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Samenvatting college's MK vitale functiekunde
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samenvatting van de college's van MK vitale functiekunde
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Medische KennisVITALE
FUNCTIEKUNDE
Ilse Goede
Hogeschool van Amsterdam
,Inhoudsopgave
Hoorcollege 1: Airway/Breathing ..................................................................................................................... 2
Redeneren volgens de ABCDE-methode ........................................................................................................ 2
Doelen ABCDE-methode .......................................................................................................................... 2
Redeneerhulp inschatten ernst situatie.................................................................................................... 3
Systematisch overdragen via de SBAR ...................................................................................................... 3
Respiratoire insufficiëntie/COPD ................................................................................................................... 4
Acute respiratoire insufficiëntie ............................................................................................................... 4
COPD....................................................................................................................................................... 4
Hoorcollege 2: Circulation ................................................................................................................................ 5
Shock ........................................................................................................................................................... 5
Verschillende oorzaken shock .................................................................................................................. 5
Symptomen van shock ............................................................................................................................. 6
Aanvullend onderzoek ............................................................................................................................. 6
Hoorcollege 3: Ciculation ................................................................................................................................. 7
Septische shock ............................................................................................................................................ 7
Symptomen ............................................................................................................................................. 7
Kenmerken sepsis.................................................................................................................................... 7
Pathofysiologie ........................................................................................................................................ 8
Risicogroep.............................................................................................................................................. 9
Hoorcollege 4: Circulation/disability .............................................................................................................. 10
Fysiologie: Pancreas ................................................................................................................................... 10
Diabetes mellitus........................................................................................................................................ 10
Pathofysiologie ...................................................................................................................................... 10
Soorten diabetes mellitus ...................................................................................................................... 10
Symptomen niet behandelde ernstig ontregelde DM1 ........................................................................... 10
Symptomen ketoacidose ....................................................................................................................... 10
Aanvullend onderzoek ........................................................................................................................... 11
Behandeling diabetische ketoacidose .................................................................................................... 11
Behandeling DM .................................................................................................................................... 12
Hoorcollege 5: Disability/Exposure/environment .......................................................................................... 13
Oorzaken verlaagd bewustzijn .................................................................................................................... 13
CVA............................................................................................................................................................ 14
Symptomen CVA.................................................................................................................................... 14
Trauma capitis ........................................................................................................................................... 14
Hoogenergetisch trauma (HET) .............................................................................................................. 14
Verhoogde intracraniële druk ................................................................................................................ 15
1
, Hoorcollege 1: Airway/Breathing
De vitale functies zijn: ademhaling, circulatie (pols/bloeddruk) en bewustzijn
Redeneren volgens de ABCDE-methode
A: Airway (luchtweg vrij en niet bedreigd?)
- Aanspreken van de patiënt
- corpus alienum (vreemd voorwerp in de luchtweg)
- Look listen feel methode
- Afwijkende ademhalingsgeluiden (stridor, heesheid, rochelen, snurken)
B: Breathing (beoordelen van de ademhaling)
- Ademfrequentie (12-20 per minuut)
- Saturatie (95% - 100%)
- Adequaat; diepte, symmetrische ademhaling, gebruik hulpademhalingsspieren?
- Beoordeel de kleur van de mond/lippen/tong (blauw?) à centrale cyanose
C: Circulation
- Bloeddruk
- Hartfrequentie (gemiddeld 60-100/min)
- Capillaire refill (<2sec.)
- temperatuur acra, kleur huid
- Gestuwde halsvenen?
- Slijmvliezen
- Uitwendige wonden
D: Disability
- Beoordelen van bewustzijn (EMV/AVPU)
- Pupillen à PEARRL (Pupils equal and round reactive to light)
- Lateralisatie
- Glucose (vingerprik)
E: Exposure/Environment
- Huid
- Temperatuur
- Pijn
Doelen ABCDE-methode
• Minder snel stoornis vitale functies over het hoofd zien
• Biedt houvast in een stressvolle situatie
• Iedereen praat over hetzelfde
• Betere aansluiting aan en samenwerking met professionele hulpverlener
• Niet alleen bij trauma, ook bij acute situaties op zaal, tehuis etc.
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