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Andrew Marchant Patrick McCormick

Andrew Marchant Patrick McCormick

Jane Millar Monica Harry Toni Morrison 

Discussion of "across bend arm position" - does not appear to be a physiotherapy concept, nor an operating room concept. Perhaps this is more closely related to Neuro Rehabilitation - Jane Millar to discuss with Physiotherapy colleagues (who may need to be very sub-specialised in Neuro Rehab) to see whether or not we can clarify the area.

Potential Program of Work:

• ICU flowsheet gap assessment
• Assessment scale gap assessment
• Ventilation mode gap assessment

Ventilation mode discussion

Procedure is "done once", regime/therapy is "ongoing".  For this reason many artificial ventilation concepts are regime/therapy.  Multiple changes have been made in the current version of SNOMED. (See https://prod-dailybuild.ihtsdotools.org/)  Some modes may still need to be added with CRS requests.  Plan is to also propose hierarchy changes in CRS.

"Mode of ventilation monitoring" term noted as being somewhat confusing, and defined as both an observable and a regime.  Is anyone using it?  Monica Harry to follow up.

Assessment scales

Glasgow Coma Score reference is one-pager PDF from NHS Glasgow and Clyde.  Prod build has terms for GCS scores 3 through 15 present.  Similar work has been done for a dysphagia assessment. 

Andrew Marchant suggests we should have intermediate GCS concepts for Eye 1-5, Verbal 1-5, Motor 1-5.  Many paper flowsheets and systems retain the components of GCS and then separately record the total.  All are important for different clinical and research reasons. Charles Gutteridge notes that recording of the individual scores is recommended and it was generally agreed that we should facilitate this. Monica Harry will experiment with how this can be structured - if we can retain some of the description of the individual responses that is likely to be helpful to end users.

Steven Dain 

Recent specification ISO 19223 and IEEE 11073-10101 (still in press) has several terms that need to be addressed in SNOMED.

See attached Word document for outline.

(postponed to next meeting)

Patrick McCormick Andrew Marchant