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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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Document information

  • March 16, 2019
  • 102
  • 2018/2019
  • Summary

Subjects

  • 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

Written for

  • Radboud Universiteit Nijmegen (RU)
  • Geneeskunde
  • Klinische vraagstukken
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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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