Re: Comment on openEHR-EHR-CLUSTER.inspection-skin-wound.v1 archetype

[Heather Leslie <heather.leslie@oceaninformatics.com>]

Hi Otavio,

As Ian has already suggested, there is currently some collaborative work being done around wounds and the group is exploring whether Google Wave is a good media to facilitate the discussion.

It would be of great value to the community if you (and anyone else with queries, concerns or suggestions) could add any your comments into the Clinical Knowledge Manager directly, so that when the archetype is formally reviewed for publication, your comments can be considered and not lost in the email lists - www.openEHR.org/knowledge. When you are viewing the archetype in CKM, the 'Discussion' icon is the eighth from the left - the person with the single speech bubble.  You can include any comments here for other registered users to see and join in with as well.   If you have identified that there are other attributes missing in the archetype that are required to capture inspection of animal bites, please add them as well.

The archetype is a CLUSTER, and designed to be incorporated within the OBSERVATION.exam archetype , although the metadata is probably not clear enough about this and needs to be updated.  The Use for OBSERVATION.exam archetype states "Designed as a container for nesting detailed examination-related clusters including the inspection, palpation, auscultation and percussion CLUSTERS and their specialisations". The inspection archetype can then sit alongside a (yet non-existent) palpation of skin/wound archetype within the OBSERVATION to bring together all exam findings.

As this is an archetype for inspection of the wound, the intention is to be pure about the type of wound being observed and deliberately not attributing cause eg the types are currently abrasion, laceration, incision, puncture, penetration, gunshot.  I can see that gunshot is similar to your suggestion of animal aggression, and its inclusion should be considered carefully during the review process.  From memory gunshot was included specifically as it had very specific characteristics, but this will need to be discussed by domain experts more fully during the review process. There may be other attributes that need to be added, including ones to describe more complex wounds as well.

Ideally the cause of wound should be captured during the history-taking process, and the inspection archetype should be recording just the observed findings eg a presence of puncture wound, which when considered with history etc the clinician can attribute to a diagnosis of an animal bite.

Hope this helps

Heather


On 5/02/2010 12:15 AM, Otavio Silva wrote:

   Dear all,

   I would like to ask you to consider the inclusion in the "type of wound" of "animal agression".

   Because this kind of wound has proper features that should be differentiated of all the rest and so incluiding would avoid of making another archetype almost identical to openEHR-EHR-CLUSTER.inspection-skin-wound.v1 just to consider those wounds made by animals...

   Thanks in advance,

   Otavio 

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Dr Heather Leslie
MBBS FRACGP FACHI
Director of Clinical Modelling
Ocean Informatics
Phone (Aust) +61 (0)418 966 670
Skype - heatherleslie
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