ID

24392

Description

Routine documentation in German hospitals. Source file name: SD070109_Geburtenbogen. Examplary forms provided by DMI (http://www.dmi.de/)

Link

http://www.dmi.de/

Keywords

Versions (2)
  1. 6/8/17 6/8/17 -
  2. 7/30/17 7/30/17 -
Uploaded on

July 30, 2017

DOI

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License

Creative Commons BY-NC 3.0
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Birth sheet, newborn Routine documentation in German hospitals DMI

German English

Birth sheet, newborn Routine documentation in German hospitals DMI

1 forms  
Kind Nr. 1
Description

Kind Nr. 1

Alias
UMLS CUI-1
C0008059
Geschlecht
Description

Sex

Data type

text

Alias
UMLS CUI [1]
C0079399
Gewicht
Description

Weight

Data type

integer

Measurement units
  • g
Alias
UMLS CUI [1]
C0005910
g
Länge
Description

Length

Data type

float

Measurement units
  • cm
Alias
UMLS CUI [1]
C1444754
cm
Kopfumfang
Description

Head circumference

Data type

float

Measurement units
  • cm
Alias
UMLS CUI [1]
C0262499
cm
Schulterumfang
Description

circumference Shoulder

Data type

float

Measurement units
  • cm
Alias
UMLS CUI [1,1]
C0332520
UMLS CUI [1,2]
C0037004
cm
Blennorrhoeprophylaxe
Description

prevention Blennorrhoea

Data type

text

Alias
UMLS CUI [1,1]
C0199176
UMLS CUI [1,2]
C0456116
2 mg Konakion oral
Description

Konakion

Data type

boolean

Alias
UMLS CUI [1]
C0031862
Kind Nr. 2
Description

Kind Nr. 2

Alias
UMLS CUI-1
C0008059
Geschlecht
Description

Sex

Data type

text

Alias
UMLS CUI [1]
C0079399
Gewicht
Description

Weight

Data type

integer

Measurement units
  • g
Alias
UMLS CUI [1]
C0005910
g
Länge
Description

Length

Data type

integer

Measurement units
  • cm
Alias
UMLS CUI [1]
C1444754
cm
Kopfumfang
Description

Head circumference

Data type

integer

Measurement units
  • cm
Alias
UMLS CUI [1]
C0262499
cm
Schulterumfang
Description

circumference Shoulder

Data type

integer

Measurement units
  • cm
Alias
UMLS CUI [1,1]
C0332520
UMLS CUI [1,2]
C0037004
cm
Blennorrhoeprophylaxe
Description

prevention Blennorrhoea

Data type

text

Alias
UMLS CUI [1,1]
C0199176
UMLS CUI [1,2]
C0456116
2 mg Konakion oral
Description

Konakion

Data type

boolean

Alias
UMLS CUI [1]
C0031862
Reifezeichen
Description

Reifezeichen

Alias
UMLS CUI-1
C0419397
Fingernägel
Description

Fingernails

Data type

text

Alias
UMLS CUI [1]
C0222001
Vernix
Description

Vernix

Data type

text

Alias
UMLS CUI [1]
C0042541
Lanugo
Description

Lanugo

Data type

text

Alias
UMLS CUI [1]
C0423866
Testicles
Description

Testicles

Data type

text

Alias
UMLS CUI [1]
C0039597
Vulva
Description

Vulva

Data type

text

Alias
UMLS CUI [1]
C0042993
Hautabschilferungen
Description

Peeling skin

Data type

text

Alias
UMLS CUI [1]
C0237849
Waschfrauenhände und -füße
Description

Wrinkled hands and feet

Data type

text

Alias
UMLS CUI [1]
C1856714
Apgar-Status: 1'
Description

Apgar-Status: 1'

Alias
UMLS CUI-1
C0426279
Kolorit
Description

Skin color

Data type

integer

Alias
UMLS CUI [1]
C0599910
Atmung
Description

Respiration

Data type

integer

Alias
UMLS CUI [1]
C0035203
Tonus
Description

Muscle tone

Data type

text

Alias
UMLS CUI [1]
C0026841
Reaktion auf Reize
Description

Reflex irritability

Data type

integer

Alias
UMLS CUI [1]
C1317677
Herzschläge
Description

Heart rate

Data type

integer

Alias
UMLS CUI [1]
C0018810
Apgar-Status: 5'
Description

Apgar-Status: 5'

Alias
UMLS CUI-1
C1286416
Kolorit
Description

Skin color

Data type

integer

Alias
UMLS CUI [1]
C0599910
Atmung
Description

Respiration

Data type

integer

Alias
UMLS CUI [1]
C0035203
Tonus
Description

Muscle tone

Data type

text

Alias
UMLS CUI [1]
C0026841
Reaktion auf Reize
Description

Reflex irritability

Data type

integer

Alias
UMLS CUI [1]
C1317677
Herzschläge
Description

Heart rate

Data type

integer

Alias
UMLS CUI [1]
C0018810
Apgar-Status: 10'
Description

Apgar-Status: 10'

Alias
UMLS CUI-1
C1286417
Kolorit
Description

Skin color

Data type

integer

Alias
UMLS CUI [1]
C0599910
Atmung
Description

Respiration

Data type

integer

Alias
UMLS CUI [1]
C0035203
Tonus
Description

Muscle tone

Data type

text

Alias
UMLS CUI [1]
C0026841
Reaktion auf Reize
Description

Reflex irritability

Data type

integer

Alias
UMLS CUI [1]
C1317677
Herzschläge
Description

Heart rate

Data type

integer

Alias
UMLS CUI [1]
C0018810
Analyse-Nabelschnurblut
Description

Analyse-Nabelschnurblut

Alias
UMLS CUI-1
C0936012
UMLS CUI-2
C0162371
Art.
Description

Artery

Data type

boolean

Alias
UMLS CUI [1]
C0003842
Ven.
Description

Vein

Data type

boolean

Alias
UMLS CUI [1]
C0042449
Weitere Maßnahmen
Description

Weitere Maßnahmen

Alias
UMLS CUI-1
C2700391
Absaugen
Description

Suctioning

Data type

boolean

Alias
UMLS CUI [1]
C0204794
Pädiater bei Geburt anwesend
Description

Pediatrician

Data type

boolean

Alias
UMLS CUI [1]
C0237433
Vorstellung beim Pädiater
Description

Seen by pediatrician

Data type

boolean

Alias
UMLS CUI [1]
C0583542
Vorstellung beim Pädiater wegen
Description

reason

Data type

text

Alias
UMLS CUI [1]
C0392360
Verlegung in Kikl.
Description

pediatric clinic

Data type

boolean

Alias
UMLS CUI [1]
C3839701
Verlegung in Kikl. wegen
Description

reason

Data type

text

Alias
UMLS CUI [1]
C0392360
O2-Maske
Description

Oxygen mask

Data type

boolean

Alias
UMLS CUI [1]
C0181744
Intubation
Description

Intubation

Data type

boolean

Alias
UMLS CUI [1]
C0021925
Kindesentwicklung
Description

Kindesentwicklung

Alias
UMLS CUI-1
C0008071
Kindesentwicklung normal
Description

normal

Data type

boolean

Alias
UMLS CUI [1]
C0205307
Kindesentwicklung:
Description

Child development

Data type

text

Alias
UMLS CUI [1]
C0008071
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Similar models

Birth sheet, newborn Routine documentation in German hospitals DMI

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Kind Nr. 1
C0008059 (UMLS CUI-1)
Sex
Item
Geschlecht
text
C0079399 (UMLS CUI [1])
Weight
Item
Gewicht
integer
C0005910 (UMLS CUI [1])
Length
Item
Länge
float
C1444754 (UMLS CUI [1])
Head circumference
Item
Kopfumfang
float
C0262499 (UMLS CUI [1])
circumference Shoulder
Item
Schulterumfang
float
C0332520 (UMLS CUI [1,1])
C0037004 (UMLS CUI [1,2])
Item
Blennorrhoeprophylaxe
text
C0199176 (UMLS CUI [1,1])
C0456116 (UMLS CUI [1,2])
Blennorrhoea prevention
Code List
Blennorrhoeprophylaxe
CL Item
durchgeführt (executed)
CL Item
abgelehnt (refused)
Konakion
Item
2 mg Konakion oral
boolean
C0031862 (UMLS CUI [1])
Item Group
Kind Nr. 2
C0008059 (UMLS CUI-1)
Sex
Item
Geschlecht
text
C0079399 (UMLS CUI [1])
Weight
Item
Gewicht
integer
C0005910 (UMLS CUI [1])
Length
Item
Länge
integer
C1444754 (UMLS CUI [1])
Head circumference
Item
Kopfumfang
integer
C0262499 (UMLS CUI [1])
circumference Shoulder
Item
Schulterumfang
integer
C0332520 (UMLS CUI [1,1])
C0037004 (UMLS CUI [1,2])
Item
Blennorrhoeprophylaxe
text
C0199176 (UMLS CUI [1,1])
C0456116 (UMLS CUI [1,2])
Blennorrhoea prevention
Code List
Blennorrhoeprophylaxe
CL Item
durchgeführt (executed)
CL Item
abgelehnt (refused)
Konakion
Item
2 mg Konakion oral
boolean
C0031862 (UMLS CUI [1])
Item Group
Reifezeichen
C0419397 (UMLS CUI-1)
Item
Fingernägel
text
C0222001 (UMLS CUI [1])
Fingernails
Code List
Fingernägel
CL Item
überragen (Extend beyond the fingertips)
CL Item
schließen ab (Reach the fingertips)
CL Item
schließen nicht ab (Do not reach the fingertips)
Item
Vernix
text
C0042541 (UMLS CUI [1])
Vernix
Code List
Vernix
CL Item
O (O)
CL Item
+ (+)
CL Item
++ (++)
Item
Lanugo
text
C0423866 (UMLS CUI [1])
Lanugo
Code List
Lanugo
CL Item
O (O)
CL Item
+ (+)
CL Item
++ (++)
Item
Testicles
text
C0039597 (UMLS CUI [1])
Testicles
Code List
Testicles
CL Item
descendiert (descended)
CL Item
nicht descendiert (undescended)
Item
Vulva
text
C0042993 (UMLS CUI [1])
Vulva
Code List
Vulva
CL Item
geschlossen (closed)
CL Item
klafft (gaping)
Item
Hautabschilferungen
text
C0237849 (UMLS CUI [1])
Peeling skin
Code List
Hautabschilferungen
CL Item
+ (+)
CL Item
O (O)
Item
Waschfrauenhände und -füße
text
C1856714 (UMLS CUI [1])
Wrinkled hands and feet
Code List
Waschfrauenhände und -füße
CL Item
+ (+)
CL Item
O (O)
Item Group
Apgar-Status: 1'
C0426279 (UMLS CUI-1)
Item
Kolorit
integer
C0599910 (UMLS CUI [1])
Skin color
Code List
Kolorit
CL Item
blau, weiß (0)
CL Item
Stamm rosig, Extremit. blau (1)
CL Item
rosig (2)
Item
Atmung
integer
C0035203 (UMLS CUI [1])
Respiration
Code List
Atmung
CL Item
keine (0)
CL Item
Schnappatm., unregelm. (1)
CL Item
regelmäßig, kräftig (2)
Item
Tonus
text
C0026841 (UMLS CUI [1])
Muscle tone
Code List
Tonus
CL Item
schlaff (0)
CL Item
träge Flexionsbewegung (1)
CL Item
gute Spontanbewegung (2)
Item
Reaktion auf Reize
integer
C1317677 (UMLS CUI [1])
Reflex irritability
Code List
Reaktion auf Reize
CL Item
keine (0)
CL Item
gering (1)
CL Item
lebhaft (2)
Item
Herzschläge
integer
C0018810 (UMLS CUI [1])
Heart rate
Code List
Herzschläge
CL Item
absent (0)
CL Item
<100 (1)
CL Item
>100 (2)
Item Group
Apgar-Status: 5'
C1286416 (UMLS CUI-1)
Item
Kolorit
integer
C0599910 (UMLS CUI [1])
Skin color
Code List
Kolorit
CL Item
blau, weiß (0)
CL Item
Stamm rosig, Extremit. blau (1)
CL Item
rosig (2)
Item
Atmung
integer
C0035203 (UMLS CUI [1])
Respiration
Code List
Atmung
CL Item
keine (0)
CL Item
Schnappatm., unregelm. (1)
CL Item
regelmäßig, kräftig (2)
Item
Tonus
text
C0026841 (UMLS CUI [1])
Muscle tone
Code List
Tonus
CL Item
schlaff (0)
CL Item
träge Flexionsbewegung (1)
CL Item
gute Spontanbewegung (2)
Item
Reaktion auf Reize
integer
C1317677 (UMLS CUI [1])
Reflex irritability
Code List
Reaktion auf Reize
CL Item
keine (0)
CL Item
gering (1)
CL Item
lebhaft (2)
Item
Herzschläge
integer
C0018810 (UMLS CUI [1])
Heart rate
Code List
Herzschläge
CL Item
absent (0)
CL Item
<100 (1)
CL Item
>100 (2)
Item Group
Apgar-Status: 10'
C1286417 (UMLS CUI-1)
Item
Kolorit
integer
C0599910 (UMLS CUI [1])
Skin color
Code List
Kolorit
CL Item
blau, weiß (0)
CL Item
Stamm rosig, Extremit. blau (1)
CL Item
rosig (2)
Item
Atmung
integer
C0035203 (UMLS CUI [1])
Respiration
Code List
Atmung
CL Item
keine (0)
CL Item
Schnappatm., unregelm. (1)
CL Item
regelmäßig, kräftig (2)
Item
Tonus
text
C0026841 (UMLS CUI [1])
Muscle tone
Code List
Tonus
CL Item
schlaff (0)
CL Item
träge Flexionsbewegung (1)
CL Item
gute Spontanbewegung (2)
Item
Reaktion auf Reize
integer
C1317677 (UMLS CUI [1])
Reflex irritability
Code List
Reaktion auf Reize
CL Item
keine (0)
CL Item
gering (1)
CL Item
lebhaft (2)
Item
Herzschläge
integer
C0018810 (UMLS CUI [1])
Heart rate
Code List
Herzschläge
CL Item
absent (0)
CL Item
<100 (1)
CL Item
>100 (2)
Item Group
Analyse-Nabelschnurblut
C0936012 (UMLS CUI-1)
C0162371 (UMLS CUI-2)
Artery
Item
Art.
boolean
C0003842 (UMLS CUI [1])
Vein
Item
Ven.
boolean
C0042449 (UMLS CUI [1])
Item Group
Weitere Maßnahmen
C2700391 (UMLS CUI-1)
Suctioning
Item
Absaugen
boolean
C0204794 (UMLS CUI [1])
Pediatrician
Item
Pädiater bei Geburt anwesend
boolean
C0237433 (UMLS CUI [1])
Seen by pediatrician
Item
Vorstellung beim Pädiater
boolean
C0583542 (UMLS CUI [1])
reason
Item
Vorstellung beim Pädiater wegen
text
C0392360 (UMLS CUI [1])
pediatric clinic
Item
Verlegung in Kikl.
boolean
C3839701 (UMLS CUI [1])
reason
Item
Verlegung in Kikl. wegen
text
C0392360 (UMLS CUI [1])
Oxygen mask
Item
O2-Maske
boolean
C0181744 (UMLS CUI [1])
Intubation
Item
Intubation
boolean
C0021925 (UMLS CUI [1])
Item Group
Kindesentwicklung
C0008071 (UMLS CUI-1)
normal
Item
Kindesentwicklung normal
boolean
C0205307 (UMLS CUI [1])
Child development
Item
Kindesentwicklung:
text
C0008071 (UMLS CUI [1])
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