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

      <id value="2minute-apgar-score"/><!--   Using a contained patient for the purposes of this example Observation.  Typically the reference would be to an external resource    --><meta>
  <security>
    <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
    <code value="HTEST"/>
    <display value="test health data"/>
  </security>
</meta>
<contained>
              <Patient>
                      <id value="newborn"/><!--     MRN assigned by ACME healthcare on     --><identifier>
                              <system value="http://acmehealthcare/org/mrns"/>
                              <value value="12345"/>
                      </identifier>
                      <active value="true"/><!--     Peter James Chalmers     --><name>
                              <family value="Chalmers"/>
                              <given value="Peter"/>
                              <given value="James"/>
                      </name><!--     use FHIR code system for male / female     --><gender value="male"/>
                      <birthDate value="2016-05-18">
                              <extension url="http://hl7.org/fhir/StructureDefinition/patient-birthTime">
                                      <valueDateTime value="2016-05-18T10:28:45Z"/>
                              </extension>
                      </birthDate>
              </Patient>
      </contained>
      <status value="final"/>
      <category>
              <coding>
                      <system value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                      <code value="survey"/>
                      <display value="Survey"/>
              </coding>
              <text value="Survey"/>
      </category>
      <code>
              <coding>
                      <system value="http://loinc.org"/>
                      <code value="9273-4"/>
                      <display value="2 minute Apgar Score"/>
              </coding>
              <text value="2 minute Apgar Score"/>
      </code>
      <subject>
              <reference value="#newborn"/>
      </subject>
      <effectiveDateTime value="2016-05-18T22:33:22Z"/>
      <performer>
              <reference value="Practitioner/example"/>
      </performer>
      <valueQuantity>
              <value value="5"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="{score}"/>
      </valueQuantity>
      <component>
              <code>
                      <coding>
                              <system value="http://snomed.info/sct"/>
                              <code value="249227004"/>
                              <display value="Apgar color score"/>
                      </coding>
                      <text value="Apgar color score"/>
              </code>
              <valueCodeableConcept>
                      <coding><!--  this  extension  maps a numeric score to the code this may already be known and unecessary  --><extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
                                      <valueDecimal value="1"/>
                              </extension>
                              <system value="http://loinc.org"/>
                              <code value="LA6723-6"/>
                              <display value="Good color in body with bluish hands or feet"/>
                      </coding>
                      <coding>
                              <system value="http://acme.ped/apgarcolor"/>
                              <code value="1"/>
                      </coding>
                      <text value="1. Good color in body with bluish hands or feet"/>
              </valueCodeableConcept>
      </component>
      <component>
              <code>
                      <coding>
                              <system value="http://snomed.info/sct"/>
                              <code value="249223000"/>
                              <display value="Apgar heart rate score"/>
                      </coding>
                      <text value="Apgar respiratory effort score"/>
              </code>
              <valueCodeableConcept>
                      <coding><!--  this  extension  maps a numeric score to the code this may already be known and unecessary  --><extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
                                      <valueDecimal value="1"/>
                              </extension>
                              <system value="http://loinc.org"/>
                              <code value="LA6720-2"/>
                              <display value="Fewer than 100 beats per minute"/>
                      </coding>
                      <coding>
                              <system value="http://acme.ped/apgarheartrate"/>
                              <code value="1"/>
                      </coding>
                      <text value="1. Fewer than 100 beats per minute"/>
              </valueCodeableConcept>
      </component>
      <component>
              <code>
                      <coding>
                              <system value="http://snomed.info/sct"/>
                              <code value="249226008"/>
                              <display value="Apgar response to stimulus score"/>
                      </coding>
                      <text value="Apgar response to stimulus score"/>
              </code>
              <valueCodeableConcept>
                      <coding><!--  this  extension  maps a numeric score to the code this may already be known and unecessary  --><extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
                                      <valueDecimal value="1"/>
                              </extension>
                              <system value="http://loinc.org"/>
                              <code value="LA6721-0"/>
                              <display value="Grimace during suctioning"/>
                      </coding>
                      <coding>
                              <system value="http://acme.ped/apgarreflexirritability"/>
                              <code value="1"/>
                      </coding>
                      <text value="1. Grimace during suctioning"/>
              </valueCodeableConcept>
      </component>
      <component>
              <code>
                      <coding>
                              <system value="http://snomed.info/sct"/>
                              <code value="249225007"/>
                              <display value="Apgar muscle tone score"/>
                      </coding>
                      <text value="Apgar muscle tone score"/>
              </code>
              <valueCodeableConcept>
                      <coding><!--  this  extension  maps a numeric score to the code this may already be known and unecessary  --><extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
                                      <valueDecimal value="1"/>
                              </extension>
                              <system value="http://loinc.org"/>
                              <code value="LA6714-5"/>
                              <display value="Some flexion of arms and legs"/>
                      </coding>
                      <coding>
                              <system value="http://acme.ped/apgarmuscletone"/>
                              <code value="1"/>
                      </coding>
                      <text value="1. Some flexion of arms and legs"/>
              </valueCodeableConcept>
      </component>
      <component>
              <code>
                      <coding>
                              <system value="http://snomed.info/sct"/>
                              <code value="249224006"/>
                              <display value="Apgar respiratory effort score"/>
                      </coding>
                      <text value="Apgar respiratory effort score"/>
              </code>
              <valueCodeableConcept>
                      <coding><!--  this  extension  maps a numeric score to the code this may already be known and unecessary  --><extension url="http://hl7.org/fhir/StructureDefinition/ordinalValue">
                                      <valueDecimal value="1"/>
                              </extension>
                              <system value="http://loinc.org"/>
                              <code value="LA6726-9"/>
                              <display value="Weak cry; may sound like whimpering, slow or irregular breathing"/>
                      </coding>
                      <coding>
                              <system value="http://acme.ped/apgarrespiratoryeffort"/>
                              <code value="1"/>
                      </coding>
                      <text value="1. Weak cry; may sound like whimpering, slow or irregular breathing"/>
              </valueCodeableConcept>
      </component>

</Observation>