Hierbij een samenvatting voor de opleiding tot IC-verpleegkundige met als onderwerp Beademing (respiratie). In deze samenvatting komt het boek van Diederik Gommers "beademing, een praktische handleiding" volledig aan bod en zijn daarnaast de overige te leren onderwerpen samengevat.
Venticare – Boekje - Beademing................................................................................................................... 18
Hoofdstuk 1: De normale ademhaling...............................................................................................................18
Ademhalingsspieren......................................................................................................................................18
Diffusie...........................................................................................................................................................18
Perfusie..........................................................................................................................................................18
Longvolumes..................................................................................................................................................19
Hoofdstuk 2: Fysiologie van beademen.............................................................................................................19
Weerstand/ Resistance..................................................................................................................................19
Elasticiteit / Compliance................................................................................................................................20
Surfactant......................................................................................................................................................20
Hoofdstuk 3: De gasuitwisseling........................................................................................................................21
Twee typen respiratoire insufficiëntie...........................................................................................................21
Kooldioxide en Hypercapnie..........................................................................................................................21
Behandelen van hypercapnie........................................................................................................................22
Zuurstof en hypoxemie..................................................................................................................................23
Behandelen van hypoxemie..........................................................................................................................24
Hoofdstuk 4: Indeling van de beademing, wie triggert en stuurt?....................................................................25
Wie of wat start en eindigt de inspiratie?.....................................................................................................25
Controlbeademing.........................................................................................................................................25
Supportbeademing........................................................................................................................................26
Control- of supportbeademing? Hoe zie je het verschil................................................................................26
Hoofdstuk 5: Indeling van de beademing, druk of volume gecontroleerd?.......................................................27
Expiratie en inspiratie....................................................................................................................................27
Druk gecontroleerde beademing...................................................................................................................27
Modi die worden gebruik bij druk gecontroleerde beademing....................................................................29
Volume gecontroleerde beademing...................................................................................................................30
Modi die gebruik maken van volume gecontroleerde beademing...............................................................31
Volumesupport..............................................................................................................................................31
Hoofdstuk 6: Indeling van de beademing, wat is het doel?...............................................................................32
Verschillende beademingsdoelen.................................................................................................................32
Kenmerken en eigenschappen van bekende beademingsmodi....................................................................32
Hoofdstuk 7: Beademing in de praktijk..............................................................................................................33
Patiënten met gezonde longen.....................................................................................................................33
Patiënten met COPD of Astma......................................................................................................................33
, Patiënten met ARDS (Acute Respiratory Distress Syndrome).......................................................................35
Samenvattend................................................................................................................................................36
Hoofdstuk 8: Recruteren....................................................................................................................................37
Inleiding.........................................................................................................................................................37
Open long.......................................................................................................................................................37
Recruteren.....................................................................................................................................................37
Methodes.......................................................................................................................................................37
Voorzorgen....................................................................................................................................................38
Hoofdstuk 9: Weanen.........................................................................................................................................39
Inleiding.........................................................................................................................................................39
Afbouwen.......................................................................................................................................................40
Spontaneous breathing trial..........................................................................................................................40
Rapid Shallow breathing index (RSBI)............................................................................................................41
ABC voor difficult-to-wean............................................................................................................................41
Hoofdstuk 10: De kunstmatige luchtweg...........................................................................................................42
Tube...............................................................................................................................................................42
De tracheacanule...........................................................................................................................................43
Assisteren bij intubatie..................................................................................................................................43
Hoofdstuk 11: Beademingsinstellingen..............................................................................................................43
Expiratory trigger sensitivity..........................................................................................................................43
Zucht..............................................................................................................................................................44
Drukstijgtijd....................................................................................................................................................44
I:E-ratio..........................................................................................................................................................45
Triggergevoeligheid.......................................................................................................................................45
Pauzetijd........................................................................................................................................................47
Hoofdstuk 12: Patiënt-ventilator-synchronie.....................................................................................................47
Modus-dyssynchronie....................................................................................................................................47
Trigger- en cyclingfouten...............................................................................................................................48
Samenvattend................................................................................................................................................49
Hoofdstuk 13: Specifieke metingen....................................................................................................................49
Inspiration hold / expiration hold..................................................................................................................49
Compliantie....................................................................................................................................................50
Hoofdstuk 14: Specifieke verpleegkundige aspecten.........................................................................................50
Maatregelen om een VAP te voorkomen......................................................................................................50
Endotracheaal uitzuigen................................................................................................................................51
Powerpoint 1 – Respiratoire insufficiëntie.................................................................................................... 51
Anatomie en fysiologie.......................................................................................................................................51
Regulatie ademhaling........................................................................................................................................51
Inspiratie (inademing)........................................................................................................................................52
Expiratie (uitademing)........................................................................................................................................52
Drukken met betrekking tot de ademhaling......................................................................................................53
Werking slijmvliezen bij de luchtwegen:............................................................................................................54
Respiratoire insufficiëntie...................................................................................................................................54
Soorten zuurstoftherapie...................................................................................................................................54
Verschil tussen hypoxie en hypoxemie...............................................................................................................54
Oorzaken van een bedreigde luchtweg..............................................................................................................55
Compliance/ elasticiteit......................................................................................................................................56
PowerPoint 2 – Luchtwegmanagement farmacologie...................................................................................59
Intubatie bij de acute patiënt.............................................................................................................................59
Intubatie.............................................................................................................................................................59
Redenen van intubatie...................................................................................................................................59
Gevolgen van intubatie..................................................................................................................................59
Luchtweg algoritme...........................................................................................................................................60
Positie voor intubatie.........................................................................................................................................60
Inschatting moeilijke luchtweg...........................................................................................................................61
OBESE.............................................................................................................................................................61
LEMON-law....................................................................................................................................................61
MACOCHA-Score............................................................................................................................................62
Stappenplan intubatie........................................................................................................................................62
Medicatie intubatie.......................................................................................................................................63
Post intubatie medicatie................................................................................................................................63
Invloed van positieve druk op de hemodynamiek..............................................................................................63
CVD en positieve druk........................................................................................................................................64
PowerPoint 3 – Beademing Basics 1............................................................................................................. 64
Wat doen ventilatoren?.....................................................................................................................................64
Doel van beademen............................................................................................................................................64
Anesthesie.....................................................................................................................................................64
Intensive care.................................................................................................................................................64
Soorten beademingmodussen............................................................................................................................65
Ventilatie circuit.................................................................................................................................................65
Classificatie volgens chatburn............................................................................................................................65
Hoofdgroepen beademing.................................................................................................................................66
Invasief...........................................................................................................................................................66
Non-invasief...................................................................................................................................................67
Volume gecontroleerde beademing...................................................................................................................67
Wat stel je in? Wat bewaak je?.....................................................................................................................67
Flow/volume gecontroleerd..........................................................................................................................67
Druk/flow.......................................................................................................................................................68
Druk gecontroleerde beademing.......................................................................................................................68
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