Summary

Samenvatting E2 Acute complexe zorg

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Course
Klinische vraagstukken

Institution
Radboud Universiteit Nijmegen (RU)

Samenvatting van het blok E2 Acute complexe zorg met onder andere acute complexe zorg en organisatie van zorg, intensive care, beademing, aandachtspunten bij ouderen, aandachtspunten bij kinderen, pijnbestrijding, anesthetica, shock, fractuurleer, calcium0 en botstofwisseling, bloedstolling en thro...

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Uploaded on March 16, 2019
Number of pages 102
Written in 2018/2019
Type Summary

acute complexe zorg
afkortingen acute zorg
organisatie acute zorg
crew resource management
intensive care
medical emergency team
met
beademing
vormen van beademing
aandacht
aandachtspunten bij ouderen

Institution
Radboud Universiteit Nijmegen (RU)
Education
Geneeskunde
Course
Klinische vraagstukken

LiekeSchonberger

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1. Summary - Samenvatting e3 oncologie, palliatieve behandeling en levenseinde
2. Summary - Samenvatting e2 acute complexe zorg
3. Summary - Samenvatting e1 algemene klachten, infectieziekten en endocriene ziekten
4. Summary - Samenvatting e4 chronisch ziek zijn en specifieke patiëntgroepen
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E2 Acute complexe
zorg
SAMENVATTING

Lieke Schönberger

,Inhoud
Acute complexe zorg en organisatie van zorg ......................................................................................7
Afkortingen in de acute zorg ...........................................................................................................7
Organisatie van acute zorg ..............................................................................................................8
Definities acute zorg....................................................................................................................8
Organisatie van acute zorg ..........................................................................................................9
Acute zorg in de eerste lijn ..........................................................................................................9
Acute zorg in de tweede lijn ...................................................................................................... 10
Acute zorg in de derde lijn ......................................................................................................... 11
Transport van acute zorgpatiënten ............................................................................................ 12
Crew resource management ......................................................................................................... 13
Intensive care ................................................................................................................................... 14
Intensive care ............................................................................................................................... 14
Monitoring .................................................................................................................................... 14
Circulatie................................................................................................................................... 14
Respiratie.................................................................................................................................. 15
Bewustzijn................................................................................................................................. 15
Medical emergency team (MET).................................................................................................... 16
Bloedgasanalyse ........................................................................................................................... 17
Centraal veneuze catheter (CVC) ................................................................................................... 17
Cardiac output meting .................................................................................................................. 17
Sepsis............................................................................................................................................ 18
Nierinsufficiëntie op IC .................................................................................................................. 19
Delier ............................................................................................................................................ 20
Prognose....................................................................................................................................... 21
Beademing........................................................................................................................................ 22
Beademing/mechanische ventilatie .............................................................................................. 22
Vormen van beademing ............................................................................................................ 22
Beademingsmodus .................................................................................................................... 23
Complicaties ............................................................................................................................. 25
Aandachtspunten bij ouderen ........................................................................................................... 26
Aandachtspunten bij kinderen .......................................................................................................... 27
Relevante verschillen tussen kinderen en volwassenen ................................................................. 27

2

, ABCDE........................................................................................................................................... 29
Resuscitaties ................................................................................................................................. 30
Pijnbestrijding ................................................................................................................................... 32
Nociceptie..................................................................................................................................... 32
Farmacologische behandeling van acute pijn ................................................................................ 33
Paracetamol (acetaminophen) .................................................................................................. 37
Metamizol (dipyron).................................................................................................................. 37
NSAID’s ..................................................................................................................................... 37
Tramadol (zwak opiaat) ............................................................................................................. 38
Opioïden ................................................................................................................................... 39
Co-analgetica ............................................................................................................................ 41
Anesthetica....................................................................................................................................... 43
Werking .................................................................................................................................... 43
Opbouw .................................................................................................................................... 43
Ionisatie .................................................................................................................................... 44
Zenuw conductie fysiologie ....................................................................................................... 45
Bloedconcentratie ..................................................................................................................... 46
Spinale en epidurale anesthesie .................................................................................................... 46
Spinale anesthesie .................................................................................................................... 47
Epidurale anesthesie ................................................................................................................. 48
Shock ................................................................................................................................................ 49
Fysiologie circulatie ....................................................................................................................... 49
Hartcyclus ................................................................................................................................. 50
Preload ..................................................................................................................................... 50
Afterload................................................................................................................................... 51
Contractiliteit ............................................................................................................................ 51
Slagvolume ............................................................................................................................... 51
Cardiac output .......................................................................................................................... 52
Bloeddruk ................................................................................................................................. 52
Autonome zenuwstelsel ............................................................................................................ 53
Cardiogene shock .......................................................................................................................... 54
Oorzaken .................................................................................................................................. 55
Diagnostiek ............................................................................................................................... 55
Behandeling .............................................................................................................................. 55

3

, Distributieve shock ....................................................................................................................... 56
Obstructieve shock ....................................................................................................................... 56
Hypovolemische shock .................................................................................................................. 57
Fractuurleer ...................................................................................................................................... 58
Trauma mechanismen................................................................................................................... 58
Hoog energetisch trauma (HET) ................................................................................................. 58
Gevolgen................................................................................................................................... 58
Soorten fracturen ......................................................................................................................... 59
Descriptieve beschrijving van fracturen ..................................................................................... 59
Opbouw diagnostiek fracturen ...................................................................................................... 61
Anamnese ................................................................................................................................. 61
Lichamelijk onderzoek ............................................................................................................... 61
Aanvullend onderzoek............................................................................................................... 62
Fractuurgenezing .......................................................................................................................... 62
Secundaire fractuurgenezing ..................................................................................................... 62
Primaire fractuurgenezing ......................................................................................................... 63
Behandeling .................................................................................................................................. 64
Repositie ................................................................................................................................... 64
Fixatie ....................................................................................................................................... 64
Conservatieve behandelingen (niet-operatief) .............................................................................. 65
Functionele behandeling ........................................................................................................... 65
Steunverband/tape ................................................................................................................... 65
Spalk ......................................................................................................................................... 65
Scharnierbrace .......................................................................................................................... 66
Tractie....................................................................................................................................... 66
Operatieve technieken .................................................................................................................. 66
Percutane Kirschner (K)-draad fixatie ........................................................................................ 66
Schroeffixatie ............................................................................................................................ 67
Plaat-osteosynthese .................................................................................................................. 67
Intra-medullaire fixatie.............................................................................................................. 68
Fixateur externe ........................................................................................................................ 68
Resectie artoplastiek ................................................................................................................. 68
Endoprothese ........................................................................................................................... 68
Amputatie ................................................................................................................................. 69

4

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