Burnwound-v3.1(2017EN) - Bewerkingsoverzicht

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	<ul>		<ul>
	<li>HL7® version 3 CDA compatible specifications, available through the Nictiz ART-DECOR® environment [http://decor.nictiz.nl/art-decor/decor-scenarios--zib2017bbr-?id=2.16.840.1.113883.2.4.3.11.60.7.4.2.19.4&effectiveDate=2017-09-04T00:00:00&language=en-US&scenariotree=false [[File:artdecor.jpg\|16px\|link=]]]</li>		<li>HL7® version 3 CDA compatible specifications, available through the Nictiz ART-DECOR® environment [http://decor.nictiz.nl/art-decor/decor-scenarios--zib2017bbr-?id=2.16.840.1.113883.2.4.3.11.60.7.4.2.19.4&effectiveDate=2017-09-04T00:00:00&language=en-US&scenariotree=false [[File:artdecor.jpg\|16px\|link=]]]</li>
	<li>HL7® FHIR® compatible specifications, available through the Nictiz environment on the Simplifier FHIR [https://simplifier.net/NictizSTU3/~resources?text=zib&category=~~StructureDefinition~~ [[File:fhir.png\|link=]]]</li>		<li>HL7® FHIR® compatible specifications, available through the Nictiz environment on the Simplifier FHIR [https://simplifier.net/NictizSTU3/~resources?text=zib&category=Profile [[File:fhir.png\|link=]]]</li>
	</ul>		</ul>
	This information model is also available as [[Media:nl.zorg.Burnwound-v3.1(2017EN).pdf\|pdf file]] [[File:PDF.png\|link=]] or as [[Media:nl.zorg.Burnwound-v3.1(2017EN).xlsx\|spreadsheet]] [[File:xlsx.png\|link=]]		This information model is also available as [[Media:nl.zorg.Burnwound-v3.1(2017EN).pdf\|pdf file]] [[File:PDF.png\|link=]] or as [[Media:nl.zorg.Burnwound-v3.1(2017EN).xlsx\|spreadsheet]] [[File:xlsx.png\|link=]]

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	==More on this information model==		==More on this information model==
	More technical information and HL7/XML documentation you can find on the Nictiz Art-Decor page about this information model[http://decor.nictiz.nl/art-decor/decor-datasets--zib1bbr-?id=2.16.840.1.113883.2.4.3.11.60.40.3.19.4] <BR>		More technical information and HL7/XML documentation you can find on the Nictiz Art-Decor page about this information model[http://decor.nictiz.nl/art-decor/decor-datasets--zib1bbr-?id=2.16.840.1.113883.2.4.3.11.60.40.3.19.4] <BR>
	This information model is also available as [[Media:nl.zorg.Burnwound-v3.1(EN).pdf\|pdf file]] [[File:PDF.png\|link=]] or as [[Media:nl.zorg.Burnwound-v3.1(EN).xlsx\|spreadsheet]] [[File:xlsx.png\|link=]]		This information model is also available as [[Media:nl.zorg.Burnwound-v3.1(2017EN).pdf\|pdf file]] [[File:PDF.png\|link=]] or as [[Media:nl.zorg.Burnwound-v3.1(2017EN).xlsx\|spreadsheet]] [[File:xlsx.png\|link=]]
	==About this information==		==About this information==
	The information in this wikipage is based on Prerelease 2017 #1 <BR>		The information in this wikipage is based on Prerelease 2017 #1 <BR>
	Conditions for use are located on the mainpage [[Bestand:list2.png\|link=HCIM_Mainpage]]<BR>		Conditions for use are located on the mainpage [[Bestand:list2.png\|link=HCIM_Mainpage]]<BR>
	This page is generated on 21/09/2017 18:~~24:15~~ <BR>		This page is generated on 28/09/2017 11:18:11 <BR>
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	The information in this wikipage is based on Prerelease 2017 #1 <BR>		The information in this wikipage is based on Prerelease 2017 #1 <BR>
	Conditions for use are located on the mainpage [[Bestand:list2.png\|link=HCIM_Mainpage]]<BR>		Conditions for use are located on the mainpage [[Bestand:list2.png\|link=HCIM_Mainpage]]<BR>
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	<div style="text-align: right; direction: ltr; margin-left: 1em;" >[[Bestand: Back 16.png\| link= HCIM_Release_2017(EN)]] [[HCIM_Release_2017(EN) \|Back to HCIM list ]]</div>		<div style="text-align: right; direction: ltr; margin-left: 1em;" >[[Bestand: Back 16.png\| link= HCIM_Release_2017(EN)]] [[HCIM_Release_2017(EN) \|Back to HCIM list ]]</div>

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	The information in this wikipage is based on Prerelease 2017 #1 <BR>		The information in this wikipage is based on Prerelease 2017 #1 <BR>
	Conditions for use are located on the mainpage [[Bestand:list2.png\|link=HCIM_Mainpage]]<BR>		Conditions for use are located on the mainpage [[Bestand:list2.png\|link=HCIM_Mainpage]]<BR>
	This page is generated on 21/09/2017 15:46:23 <BR>		This page is generated on 21/09/2017 18:14:07 <BR>
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Version: '''3.1'''
HCIM Status:Final
Publicati...'

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==General information==
Name: '''nl.zorg.Burnwound''' [[Bestand:NL.png|link=Brandwond-v3.1(2017NL)]] 
Version: '''3.1''' 
HCIM Status:Final 
Publication: '''2017''' 
Release status: Prepublished 
Publication date: 04-09-2017
-----
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==Metadata==
{| class="wikitable" style="font-size:90%; width: 750px"
|-
|style="width:250px; "|DCM::CoderList||Werkgroep RadB Verpleegkundige Gegevens
|-
|style="width:250px; "|DCM::ContactInformation.Address||*
|-
|style="width:250px; "|DCM::ContactInformation.Name||*
|-
|style="width:250px; "|DCM::ContactInformation.Telecom||*
|-
|style="width:250px; "|DCM::ContentAuthorList||Werkgroep RadB Verpleegkundige Gegevens
|-
|style="width:250px; "|DCM::CreationDate||18-9-2014
|-
|style="width:250px; "|DCM::DeprecatedDate||
|-
|style="width:250px; "|DCM::DescriptionLanguage||nl
|-
|style="width:250px; "|DCM::EndorsingAuthority.Address||
|-
|style="width:250px; "|DCM::EndorsingAuthority.Name||PM
|-
|style="width:250px; "|DCM::EndorsingAuthority.Telecom||
|-
|style="width:250px; "|DCM::Id||2.16.840.1.113883.2.4.3.11.60.40.3.19.4
|-
|style="width:250px; "|DCM::KeywordList||Brandwond
|-
|style="width:250px; "|DCM::LifecycleStatus||Final
|-
|style="width:250px; "|DCM::ModelerList||Werkgroep RadB Verpleegkundige Gegevens
|-
|style="width:250px; "|DCM::Name||nl.zorg.Brandwond
|-
|style="width:250px; "|DCM::PublicationDate||04-09-2017
|-
|style="width:250px; "|DCM::PublicationStatus||Prepublished
|-
|style="width:250px; "|DCM::ReviewerList||Projectgroep RadB Verpleegkundige Gegevens & Kerngroep Registratie aan de Bron
|-
|style="width:250px; "|DCM::RevisionDate||04-09-2017
|-
|style="width:250px; "|DCM::Superseeds||nl.zorg.Brandwond-v3.0
|-
|style="width:250px; "|DCM::Version||3.1
|-
|style="width:250px; "|HCIM::PublicationLanguage||EN
|}

==Revision History==
<div class="mw-collapsible mw-collapsed">
''Only available in Dutch''

Publicatieversie 1.0 (01-07-2015)

Publicatieversie 3.0 (01-05-2016)
{|
|}

Publicatieversie 3.1 (04-09-2017)
{|
|-
|style="width:75px; "|[[ZIBIssues#ZIB-530 | ZIB-530 ]]
|Verwijzingen naar de bouwsteen Verpleegkundige Interventie verwijderd
|-
|style="width:75px; "|[[ZIBIssues#ZIB-532 | ZIB-532 ]]
|Toevoegen concept BrandwondSoort met waardelijst
|-
|style="width:75px; "|[[ZIBIssues#ZIB-585 | ZIB-585 ]]
|Toevoegen concept Lateraliteit aan het concept Anatomische Locatie
|}
</div>

==Concept==
A burn wound is a wound caused by skin being exposed to heat for a certain time above a certain critical temperature. Heat above this critical temperature (+/- 40°C) will cause damage to the skin. There are different types of burn wounds, which are categorized according to the depth of the burn wound. 
The depth of the burn wound depends on: 
<ul>
<li>the temperature of the impacting heat; </li>
</ul>
<ul>
<li>the duration of the impact of heat on the skin; </li>
</ul>
<ul>
<li>the source of the burn (e.g. fire, fluid).</li>
</ul>

==Purpose==
The description of the burn wound is of importance for starting or continuing the best possible wound treatment and to be able to properly monitor the wound healing process.

==Evidence Base==
Different degrees are used to evaluate the depth of the burn wound: 
 
First-degree burn (no wound): 
<ul>
<li>redness </li>
</ul>
<ul>
<li>good capillary refill </li>
</ul>
<ul>
<li>supple </li>
</ul>
<ul>
<li>painful </li>
</ul>
 
Superficial second-degree burn wound (partial thickness of the skin): 
<ul>
<li>intact / broken blisters </li>
</ul>
<ul>
<li>pink, shiny, uniform </li>
</ul>
<ul>
<li>good capillary refill </li>
</ul>
<ul>
<li>supple </li>
</ul>
<ul>
<li>painful </li>
</ul>
 
<ul>
<li>Deep second-degree burn wound: </li>
</ul>
<ul>
<li>intact / broken blisters </li>
</ul>
<ul>
<li>pink, matte, not homogenous, damp </li>
</ul>
<ul>
<li>slow capillary refill </li>
</ul>
<ul>
<li>slightly more firm </li>
</ul>
<ul>
<li>painful </li>
</ul>
 
Third-degree burn wound 
<ul>
<li>intact / broken blisters, epidermis stuck to burned dermis </li>
</ul>
<ul>
<li>white, brown, yellow, red (when kept in hot water for a prolonged period of time) </li>
</ul>
<ul>
<li>no capillary refill, non-removable redness </li>
</ul>
<ul>
<li>firm </li>
</ul>
<ul>
<li>less painful than the size of the wound makes it appear </li>
</ul>
 
(Source: Brandwondenprotocol 2010, Rode Kruis Brandwondencentrum Beverwijk [2010 Burn wound protocol, Beverwijk Red Cross Burn Wound Center]) 

==Information Model==
 
[[Bestand: Burnwound-v3.1Model(EN).png | center]]
 
{| border= "1" width="1500px" style = "font-size: 9.5pt; border: solid 1px silver; border-collapse:collapse;" cellpadding = "3px" cellspacing ="0px"
|-style="background-color: #1F497D; color: white; font-weight: bold; font-variant: small-caps; "
|style="width:30px;"|Type||style="width:100px;"|Id||colspan="6 " style="width:140px;"|Concept||Card.||style="width: 600px;"|Definition||style="width:200px;"|DefinitionCode||style="width:200px;"|Reference
|-style="vertical-align:top; background-color: #E3E3E3; "
|style = "text-align:center" |[[Bestand: block.png| 20px]]
||NL-CM:19.4.1
|colspan ="6" style ="padding-left: 0px"|[[Bestand: arrowdown.png | 10px]]BurnWound
|
|Root concept of the BurnWound information model. This concept contains all data elements of the BurnWound information model.
|
{|
|-
| 125666000 Brandwond 
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: TS.png| 16px]]
||NL-CM:19.4.3
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px]]DateOfOnset
|0..1
|Date on which the burn wound appeared.
|
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: PQ.png| 16px]]
||NL-CM:19.4.7
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px]]Extent
|0..1
|The extent of a burn wound is indicated in a percentage of the ‘Total Body Surface Area’ (TBSA). For adults, the TBSA can be calculated on the basis of the ‘rule of nines’, in which body parts are expressed in the percentage 9 and multiples of 9. This ‘rule of nines’ cannot be used for children because a child’s body proportions are different from those of an adult. For children, separate tables were developed per age group to determine the extent of burn wounds. Another option is measuring the extent using the patient’s hand surface area. The surface area of a patient’s hand (including the fingers) equals approximately 1% of their total body surface area.

(Source: Brandwonden genezen. Hoe verder? [Healing Burn Wounds. What now?)

|
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: CD.png| 16px]]
||NL-CM:19.4.9
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px]]BrandwondSoort
|0..1
|Indication of the kind of the burn wound, differentiated into the cause of the injury.
|
|
{|
|-
|[[Bestand: List2.png]]||[[#BurnTypeCodelist|BurnTypeCodelist]]
|}
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: CD.png| 16px]]
||NL-CM:19.4.4
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px]]AnatomicalLocation
|0..1
|The location of the burn wound on the body.
|
{|
|-
| 363698007 Finding site
|}
|
{|
|-
|[[Bestand: List2.png]]||[[#BurnWoundAnatomicalLocationCodelist|BurnWoundAnatomicalLocationCodelist]]
|}
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: CD.png| 16px]]
||NL-CM:19.4.10
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px]]Laterality
|0..1
|Laterality adds information about body side to the anatomic location, e.g. left
|
{|
|-
| 272741003 Laterality
|}
|
{|
|-
|[[Bestand: List2.png]]||[[#BurnWoundLateralityCodelist|BurnWoundLateralityCodelist]]
|}
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: CO.png| 16px]]
||NL-CM:19.4.2
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px]]Depth
|1
|Description of the severity of the burn wound, ranging from degree 1 - 3.
|
|
{|
|-
|[[Bestand: List2.png]]||[[#DepthCodelist|DepthCodelist]]
|}
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: ST.png| 16px]]
||NL-CM:19.4.5
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px]]Comment
|0..1
|Comment on the burn wound.
|
{|
|-
| 48767-8 Annotation comment
|}
|
|-style="vertical-align:top; background-color: transparent; "
|style = "text-align:center" |[[Bestand: TS.png| 16px]]
||NL-CM:19.4.8
|style = "width: 7px; padding-left: 0px; padding-right: 0px; border-left: none; border-right: 1px dotted silver;" |
|colspan ="5" style ="padding-left: 0px"|[[Bestand: arrowright.png | 10px]]DateOfLastDressingChange
|0..1
|Date on which the dressing was last changed.
|
|
|}
Columns Concept and DefinitionCode: hover over the values for more information 
For explanation of the symbols, please see the legend page [[Bestand:list2.png|link=Legend]]

==Example Instances==
''Only available in Dutch''

{|class="wikitable" width="564px" style= "font-size: 9.5pt;"
|-style=vertical-align:top;
|colspan="2" style="background-color: #1F497D; width: 100%; color: #FFFFFF; font-weight: bold; "|Brandwond
|-style=vertical-align:top;
| style="width: 42%; "|Dieptegraad
| style="width: 58%; "|2e graad, oppervlakkig
|-style=vertical-align:top;
| style="width: 42%; "|Uitgebreidheid
| style="width: 58%; "|1%
|-style=vertical-align:top;
| style="width: 42%; "|AnatomischeLocatie
| style="width: 58%; "|onderarm
|-style=vertical-align:top;
| style="width: 42%; "|Lateraliteit
| style="width: 58%; "|rechts
|-style=vertical-align:top;
| style="width: 42%; "|Soort
| style="width: 58%; "|thermische brandwond
|-style=vertical-align:top;
| style="width: 42%; "|OntstaansDatum
| style="width: 58%; "|29-09-2014
|-style=vertical-align:top;
| style="width: 42%; "|DatumLaatste Verbandwissel
| style="width: 58%; "|10-10-2014
|-style=vertical-align:top;
| style="width: 42%; "|Toelichting
| style="width: 58%; "|Mevrouw kreeg hete thee over zich heen, wond is ongeveer 10 bij 4 cm.
|}

==Issues==
Damages to the skin as a result of exposure to intense heat and cold can lead to similar wounds. Nevertheless, we have decided not to expand the information model to become a generic thermal wound information model. The reason for this was the lack of a guideline for treating freeze wounds and insufficient agreement in the field on the applicability of the burn wound classification for freeze wounds. Freeze wounds also rarely occur in the Netherlands, due to the climate.

==References==
1. Brandwondenprotocol 2010 [Online] Beschikbaar op:https://www.rkz.nl/brandwondenprotocol_online [Geraadpleegd: 13 februari 2015]

2. Brandwonden genezen. Hoe verder? [Online] Beschikbaar op:http://brandwondenstichting.nl/wp-content/uploads/2013/08/NBS_Hoe-verder-huisartsen-2011.pdf [Geraadpleegd: 13 februari 2015]

== Valuesets ==
=== BurnTypeCodelist===
{| class="wikitable" width="60%"
|-style='vertical-align:top; background-color: #E8D7BE;'
|Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.19.4.3
|}
{| class="wikitable" width="60% "
|-style="background-color: #1F497D; color: white; font-weight: bold; "
|Conceptname
|Conceptcode
|Codesystem name||Codesystem OID
|Description
|-style="vertical-align:top; "
|Chemical burn
|26696002
|SNOMED CT
|2.16.840.1.113883.6.96
|Chemisch brandwond
|-style="vertical-align:top; "
|Electrical burn
|21720007
|SNOMED CT
|2.16.840.1.113883.6.96
|Elektrische brandwond
|-style="vertical-align:top; "
|Thermal burn
|105594005
|SNOMED CT
|2.16.840.1.113883.6.96
|Thermische brandwond
|}

=== BurnWoundAnatomicalLocationCodelist===
{| class="wikitable" width="60%"
|-style='vertical-align:top; background-color: #E8D7BE;'
|Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.19.4.2
|}
{| class="wikitable" width="60% "
|-style="background-color: #1F497D; color: white; font-weight: bold; "
|Conceptname
|Codesystem name||Codesystem OID
|-style="vertical-align:top; "
|SNOMED CT: < 442083009 <noWiki>|</noWiki>Anatomical or acquired body structure<noWiki>|</noWiki>
|SNOMED CT
|2.16.840.1.113883.6.96
|}

=== BurnWoundLateralityCodelist===
{| class="wikitable" width="60%"
|-style='vertical-align:top; background-color: #E8D7BE;'
|Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.19.4.4
|}
{| class="wikitable" width="60% "
|-style="background-color: #1F497D; color: white; font-weight: bold; "
|Conceptname
|Conceptcode
|Codesystem name||Codesystem OID
|Description
|-style="vertical-align:top; "
|Left
|7771000
|SNOMED CT
|2.16.840.1.113883.6.96
|Links
|-style="vertical-align:top; "
|Right
|24028007
|SNOMED CT
|2.16.840.1.113883.6.96
|Rechts
|-style="vertical-align:top; "
|Right and left
|51440002
|SNOMED CT
|2.16.840.1.113883.6.96
|Rechts en links
|}

=== DepthCodelist===
{| class="wikitable" width="60%"
|-style='vertical-align:top; background-color: #E8D7BE;'
|Valueset OID 2.16.840.1.113883.2.4.3.11.60.40.2.19.4.1
|}
{| class="wikitable" width="60% "
|-style="background-color: #1F497D; color: white; font-weight: bold; "
|Conceptname
|Conceptcode
|Codesystem name||Codesystem OID
|Description
|-style="vertical-align:top; "
|first degree burn injury
|77140003
|SNOMED CT
|2.16.840.1.113883.6.96
|1e graad
|-style="vertical-align:top; "
|superficial partial thickness burn
|262587005
|SNOMED CT
|2.16.840.1.113883.6.96
|2e graad, oppervlakkig
|-style="vertical-align:top; "
|deep partial thickness burn
|262588000
|SNOMED CT
|2.16.840.1.113883.6.96
|2e graad, diep
|-style="vertical-align:top; "
|third degree burn injury
|80247002
|SNOMED CT
|2.16.840.1.113883.6.96
|3e graad
|}

==More on this information model==
More technical information and HL7/XML documentation you can find on the Nictiz Art-Decor page about this information model[http://decor.nictiz.nl/art-decor/decor-datasets--zib1bbr-?id=2.16.840.1.113883.2.4.3.11.60.40.3.19.4] 
This information model is also available as [[Media:nl.zorg.Burnwound-v3.1(EN).pdf|pdf file]] [[File:PDF.png|link=]] or as [[Media:nl.zorg.Burnwound-v3.1(EN).xlsx|spreadsheet]] [[File:xlsx.png|link=]]
==About this information==
The information in this wikipage is based on Prerelease 2017 #1 
Conditions for use are located on the mainpage [[Bestand:list2.png|link=HCIM_Mainpage]] 
This page is generated on 21/09/2017 15:46:23 
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