14 > CONTAINS INCLUDE DTID (xx07) Imaging 1 M $PlanType = EV (newcode113, DCM, Agent Administration “Delivered”) Plan 15 > INCLUDE DTID (xx11) Imaging 1 U Agent Administration Adverse Events 16 > INCLUDE DTID (xx19) Imaging 1 U Agent Administration Injector Events 17 > CONTAINS CODE EV(newcode603, 1 M DCID (xx17) Imaging Agent Administration Completion 99SUP164, “Imaging Status Agent Administration Completion Status”) Content Item Descriptions Row 4 Persons and devices responsible for administering the imaging agent. If an automated injector was used, it is recorded here. Row 7 of Ultravist using e.g., “Administered 30ml guage22 via LeftAC.” Row 11 Describes all imaging agents used. Row 13 Programmed plan, this is the instructions for the injector at the start of the administration. Row 14 Performed plan, this is the actual delivery of the injector recorded after the end of the administration. Add TID xx11 as shown. TID xx11 Imaging Agent Administration Adverse Events This template provides information on adverse events occurring to a patient as a result of administration of an imaging agent. TID xx11 Imaging Agent Administration Adverse Events Type : Extensible Order : Non-Significant Root : No NL Rel with VT Concept Name VM Req Condition Value Set Constraint Parent Type EV (newcode701, 1 CONTAINER 1 M 99SUP164, Agent “Imaging Administration Adverse Events”) EV (newcode715, 2 > HAS CODE 1 U DCID 230 “Yes-No” 99SUP164, PROPERTIES “Administration discontinued”) 3 > CONTAINS CODE EV (newcode703, 1-n M DCID (xx1) Imaging Agent DCM, Administration Adverse “Adverse Events Event”)
14 > CONTAINS INCLUDE DTID (xx07) Imaging Agent Administration Plan 1 M $PlanType = EV (newcode113, DCM, “Delivered”) 15 > INCLUDE DTID (xx11) Imaging Agent Administration Adverse Events 1 U 16 > INCLUDE DTID (xx19) Imaging Agent Administration Injector Events 1 U 17 > CONTAINS CODE EV(newcode603, 99SUP164, “Imaging Agent Administration Completion Status”) 1 M DCID (xx17) Imaging Agent Administration Completion Status Content Item Descriptions Row 4 Persons and devices responsible for administering the imaging agent. If an automated injector was used, it is recorded here. Row 7 e.g., “Administered 30ml of Ultravist using guage22 via LeftAC.” Row 11 Describes all imaging agents used. Row 13 Programmed plan, this is the instructions for the injector at the start of the administration. Row 14 Performed plan, this is the actual delivery of the injector recorded after the end of the administration. Add TID xx11 as shown. TID xx11 Imaging Agent Administration Adverse Events This template provides information on adverse events occurring to a patient as a result of administration of an imaging agent. TID xx11 Imaging Agent Administration Adverse Events Type : Extensible Order : Non-Significant Root : No NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint 1 CONTAINER EV (newcode701, 99SUP164, “Imaging Agent Administration Adverse Events”) 1 M 2 > HAS PROPERTIES CODE EV (newcode715, 99SUP164, “Administration discontinued”) 1 U DCID 230 “Yes-No” 3 > CONTAINS CODE EV (newcode703, DCM, “Adverse Event”) 1-n M DCID (xx1) Imaging Agent Administration Adverse Events
sup164_pc-Contrast_Agent_Administration_Reporting.docx