Represents unverified clinical information reported by a caller or dispatcher before physical patient assessment by an emergency medical practitioner.

Caller-reported observations must remain distinct from observations recorded after direct clinical assessment.

Represents a patient's allergy or intolerance recorded during Kenya emergency medical services and facility workflows.

Criticality and reaction detail are must-fetch on patient lookup and must never be silently dropped. By the time the allergy-history section of an assessment is marked complete, the patient must have either one or more EMAllergyIntolerance instances with a real allergen code, or exactly one EMNoKnownAllergy instance — never both, never neither.

A looser variant of EMAllergyIntolerance for sources that capture allergy history as free text during initial intake (e.g. "Penicillin allergy", manifestation "moderate") rather than fully coded clinicalStatus, verificationStatus, and criticality. Use EMAllergyIntolerance instead once a source can supply those fields.

An explicit record asserting that a full allergy history was taken and nothing was found, distinct from simply having zero AllergyIntolerance resources.

The absence of any AllergyIntolerance resource is ambiguous — it could mean 'confirmed none' or 'never asked' — and that ambiguity is exactly the kind of gap that can lead to a contraindicated drug being administered.

Represents an emergency investigation result, e.g. a 12-lead ECG, laboratory result, or imaging report, generated during pre-hospital or facility-based emergency care.

Represents the complete emergency medical services incident from dispatch initiation through handover at the receiving facility.

This Encounter is the root encounter for an EMS episode. It captures dispatch information, the reporting caller, the dispatcher, responding units, participating emergency agencies, scene information, and the destination facility.

Clinical care performed by the responding emergency team should be represented using a separate point-of-care Encounter whose partOf element references this Encounter.

Represents the direct patient-care encounter performed by an emergency medical team at the scene or during transport.

The point-of-care Encounter is subordinate to the root emergency incident Encounter and references it through Encounter.partOf.

A prominent, must-see alert referencing a high-criticality EMAllergyIntolerance record.

Reuses the base FHIR Flag resource, designed exactly for prominent alerts, rather than requiring every consuming system to know a local convention on AllergyIntolerance. Intended for use specifically with EMAllergyIntolerance instances where criticality = high.

Represents the physical healthcare facility or emergency-care location intended to receive, or that actually received, a patient transported by emergency medical services.

The Location identifies the physical destination. The organization operating the facility is referenced through Location.managingOrganization.

Represents the physical location at which an emergency incident occurred or at which the patient was found.

The location supports coordinates, landmarks, descriptive directions, and administrative geographic details.

Represents the real-time geographic position and response status of an emergency responder unit, referenced from EMResponderUnit.location.

Represents a medication administered to a patient during Kenya emergency medical services and facility clinical workflows.

Used instead of MedicationRequest because emergency care is administration-heavy — drugs are given in real time, not merely prescribed.

Represents whether active bleeding was reported by the caller or dispatcher before direct clinical assessment.

Represents the patient's apparent breathing status as reported by a caller or dispatcher before direct clinical assessment.

Represents the patient's apparent level of consciousness as reported by the caller or dispatcher before direct clinical assessment.

Represents a single investigation (lab test, imaging study, or similar) ordered or resulted during emergency care — one Observation instance per investigation, mirroring the explicit-absence pattern used on EMSecondarySurveyObservation.

Represents the examination of a single body region during an emergency secondary survey — one Observation instance per body region examined (head, neck, chest, back-and-spine, abdomen, pelvis, upper-extremities, lower-extremities), not one Observation for the whole secondary survey.

Mirrors the explicit-absence pattern used on EMAllergyIntolerance: a region with nothing abnormal found must be recorded as an explicit "examined, no findings" Observation, never left as a silently-missing resource. A full-body exam is expected to produce exactly 8 Observation instances (fewer only if the survey was genuinely partial, e.g. limited by scene safety) — that expectation is a workflow-completeness rule, not a FHIR structural constraint on this profile.

A standalone, trendable triage acuity record, separate from EMIncidentEncounter.priority (dispatch) and EMPOCEncounter.priority (on-scene).

Only create this Observation when the workflow needs acuity trending as discrete timestamped events; if a single current-priority value per encounter is sufficient, Encounter.priority alone is enough and this Observation is unnecessary.

Represents a single vital-sign measurement (heart rate, respiratory rate, temperature, SpO2, blood pressure, or Glasgow Coma Scale) captured during Kenya emergency medical services and point-of-care workflows.

Largely reuses the standard FHIR vital-signs pattern rather than inventing new structure. One Observation instance is created per measurement, per reading time, so trends across the episode (dispatch snapshot, on-scene, in-transit, ED arrival) can be reconstructed.

Represents a clinical procedure performed during Kenya emergency medical services and point-of-care workflows, e.g. CPR, endotracheal intubation, wound dressing, or splinting.

Same as EMProcedure, except code is bound to the ICHI-based EMProcedureCodesVS (sourced from the MOH-PPB "EmergencyProcedures" OCL collection) instead of the local ProcedureCodeVS.

Describes whether a destination facility provides emergency-care services and the level of emergency capability available.

Auto-generated clinical guidance text tied to an observation's severity flag, e.g. instructions to start supplemental oxygen and reassess airway and breathing.

Represents the Kenya health-system level assigned to a receiving healthcare facility.

Captures the person who reported the emergency incident.

The caller may be the Patient, a person related to the Patient, or an unlinked person such as a bystander. This extension is necessary because the base Encounter.participant.individual element does not permit Patient or Person references in FHIR R4/R4B.

Number of attempts made to administer a medication, relevant for repeated-dose protocols and difficult-access scenarios.

Explicit flag confirming that a body region was examined and that nothing abnormal was found.

Explicit flag confirming whether an investigation/result value is present on this Observation.

Indicates whether the patient is considered an adult during emergency assessment or triage.

Represents the patient's estimated age when the exact date of birth is unknown or has not been verified.

Indicates whether the patient's identity has been verified through an appropriate identification or verification process.

May be recorded on the Patient resource directly, or on a point-of-care Encounter to capture that the emergency team confirmed identity at that specific encounter. When recorded on an Encounter, the linked Patient resource should also be updated so downstream systems (e.g. claims adjudication) can key off the Patient-level value alone.

Represents a practitioner or practitioner role assigned to an emergency responder unit.

The extension records both the assigned person or role and their operational crew function.

Date and time the responder unit's geographic position was last refreshed.

Ownership category of the organization operating an emergency responder unit, e.g. government, private, or NGO.

Indicates whether a responder unit has been stood down or replaced by another unit during the incident.

The responder unit's current response state, e.g. dispatched, en-route, on-scene, transporting, or at-facility.

Identifier of the onboard telematics or tracking device fitted to an emergency responder unit, if present.

References an ambulance or other emergency-response vehicle assigned to the incident.

References another emergency-response organization participating in the incident, such as fire services, police, security services, or disaster management services.

Indicates whether the Patient resource represents an individual whose identity has not yet been established.

Age-group bucket used to select the applicable reference range for a vital-sign reading, e.g. adult versus paediatric.

Qualitative descriptor of a vital-sign reading, independent of its numeric value, e.g. a pulse described as weak or a breathing pattern described as labored.

Dispatcher-assigned priority at call intake. Maps to incident.priority_level. Represents the INITIAL priority only — do not overwrite with on-scene EMT triage acuity.

Number of patients associated with this incident/dispatch. Maps to incident.number_of_patients. Kept at the EpisodeOfCare (incident) level, not duplicated on child Encounters. If >1, expect multiple EMEpisodeOfCare/Patient chains linked via identifier:groupIncidentId.

Permitted AVPU responsiveness values.

Drug/allergen active-component codes used for allergen and medication coding.

ValueSet for ambulance case status.

ValueSet for types of clinical assessments.

ValueSet for units used in medication dosing.

Value set for the incidentPriority extension. Maps to incident.priority_level.

Permitted age-group buckets used to select a reference range.

Findings that may be observed at a body region during an emergency secondary survey.

Permitted body regions examined during an emergency secondary survey.

Permitted breathing-status values.

Permitted relationships between an emergency caller and the patient.

Permitted emergency-care capability classifications for destination facilities.

Permitted facility types for an emergency transport destination.

Permitted diagnostic stages for an emergency Condition instance.

Permitted dispatch priorities assigned during emergency call intake.

Permitted high-level classifications of emergency incidents.

Permitted investigation codes for emergency care, sourced from the MOH-PPB "EmergencyInvestigations" collection on Kenya's OCL terminology server.

Single-value ValueSet containing only the generic "EM Investigation" concept.

Allowed official identifier types for an emergency patient in Kenya.

Permitted procedure codes for emergency care, sourced from the MOH-PPB "EmergencyProcedures" collection on Kenya's OCL terminology server.

Permitted roles for personnel assigned to an emergency responder unit.

Permitted ownership categories for an emergency responder unit.

Permitted real-time response states for an emergency responder unit.

Permitted types of vehicles and mobile units participating in an emergency response.

Permitted classifications for emergency incident scene locations.

Permitted secondary-survey region examination codes.

Permitted types of emergency-response organizations participating in an incident.

Permitted qualitative descriptors for a vital-sign reading.

List of vital-signs LOINC codes used by this IG.

ValueSet containing investigation codes for procedures.

Permitted Kenya health-system facility levels.

Clinical manifestations and symptoms.

ValueSet for routes of medication administration.

Local procedure code list, supplementing SNOMED CT procedure codes.

AVPU scale used to describe a patient's responsiveness.

Active pharmaceutical ingredient codes from MOH PPB OCL.

Identifies the source reporting an allergy.

Defines reasons for rejecting an ambulance case.

Defines the lifecycle statuses of an ambulance case.

Raw GCS eye-opening response codes as sent by the ambulance dispatch source system (e.g. Observation.value/assessment.gcs.eye_opening = "XC3W"). The originating code system for these codes has not been verified against a published standard; they are captured here only so a ConceptMap can crosswalk them to this IG's own EMGCSEyeOpeningCS. See EMGCSCrosswalkCM.

Raw GCS motor response codes as sent by the ambulance dispatch source system. The originating code system for these codes has not been verified against a published standard; they are captured here only so a ConceptMap can crosswalk them to this IG's own EMGCSMotorResponseCS. See EMGCSCrosswalkCM.

Raw GCS verbal response codes as sent by the ambulance dispatch source system. The originating code system for these codes has not been verified against a published standard; they are captured here only so a ConceptMap can crosswalk them to this IG's own EMGCSVerbalResponseCS. See EMGCSCrosswalkCM.

Specifies types of clinical assessments for patient evaluation.

Clinical classification of breathing rate states.

Defines priority levels for cases.

CodeSystem for Code systems

CodeSystem for Contact Relationship

CodeSystem for patient's identifier Types

CodeSystem for patient's title

Identifies the terminology source from which a clinical code originates.

Clinical severity statuses for a patient condition.

Units used to specify medication doses, sourced from the Kenya MOH National Product Catalogue (NPC).

Dispatcher-assigned priority levels at call intake.

Age-group bucket used to select the applicable clinical reference range for an emergency observation.

Findings that may be observed at a body region during an emergency secondary survey (physical exam).

Body regions examined during an emergency secondary survey.

Caller- or practitioner-reported categories describing the patient's apparent breathing status.

Relationship of an emergency caller to the patient.

Emergency-care capabilities available at a receiving health facility.

Clinical acuity assigned by an emergency practitioner after patient assessment. This terminology is distinct from dispatch priority.

Types of healthcare locations that may receive an emergency patient.

Diagnostic stage represented by an emergency Condition instance, from initial chief complaint through discharge diagnosis.

Priority assigned to an emergency incident during call intake.

Roles performed by people or organizations involved in an emergency incident.

Glasgow Coma Scale eye-opening response categories (LOINC 9267-6).

Glasgow Coma Scale motor response categories (LOINC 9268-4).

Glasgow Coma Scale verbal response categories (LOINC 9270-0).

High-level classification of an emergency incident.

Single-value marker CodeSystem for the generic "EM Investigation" category.

LOINC codes for investigations commonly ordered in emergency care, sourced from the MOH-PPB "EmergencyInvestigations" collection on Kenya's OCL terminology server (ilm-hie.dha.go.ke).

Categories used to distinguish emergency observations by their source and clinical verification status.

Local codes for emergency medical observations not adequately represented by a single preferred external terminology code.

Identifier types used to identify patients receiving emergency or pre-hospital services in Kenya.

Types of direct patient-care interactions performed during emergency response.

ICHI (International Classification of Health Interventions, WHO) codes for procedures commonly performed in emergency care, sourced from the MOH-PPB "EmergencyProcedures" collection on Kenya's OCL terminology server (ilm-hie.dha.go.ke).

Operational roles performed by personnel assigned to an emergency responder unit.

Ownership category of an organization operating an emergency responder unit.

Current operational response state of an emergency responder unit during an incident.

Types of vehicles and mobile units used during emergency response.

Types of physical locations at which emergency incidents may occur.

Identifies a secondary-survey physical examination as pertaining to a specific body region.

Types of organizations that may participate in an emergency response.

Qualitative descriptor of a vital-sign reading that is independent of, and supplements, its numeric value.

Defines the type of clinical entry recorded in the health record.

Defines Investigation Codes for Procedures.

CodeSystem for KHTS.A Counties in Kenya

Levels used to classify health facilities in the Kenya health system.

Clinical manifestations and symptoms used in allergy reactions, conditions, and observations. Source: MOH-KENYA OCL MANIFESTATION-OR-SYMPTOM.

Route by which a medication is administered, sourced from the Kenya MOH National Product Catalogue (NPC).

Fixed assertion code for an explicit no-known-allergy record, replacing SNOMED CT-based HL7 ValueSet

Clinical procedure codes used in care plan activities and service requests. Source: MOH-KENYA OCL PROCEDURE-CODE.

Clinical classification of pulse rate states.

Categories used to classify questionnaires or assessments.

LOINC codes commonly used for vital signs observations.

Identifier system assigned by the dispatch or computer-aided dispatch (CAD) system to an emergency incident.

Shared identifier system used to associate an emergency incident across EMEpisodeOfCare, EMIncidentEncounter, and EMPOCEncounter.

Identifier system for records created within the Kenya emergency and ambulance services workflow.

Unique national identifier assigned to Kenyan citizens and residents.

Local identifier system unique to a specific point-of-care encounter instance, used when a single incident involves more than one point-of-care encounter.

Maps the ambulance dispatch source system's own GCS eye-opening, motor response, and verbal response codes (EMSourceGCSEyeOpeningCS, EMSourceGCSMotorResponseCS, EMSourceGCSVerbalResponseCS) onto this IG's own EMGCSEyeOpeningCS, EMGCSMotorResponseCS, and EMGCSVerbalResponseCS. Use via $translate during ingestion so a raw source value such as "XC3W" is converted to this IG's "spontaneous" before being placed on EMVitalSignsObservation.component[gcsEye] (and similarly for gcsMotor and gcsVerbal).

Example confirmed severe allergy resulting in anaphylaxis.

Invalid allergy example demonstrating a missing required criticality.

Example explicit no-known-allergy assertion recorded after a full allergy history was taken.

Example ECG investigation result flagging an anterior STEMI.

Invalid diagnostic report example demonstrating a missing required category, tightened to 1..1 on this profile though optional in base DiagnosticReport.

Example root emergency incident Encounter for a road traffic trauma case.

Example point-of-care Encounter for direct patient assessment and treatment during the incident above.

Example must-see alert referencing the high-criticality Domiphen allergy above.

Example receiving facility for emergency transport.

Example emergency incident scene location.

Example real-time position of the ambulance responding to the incident.

Example emergency medication administration during resuscitation.

Invalid medication administration example demonstrating a missing encounter context, tightened to 1..1 on this profile though optional in base MedicationAdministration.

Example blood-pressure panel with systolic and diastolic components.

Example GCS total with eye/verbal/motor sub-scores captured separately.

Example heart-rate vital sign showing a critical qualitative pulse state.

Invalid exam example: a finding is coded but noFindingsOnExam is left true, violating invariant em-exam-1.

Example head examination with no abnormal findings, explicitly recorded.

Example upper-extremities examination with a coded abnormal finding.

Example standalone triage acuity reassessment, distinct from EMPOCEncounter.priority.

Invalid vital signs example demonstrating a missing required value.

Example emergency medical services provider and dispatch organization.

Example paramedic involved in ambulance response and emergency handover.

Example emergency airway procedure performed during transport.

Invalid procedure example demonstrating a missing required code, the specific procedure performed.