<?xml version=“1.0” encoding=“UTF-8”?> <Observation xmlns=“hl7.org/fhir”>

      <id value="glasgow"/>

      <!--    the mandatory quality flags:    -->
      <meta>
  <security>
    <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
    <code value="HTEST"/>
    <display value="test health data"/>
  </security>
</meta>
<status value="final"/>
      <!--   
  Observations are often coded in multiple code systems.
    - LOINC
              - or SNOMED
    -and/or the source system may provides its own "local" code, which may be less or more granular than LOINC.
      In this example there is only LOINC
   -->
      <code>
              <!--    LOINC - always recommended to have a LOINC code    -->
              <coding>
                      <system value="http://loinc.org"/>
                      <code value="9269-2"/>
                      <display value="Glasgow coma score total"/>
              </coding>
              <text value="Glasgow Coma Scale , (GCS)"/>
      </code>
      <subject>
              <reference value="Patient/example"/>
              <display value="Peter James Chalmers"/>
      </subject>
      <effectiveDateTime value="2014-12-11T04:44:16Z"/>
      <!--    In FHIR, units may be represented twice. Once in the
  agreed human representation, and once in a coded form.
  In this example the UCUM unit is provided but no human representation since this is often not displayed
    -->
      <valueQuantity>
              <value value="13"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="{score}"/>
      </valueQuantity>
      <referenceRange>
              <high>
                      <value value="8"/>
                      <system value="http://unitsofmeasure.org"/>
                      <code value="{score}"/>
              </high>
              <!--    meaning as text    -->
              <type>
                      <text value="Severe TBI"/>
              </type>
      </referenceRange>
      <referenceRange>
              <low>
                      <value value="9"/>
                      <system value="http://unitsofmeasure.org"/>
                      <code value="{score}"/>
              </low>
              <high>
                      <value value="12"/>
                      <system value="http://unitsofmeasure.org"/>
                      <code value="{score}"/>
              </high>
              <!--    meaning as text    -->
              <type>
                      <text value="Moderate TBI"/>
              </type>
      </referenceRange>
      <referenceRange>
              <low>
                      <value value="13"/>
                      <system value="http://unitsofmeasure.org"/>
                      <code value="{score}"/>
              </low>
              <!--    meaning as text    -->
              <type>
                      <text value="Mild TBI"/>
              </type>
      </referenceRange>

      <!--   Using components since these measurements are typically reported and interpreted together   -->
              <!--   GCS motor Component   -->
      <component>
              <code>
                      <coding>
                              <system value="http://loinc.org"/>
                              <code value="9268-4"/>
                              <display value="Glasgow coma score motor"/>
                      </coding>
                      <text value="GCS Motor"/>
              </code>
              <valueCodeableConcept>
                      <coding>
                              <system value="http://acme.ec/codes"/>
                              <code value="5"/>
                              <display value="Localizes painful stimuli"/>
                      </coding>
                      <coding>
                              <!--     This example has the extension which maps a numeric score to the code this may already be known and unecessary in the Observation resource    -->
                              <extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
                                      <!--    from Element: extension    -->
                                      <valueDecimal value="5"/>
                                      <!--    0..1 Value of extension    -->
                              </extension>
                              <system value="http://loinc.org"/>
                              <code value="LA6566-9"/>
                              <display value="Localizing pain"/>
                      </coding>
                      <text value="5 (Localizes painful stimuli)"/>
              </valueCodeableConcept>
      </component>
              <!--   GCS verbal Component   -->
      <component>
              <code>
                      <coding>
                              <system value="http://loinc.org"/>
                              <code value="9270-0"/>
                              <display value="Glasgow coma score verbal"/>
                      </coding>
                      <text value="GSC Verbal"/>
              </code>
              <valueCodeableConcept>
                      <coding>
                              <system value="http://acme.ec/codes"/>
                              <code value="4"/>
                              <display value="Confused, disoriented"/>
                      </coding>
                      <coding>
                              <!--     This example has the extension which maps a numeric score to the code this may already be known and unecessary in the Observation resource    -->
                              <extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
                                      <!--    from Element: extension    -->
                                      <valueDecimal value="4"/>
                                      <!--    0..1 Value of extension    -->
                              </extension>
                              <system value="http://loinc.org"/>
                              <!--   technicallly the code is '5' and the LA is the identifier to do hav e both  would require an extention   -->
                              <code value="LA6560-2"/>
                              <display value="Confused"/>
                      </coding>
                      <text value="4 (Confused, disoriented)"/>
              </valueCodeableConcept>
      </component>
      <!--   GCS eyes Component   -->
      <component>
              <code>
                      <coding>
                              <system value="http://loinc.org"/>
                              <code value="9267-6"/>
                              <display value="Glasgow coma score eye opening"/>
                      </coding>
                      <text value="Eyes"/>
              </code>
              <valueCodeableConcept>
                      <coding>
                              <system value="http://acme.ec/codes"/>
                              <code value="4"/>
                              <display value="Opens eyes spontaneously"/>
                      </coding>
                      <coding>
                              <!--     This example has the extension which maps a numeric score to the code this may already be known and unecessary in the Observation resource    -->
                              <extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
                                      <!--    from Element: extension    -->
                                      <valueDecimal value="4"/>
                                      <!--    0..1 Value of extension    -->
                              </extension>
                              <system value="http://loinc.org"/>
                              <!--   technicallly the code is '4' and the LA is the identifier to do hav e both  would require an extention   -->
                              <code value="LA6556-0"/>
                              <display value="Eyes open spontaneously"/>
                      </coding>
                      <text value="4 (Opens eyes spontaneously)"/>
              </valueCodeableConcept>
      </component>

</Observation>