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Samenvatting E2 acute complexe zorg

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Samenvatting van de module E2 acute complexe zorg. Bevat onder andere informatie over fractuurleer, principes op de IC, aandachtspunten bij kinderen en ouderen, shock, pijnbestrijding, stollingsstoornissen en trombo-embolische processen en fracturen door botziekten.

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  • May 27, 2018
  • 48
  • 2017/2018
  • Summary

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By: sepphoogmoet • 6 year ago

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Samenvatting E2 acute complexe zorg
Inhoud
SamenvatninE2nacutencomplexenzoro橔i...................................................................................................1
O橔ianisatenvannacutenzoro橔i.................................................................................................................2
Afo橔tnien.....................................................................................................................................5
ABCDE.............................................................................................................................................5
CRM................................................................................................................................................6
Shock..................................................................................................................................................6
Fysioloiienci橔culate........................................................................................................................7
Dist橔ibutevenshock.........................................................................................................................9
Ca橔dioienenshock...........................................................................................................................9
Obst橔uctevenshock.......................................................................................................................11
Hypovolemischenshock.................................................................................................................11
F橔actuu橔lee橔ndiainostek...................................................................................................................12
F橔actuu橔lee橔nbehandelini.................................................................................................................13
Aliemenenbehandelp橔incipesno橔thopedischent橔aumata...............................................................17
Pijnbest橔ijdini...................................................................................................................................21
Stollinisstoo橔nissennennt橔ombo-embolischenp橔ocessen...................................................................27
Aliemeneninfo橔matenhemostase..................................................................................................27
Stollinisstoo橔nissen......................................................................................................................31
T橔ombo-embolischenp橔ocessen....................................................................................................33
Aandachtspuntennbijnkinde橔en.........................................................................................................37
Aandachtspuntennbijnoude橔en..........................................................................................................38
Basisp橔incipesnICnennbeademini.......................................................................................................40
Int橔oductenIC................................................................................................................................40
Beademinisp橔incipes....................................................................................................................44
F橔actu橔enndoo橔nbotzoriekten................................................................................................................45




1

,Organisatie van acute zorg
Cateio橔ieënnennve橔delininvannacutenzoro橔involiensnNede橔landsnT橔iaienSysteem
- U0:n橔eanimate.nTennminsteneennvitalenfunctenisnuitievallen.
- U1:nlevensbed橔eiiend.nVitalenfunctesnzorijnninnievaa橔.n
- U2:nspoed.nReëlenkansndatndentoestandnvanndenpatëntnopnko橔tente橔mijnnve橔slechte橔t
- U3:nd橔iniend.nPatëntennmetnklachtenndienbinnennenkelenu橔ennmoetennwo橔dennbeoo橔deeldn
omnmedischenofnemotonelen橔edenen.n
- U4:nnietnd橔iniend.nDenkansnopnschadenopnko橔tente橔mijnnisnve橔waa橔loosbaa橔.nBeoo橔delinin
binnenn24nuu橔.
- U5:nadvies.nE橔nisnieennkansnopnschadenopnko橔tente橔mijn.n

O橔ianisatenvannacutenzoro橔i
- Ee橔stelijnszoro橔i:nhuisa橔tsen(posten)n–n橔echtst橔eeksntoeianinaannhulpve橔lene橔nvoo橔nallenvo橔men
vannzoro橔i
- Tweedelijnszoro橔i:nt橔aumacent橔umnlevelnIInennIIIn–nalleenntoeianinnanve橔wijzorininee橔stenlijnnmetn
uitzoronde橔ininvannacutene橔nstienaandoeninienn
- De橔delijnszoro橔i:nt橔aumacent橔umnlevelnIn–nalleenntoeianinnanve橔wijzorinintweedenlijnnetn
uitzoronde橔ininvannacutene橔nstienaandoeninienn

Acute zorg in de eerste lijn
- Voo橔alnU2ntotnennmetnU5
- Acuteneenvoudiienzoro橔i
o Tijdensnkantoo橔u橔ennvianhuisa橔tsp橔aktjkknbuitennkantoo橔u橔ennvianhuisa橔tsenpostenn
- O橔ianisatenhuisa橔tsp橔aktjkn
o Voo橔ndenpatëntnbe橔eikbaa橔ntelefoonnumme橔knwaa橔bijnbinnenn30nsecondennove橔leidn
kannwo橔dennmetneennmedischndeskundiinpe橔soonnenne橔ndenmoielijkheidnisnomnbinnenn
15nminutenndenpatëntntenkunnennzorienn(ande橔sndienennhulpdienstenninieschakeldnten
wo橔den).n
o P橔aktjknassistentnieschooldnvoo橔nNTSnt橔iaieknspoedplekkennie橔ese橔vee橔dninn橔eiulie橔en
sp橔eeku橔enkntjdnie橔ese橔vee橔dnvoo橔nspoedvisites.
o Buitennkantoo橔u橔ennautomatschendoo橔ve橔wijzorininnaa橔ndienstdoendenhuisa橔tsennofn
huisa橔tsenpost.n
- O橔ianisatenhuisa橔tsenpost:nvisitenhuisa橔tskntelefoonnhuisa橔tsknconsulentnhuisa橔tsn




Acute zorg in de tweede lijn
C橔ite橔ianvoo橔nt橔aumacent橔anlevelnInt/mnIII

2

, III II I
LevelindelininSEH-afdelini basis p橔ofiel compleet
Intensivenca橔enindelini niveaun1nnICU niveaun2nnICU niveaun3nnICU
Helikopte橔landinisplaatsn7x24nuu橔nope橔atoneel nee nee ja


AantallennISSn>15 0 0 >100
Aantalnt橔aumaopvaninopnshock橔oomnpe橔njaa橔 0 >50 >300

III II I
Aantalnbeddennshock橔oomnopnSEH 1 1 2
SEHnaantalnbeddennopnSEH 5 5 10
C-booinopnOK ja ja ja
SpoedliftnSEHnnaa橔nOK nee wenselijk ja
Cellnsave橔nopnOK nee nee ja
CTnscann - <n3n'nlooptjd opnSEH
aniiokame橔 nee ja ja
MRI nee ja ja




Acute zorg in de derde lijn
- 11nlevelnInt橔aumacent橔aninnNede橔land
- Laainvolumenaantalnopnamesknhooinene橔ietschenletselsn




Samenstellininkleinnt橔aumateamn(4nhulpve橔lene橔s):
- SEHna橔tsnofnAIOSnSEHnieneeskunde


3

, - assistentn橔adioloiie
- SEHnve橔pleeikundiie
- coassistentnSEHnieneeskunde

Samenstellinin橔eanimatenteamn(11nhulpve橔lene橔s):
- SEHna橔tsnennAIOSnSEH
- SEHnve橔pleeikundiiennInennII
- AnesthesistnennAIOSnAnesthesie
- Ca橔diolooinennAIOSnCa橔dioloiie
- Anesthesienmedewe橔ke橔
- CoassistentnSEHnenncoassistentnca橔dioloiien

Samenstellinini橔ootnt橔aumanteamn(16nhulpve橔lene橔s):n
- SEHna橔tsnennAIOSnSEHnieneeskunde
- Anesthesistnennanesthesienassistent
- RadiolooinennAIOSn橔adioloiie
- SEHn橔öntienlabo橔antnennCTn橔öntienlabo橔ant
- SEHnve橔pleeikundiienInennII
- T橔auma/o橔thopedischnchi橔u橔inennAIOSnt橔aumachi橔u橔iie
- ICna橔tsnennAIOSnICnieneeskunde
- CoassistentnSEHnenncoassistentnchi橔u橔iien
Bijni橔ootnt橔aumateamnneu橔onkomenne橔nnoin6nhulpve橔lene橔snbijn(totaaln22):
- CoassistentnICnenncoassistentnneu橔oloiie
- Neu橔olooinennAIOSnneu橔oloiie
- Neu橔ochi橔u橔inennAIOSnneu橔ochi橔u橔iien
Bijni橔ootnt橔aumateamnkindnzorijnne橔nmee橔ndann22nhulpve橔lene橔skno.a.nkinde橔neu橔olooikn
kinde橔anesthesistknkinde橔a橔tsknkinde橔-ICna橔tsnetc.n

T橔aumantme-outn(levelnI)
- Plenai橔enbesp橔ekininvoo橔naankomstnpatëntnmet:
o Cont橔olenenntaakve橔delininpe橔soneel
o Geievensnvannpatëntennopnt橔anspo橔t
o Voo橔be橔eidininmate橔iaal/CT/IC/OK
- Siinnout:nplenai橔enbesp橔ekininbijnve橔t橔eknvannpatëntnSEH
o UpdatenABCDE
o Samenvatninconclusiesnhoofdntotnteen
o Bepalennhoofdbehandelaa橔
o Ope橔atonelenafsp橔aken
o Evaluatenennemotonelendeb橔iefinin

Spoedncateio橔ieënnlevelnIncent橔um:ndiainosteknennbehandelininnoodzorakelijk
- Cateio橔ien1:n(pe橔ndi橔ect)nbinnenn1nuu橔
- Cateio橔ien2:n(acuut)nbinnenn6nuu橔
- Cateio橔ien3:n(subacuut)nbinnenn24nuu橔
- Cateio橔ien4:n(semi-electef)nbinnenn2nwekenn

Spoedcateio橔ieënnpatëntenntjdensncalamiteitenn(mee橔de橔enslachtofe橔sknt橔iaie):
- T1:nOnmiddellijknmedischenhulpknbinnenn2nuu橔nmaa橔nuite橔aa橔dnzoronspoediinmoielijk.
- T2:nPe橔sonenndienwelnkunnennwachtennmaa橔ncontnuniemonito橔dnmoetennwo橔dennopn
ademhaliniknci橔culatenennacutenp橔oblemen.nBehandelininbinnenn6nuu橔.
- T3:nPatëntenndienkunnennwachten.n

4

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