Comentários

                              Applications can assume that an identifier is permanent unless it explicitly says that it is temporary.

                              Controlo0..0
                              VínculoOs códigos DEVERÃO ser retirados de IdentifierUse
                              (required to http://hl7.org/fhir/ValueSet/identifier-use|4.0.1)

                              Identifies the purpose for this identifier, if known .

                              Tipocode
                              É modificadortrue porque This is labeled as "Is Modifier" because applications should not mistake a temporary id for a permanent one.
                              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                              Resumotrue
                              Requisitos

                              Allows the appropriate identifier for a particular context of use to be selected from among a set of identifiers.

                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              134. AllergyIntolerance.patient.identifier.type
                              Definição

                              A coded type for the identifier that can be used to determine which identifier to use for a specific purpose.

                              CurtoDescription of identifier
                              Comentários

                              This element deals only with general categories of identifiers. It SHOULD not be used for codes that correspond 1..1 with the Identifier.system. Some identifiers may fall into multiple categories due to common usage. Where the system is known, a type is unnecessary because the type is always part of the system definition. However systems often need to handle identifiers where the system is not known. There is not a 1:1 relationship between type and system, since many different systems have the same type.

                              Controlo0..0
                              VínculoA menos que não sejam adequados, estes códigos DEVERÃO ser retirados de Identifier Type Codes
                              (extensible to http://hl7.org/fhir/ValueSet/identifier-type)

                              A coded type for an identifier that can be used to determine which identifier to use for a specific purpose.

                              TipoCodeableConcept
                              É modificadorfalse
                              Resumotrue
                              Requisitos

                              Allows users to make use of identifiers when the identifier system is not known.

                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              136. AllergyIntolerance.patient.identifier.system
                              Definição

                              Establishes the namespace for the value - that is, a URL that describes a set values that are unique.

                              CurtoThe namespace for the identifier value
                              Comentários

                              Identifier.system is always case sensitive.

                              Controlo1..1
                              Tipouri
                              É modificadorfalse
                              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                              Resumotrue
                              Requisitos

                              There are many sets of identifiers. To perform matching of two identifiers, we need to know what set we're dealing with. The system identifies a particular set of unique identifiers.

                              Exemplo<br/><b>General</b>:http://www.acme.com/identifiers/patient
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              138. AllergyIntolerance.patient.identifier.value
                              Definição

                              The portion of the identifier typically relevant to the user and which is unique within the context of the system.

                              CurtoThe value that is unique
                              Comentários

                              If the value is a full URI, then the system SHALL be urn:ietf:rfc:3986. The value's primary purpose is computational mapping. As a result, it may be normalized for comparison purposes (e.g. removing non-significant whitespace, dashes, etc.) A value formatted for human display can be conveyed using the Rendered Value extension. Identifier.value is to be treated as case sensitive unless knowledge of the Identifier.system allows the processer to be confident that non-case-sensitive processing is safe.

                              Controlo1..1
                              Tipostring
                              É modificadorfalse
                              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                              Resumotrue
                              Exemplo<br/><b>General</b>:123456
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              140. AllergyIntolerance.patient.identifier.period
                              Definição

                              Time period during which identifier is/was valid for use.

                              CurtoTime period when id is/was valid for use
                              Controlo0..0
                              TipoPeriod
                              É modificadorfalse
                              Resumotrue
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              142. AllergyIntolerance.patient.identifier.assigner
                              Definição

                              Organization that issued/manages the identifier.

                              CurtoOrganization that issued id (may be just text)
                              Comentários

                              The Identifier.assigner may omit the .reference element and only contain a .display element reflecting the name or other textual information about the assigning organization.

                              Controlo0..0
                              TipoReference(Organization)
                              É modificadorfalse
                              Resumotrue
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              144. AllergyIntolerance.patient.display
                              Definição

                              Plain text narrative that identifies the resource in addition to the resource reference.

                              CurtoText alternative for the resource
                              Comentários

                              This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.

                              Controlo0..0
                              Tipostring
                              É modificadorfalse
                              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                              Resumotrue
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              146. AllergyIntolerance.encounter
                              Definição

                              The encounter when the allergy or intolerance was asserted.

                              CurtoEncounter when the allergy or intolerance was asserted
                              Controlo0..0
                              TipoReference(Encounter)
                              É modificadorfalse
                              Resumofalse
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              148. AllergyIntolerance.onset[x]
                              Definição

                              Ano, mês e ano ou dia, mês e ano, podendo conter também a hora em que a alergia ou reação adversa foi conhecida.

                              CurtoData da Instalação da Alergia ou Reação Adversa
                              Controlo0..1
                              TipodateTime
                              [x] NotaVerEscolha de tipos de dadospara mais informações sobre como utilizar [x]
                              É modificadorfalse
                              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                              Deve apoiartrue
                              Resumofalse
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              150. AllergyIntolerance.recordedDate
                              Definição

                              The recordedDate represents when this particular AllergyIntolerance record was created in the system, which is often a system-generated date.

                              CurtoDate first version of the resource instance was recorded
                              Controlo0..0
                              TipodateTime
                              É modificadorfalse
                              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                              Resumofalse
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              152. AllergyIntolerance.recorder
                              Definição

                              Individual who recorded the record and takes responsibility for its content.

                              CurtoWho recorded the sensitivity
                              Controlo0..0
                              TipoReference(Practitioner, PractitionerRole, Patient, RelatedPerson)
                              É modificadorfalse
                              Resumofalse
                              Nomes alternativosAuthor
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              154. AllergyIntolerance.asserter
                              Definição

                              The source of the information about the allergy that is recorded.

                              CurtoSource of the information about the allergy
                              Comentários

                              The recorder takes responsibility for the content, but can reference the source from where they got it.

                              Controlo0..0
                              TipoReference(Patient, RelatedPerson, Practitioner, PractitionerRole)
                              É modificadorfalse
                              Resumotrue
                              Nomes alternativosSource, Informant
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              156. AllergyIntolerance.lastOccurrence
                              Definição

                              Represents the date and/or time of the last known occurrence of a reaction event.

                              CurtoDate(/time) of last known occurrence of a reaction
                              Comentários

                              This date may be replicated by one of the Onset of Reaction dates. Where a textual representation of the date of last occurrence is required e.g. 'In Childhood, '10 years ago' the Comment element should be used.

                              Controlo0..0
                              TipodateTime
                              É modificadorfalse
                              Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                              Resumofalse
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              158. AllergyIntolerance.note
                              Definição

                              Additional narrative about the propensity for the Adverse Reaction, not captured in other fields.

                              CurtoEvolução da Alergia ou Reação Adversa
                              Comentários

                              For example: including reason for flagging a seriousness of 'High Risk'; and instructions related to future exposure or administration of the substance, such as administration within an Intensive Care Unit or under corticosteroid cover. The notes should be related to an allergy or intolerance as a condition in general and not related to any particular episode of it. For episode notes and descriptions, use AllergyIntolerance.event.description and AllergyIntolerance.event.notes.

                              Controlo0..1
                              TipoAnnotation
                              É modificadorfalse
                              Deve apoiartrue
                              Resumofalse
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              160. AllergyIntolerance.note.id
                              Definição

                              Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                              CurtoUnique id for inter-element referencing
                              Controlo0..1
                              Tipostring
                              É modificadorfalse
                              Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                              Resumofalse
                              162. AllergyIntolerance.note.extension
                              Definição

                              May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                              CurtoAdditional content defined by implementations
                              Comentários

                              There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                              Controlo0..*
                              TipoExtension
                              É modificadorfalse
                              Resumofalse
                              Nomes alternativosextensions, user content
                              Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                              ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                              SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.note.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                              • value @ url
                              • 164. AllergyIntolerance.note.author[x]
                                Definição

                                The individual responsible for making the annotation.

                                CurtoIndividual responsible for the annotation
                                Comentários

                                Organization is used when there's no need for specific attribution as to who made the comment.

                                Controlo0..0
                                TipoEscolha de: Reference(Practitioner, Patient, RelatedPerson, Organization), string
                                É modificadorfalse
                                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                Resumotrue
                                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                166. AllergyIntolerance.note.time
                                Definição

                                Indicates when this particular annotation was made.

                                CurtoWhen the annotation was made
                                Controlo0..0
                                TipodateTime
                                É modificadorfalse
                                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                Resumotrue
                                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                168. AllergyIntolerance.note.text
                                Definição

                                The text of the annotation in markdown format.

                                CurtoThe annotation - text content (as markdown)
                                Controlo1..1
                                Tipomarkdown
                                É modificadorfalse
                                Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                Resumotrue
                                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                170. AllergyIntolerance.reaction
                                Definição

                                Details about each adverse reaction event linked to exposure to the identified substance.

                                CurtoAdverse Reaction Events linked to exposure to substance
                                Controlo0..1
                                TipoBackboneElement
                                É modificadorfalse
                                Deve apoiartrue
                                Resumofalse
                                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                172. AllergyIntolerance.reaction.id
                                Definição

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                CurtoUnique id for inter-element referencing
                                Controlo0..1
                                Tipostring
                                É modificadorfalse
                                Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                                Resumofalse
                                174. AllergyIntolerance.reaction.extension
                                Definição

                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                CurtoAdditional content defined by implementations
                                Comentários

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Controlo0..*
                                TipoExtension
                                É modificadorfalse
                                Resumofalse
                                Nomes alternativosextensions, user content
                                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                176. AllergyIntolerance.reaction.modifierExtension
                                Definição

                                May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

                                Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).

                                CurtoExtensions that cannot be ignored even if unrecognized
                                Comentários

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Controlo0..*
                                TipoExtension
                                É modificadortrue porque Modifier extensions are expected to modify the meaning or interpretation of the element that contains them
                                Resumotrue
                                Requisitos

                                Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions.

                                Nomes alternativosextensions, user content, modifiers
                                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                178. AllergyIntolerance.reaction.substance
                                Definição

                                Identification of the specific substance (or pharmaceutical product) considered to be responsible for the Adverse Reaction event. Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance.

                                CurtoSpecific substance or pharmaceutical product considered to be responsible for event
                                Comentários

                                Coding of the specific substance (or pharmaceutical product) with a terminology capable of triggering decision support should be used wherever possible. The 'code' element allows for the use of a specific substance or pharmaceutical product, or a group or class of substances. In the case of an allergy or intolerance to a class of substances, (for example, "penicillins"), the 'reaction.substance' element could be used to code the specific substance that was identified as having caused the reaction (for example, "amoxycillin"). Duplication of the value in the 'code' and 'reaction.substance' elements is acceptable when a specific substance has been recorded in 'code'.

                                Controlo0..0
                                VínculoPara exemplos de códigos, ver SubstanceCode
                                (example to http://hl7.org/fhir/ValueSet/substance-code)

                                Codes defining the type of the substance (including pharmaceutical products).

                                TipoCodeableConcept
                                É modificadorfalse
                                Resumofalse
                                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                180. AllergyIntolerance.reaction.manifestation
                                Definição

                                Sinais e/ou sintomas clínicos observados ou associados ao evento de reação adversa.

                                CurtoSinais e sintomas clínicos associados ao evento
                                Comentários

                                Manifestation can be expressed as a single word, phrase or brief description. For example: nausea, rash or no reaction. It is preferable that manifestation should be coded with a terminology, where possible. The values entered here may be used to display on an application screen as part of a list of adverse reactions, as recommended in the UK NHS CUI guidelines. Terminologies commonly used include, but are not limited to, SNOMED CT or ICD10.

                                Controlo1..1
                                VínculoOs códigos DEVERÃO ser retirados de Reações Adversas da MedDRA
                                (required to http://www.saude.gov.br/fhir/r4/ValueSet/BRReacoesAdversasMedDRA-1.0)

                                Reações Adversas da MedDRA

                                TipoCodeableConcept
                                É modificadorfalse
                                Resumofalse
                                Nomes alternativosSymptoms, Signs
                                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                182. AllergyIntolerance.reaction.manifestation.id
                                Definição

                                Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                CurtoUnique id for inter-element referencing
                                Controlo0..1
                                Tipostring
                                É modificadorfalse
                                Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                                Resumofalse
                                184. AllergyIntolerance.reaction.manifestation.extension
                                Definição

                                May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                CurtoAdditional content defined by implementations
                                Comentários

                                There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                Controlo0..*
                                TipoExtension
                                É modificadorfalse
                                Resumofalse
                                Nomes alternativosextensions, user content
                                Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.reaction.manifestation.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                                • value @ url
                                • 186. AllergyIntolerance.reaction.manifestation.coding
                                  Definição

                                  A reference to a code defined by a terminology system.

                                  CurtoCode defined by a terminology system
                                  Comentários

                                  Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.

                                  Controlo0..1
                                  TipoCoding
                                  É modificadorfalse
                                  Resumotrue
                                  Requisitos

                                  Allows for alternative encodings within a code system, and translations to other code systems.

                                  Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  188. AllergyIntolerance.reaction.manifestation.coding.id
                                  Definição

                                  Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

                                  CurtoUnique id for inter-element referencing
                                  Controlo0..1
                                  Tipostring
                                  É modificadorfalse
                                  Formato XMLNo formato XML, esta propriedade é representada como um atributo.
                                  Resumofalse
                                  190. AllergyIntolerance.reaction.manifestation.coding.extension
                                  Definição

                                  May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

                                  CurtoAdditional content defined by implementations
                                  Comentários

                                  There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

                                  Controlo0..*
                                  TipoExtension
                                  É modificadorfalse
                                  Resumofalse
                                  Nomes alternativosextensions, user content
                                  Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                  ext-1: Must have either extensions or value[x], not both (extension.exists() != value.exists())
                                  SlicingEste elemento introduz um conjunto de fatias em AllergyIntolerance.reaction.manifestation.coding.extension. As fatias sãoNão ordenado e Opene pode ser diferenciado utilizando os seguintes discriminadores:
                                  • value @ url
                                  • 192. AllergyIntolerance.reaction.manifestation.coding.system
                                    Definição

                                    The identification of the code system that defines the meaning of the symbol in the code.

                                    CurtoIdentity of the terminology system
                                    Comentários

                                    The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should reference to some definition that establishes the system clearly and unambiguously.

                                    Controlo1..1
                                    Tipouri
                                    É modificadorfalse
                                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                    Resumotrue
                                    Requisitos

                                    Need to be unambiguous about the source of the definition of the symbol.

                                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    194. AllergyIntolerance.reaction.manifestation.coding.version
                                    Definição

                                    The version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured, and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged.

                                    CurtoVersion of the system - if relevant
                                    Comentários

                                    Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.

                                    NotaEste é um ID de versão comercial, não um ID de versão de recurso (ver discussão)
                                    Controlo0..1
                                    Tipostring
                                    É modificadorfalse
                                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                    Resumotrue
                                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    196. AllergyIntolerance.reaction.manifestation.coding.code
                                    Definição

                                    A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

                                    CurtoSymbol in syntax defined by the system
                                    Controlo1..1
                                    Tipocode
                                    É modificadorfalse
                                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                    Resumotrue
                                    Requisitos

                                    Need to refer to a particular code in the system.

                                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    198. AllergyIntolerance.reaction.manifestation.coding.display
                                    Definição

                                    A representation of the meaning of the code in the system, following the rules of the system.

                                    CurtoRepresentation defined by the system
                                    Controlo0..0
                                    Tipostring
                                    É modificadorfalse
                                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                    Resumotrue
                                    Requisitos

                                    Need to be able to carry a human-readable meaning of the code for readers that do not know the system.

                                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    200. AllergyIntolerance.reaction.manifestation.coding.userSelected
                                    Definição

                                    Indicates that this coding was chosen by a user directly - e.g. off a pick list of available items (codes or displays).

                                    CurtoIf this coding was chosen directly by the user
                                    Comentários

                                    Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.

                                    Controlo0..0
                                    Tipoboolean
                                    É modificadorfalse
                                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                    Resumotrue
                                    Requisitos

                                    This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing.

                                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    202. AllergyIntolerance.reaction.manifestation.text
                                    Definição

                                    A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

                                    CurtoPlain text representation of the concept
                                    Comentários

                                    Very often the text is the same as a displayName of one of the codings.

                                    Controlo0..1
                                    Tipostring
                                    É modificadorfalse
                                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                    Resumotrue
                                    Requisitos

                                    The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source.

                                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    204. AllergyIntolerance.reaction.description
                                    Definição

                                    Text description about the reaction as a whole, including details of the manifestation if required.

                                    CurtoDescription of the event as a whole
                                    Comentários

                                    Use the description to provide any details of a particular event of the occurred reaction such as circumstances, reaction specifics, what happened before/after. Information, related to the event, but not describing a particular care should be captured in the comment field. For example: at the age of four, the patient was given penicillin for strep throat and subsequently developed severe hives.

                                    Controlo0..0
                                    Tipostring
                                    É modificadorfalse
                                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                    Resumofalse
                                    Nomes alternativosNarrative, Text
                                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    206. AllergyIntolerance.reaction.onset
                                    Definição

                                    Record of the date and/or time of the onset of the Reaction.

                                    CurtoDate(/time) when manifestations showed
                                    Controlo0..0
                                    TipodateTime
                                    É modificadorfalse
                                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                    Resumofalse
                                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    208. AllergyIntolerance.reaction.severity
                                    Definição

                                    Clinical assessment of the severity of the reaction event as a whole, potentially considering multiple different manifestations.

                                    Curtomild | moderate | severe (of event as a whole)
                                    Comentários

                                    It is acknowledged that this assessment is very subjective. There may be some specific practice domains where objective scales have been applied. Objective scales can be included in this model as extensions.

                                    Controlo0..0
                                    VínculoOs códigos DEVERÃO ser retirados de AllergyIntoleranceSeverity
                                    (required to http://hl7.org/fhir/ValueSet/reaction-event-severity|4.0.1)

                                    Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.

                                    Tipocode
                                    É modificadorfalse
                                    Valor primitivoEste elemento primitivo pode estar presente, ausente ou ser substituído por uma extensão
                                    Resumofalse
                                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    210. AllergyIntolerance.reaction.exposureRoute
                                    Definição

                                    Identification of the route by which the subject was exposed to the substance.

                                    CurtoHow the subject was exposed to the substance
                                    Comentários

                                    Coding of the route of exposure with a terminology should be used wherever possible.

                                    Controlo0..0
                                    VínculoPara exemplos de códigos, ver SNOMEDCTRouteCodes
                                    (example to http://hl7.org/fhir/ValueSet/route-codes)

                                    A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.

                                    TipoCodeableConcept
                                    É modificadorfalse
                                    Resumofalse
                                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))
                                    212. AllergyIntolerance.reaction.note
                                    Definição

                                    Additional text about the adverse reaction event not captured in other fields.

                                    CurtoText about event not captured in other fields
                                    Comentários

                                    Use this field to record information indirectly related to a particular event and not captured in the description. For example: Clinical records are no longer available, recorded based on information provided to the patient by her mother and her mother is deceased.

                                    Controlo0..0
                                    TipoAnnotation
                                    É modificadorfalse
                                    Resumofalse
                                    Invariantesele-1: All FHIR elements must have a @value or children (hasValue() or (children().count() > id.count()))