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Class steward is Patient Care
Access tubes and drains are anything used (actually) to administer therapeutic agents (medication and vital elements) into the body, or to drain material (e.g., exsudat, pus, urine, air, blood) out of the body. Typically an access is a catheter, cannula or flexule proceeded into a compartment of the body.
Therefore, (target) body site and entry site are attributes of the access. Note that the Access role primarily exists in order to describe material actually deployed as an access, and not so much the fresh material as it comes from the manufacturer. For example, in supply ordering a box of catheters from a distributor, it is not necessary to use the access role class, since the material attributes will usually suffice to describe and identify the product for the order. But the Access role class is used to communicate about the maintenance, intake/outflow, and due replacement of accesses and drains.
Material in the role of an Access is typically used in intake/outflow observations, and in medication routing instructions. Microbiologic observations on the material itself or on fluids coming out of a drain, are also common.
This is the anatomical target site of the access, i.e., the body compartment into which material is administered or from which it is drained. For example, a pulmonary artery catheter will have the target site arteria pulmonalis with or without a known laterality.
The coding system is the same as for Service.body_site.
Body site has been copied from the Service class into the Access role class. The value of the Access.body_site_cd should be identical to the value of the Service.body_site_cd of an associated access placement service. This attribute is used if such an associated access placement service is not communicated. Since accesses are typically placed for a considerable period of time and since the access is used as a Target (resource) of many services, the target body site seems to have become an important attribute of the access itself. The body site is an important information that determine what kinds of substances may or may not administered (e.g., special care to avoid medication injections into an arterial access.)
The Access.entry_site_cd specifies the anatomic site where the access first enters the body. For example in a arteria pulmonalis catheter targets a pulmonary artery but the access entry site is typically the vena carotis interna at the neck, or the vena subclavia at the fossa subclavia.
The coding system is the same as for Service.body_site.
Entry site has been copied from the Procedure service class into the Access role class. The value of the Access.entry_site_cd should be identical to the value of the Procedure.entry_site_cd of an associated access placement service. This attribute is used if such an associated access placement service is not communicated. Since accesses are typically placed for a considerable period of time and since the access is used as a Target (resource) of many services, the entry site seems to have become an important attribute of the access itself. The entry site is one of the most distinctive descriptors that help in locating a specific access among many others.
The gauge of an access is a measure for the inner diameter of the tube (the lumen.) Typically catheter gauge is measured in terms of units not seen elsewhere. Those units are defined in the Unified Code for Units of Measure.
OpenIssue: Should this be a subtype iinstead of a role relatiionship.