,Inhoud
Table of Contents
Inleiding.................................................................................................................................................... 5
Denken in toestandsbeelden.................................................................................................................... 6
Triagegesprek........................................................................................................................................... 6
Intake.................................................................................................................................................... 6
Checklist................................................................................................................................................ 7
Triage....................................................................................................................................................... 7
Valkuilen................................................................................................................................................... 7
Urgentie.................................................................................................................................................... 8
Urgentieclassificatie.............................................................................................................................. 8
Context en alarmsignalen......................................................................................................................... 9
Alarmsignalen ↑↑................................................................................................................................. 9
Risicogroepen ↑.................................................................................................................................... 9
Contextuele factoren ↑,↓...................................................................................................................... 9
Vervolgactie............................................................................................................................................. 9
Advies..................................................................................................................................................... 10
Afronding van het contact...................................................................................................................... 10
Tot slot................................................................................................................................................ 10
Het beoordelen van pijn......................................................................................................................... 11
Numeric Rating Scale (NRS)................................................................................................................ 11
Verbal Rating Scale (VRS).................................................................................................................... 11
Pijngedragsschaal................................................................................................................................ 11
Pijnladder............................................................................................................................................ 11
Invloed van angst en ongerustheid......................................................................................................... 12
Invloed van cultuur................................................................................................................................. 12
Pijnmedicatie.......................................................................................................................................... 13
Algemeen............................................................................................................................................ 13
Stap 1a - Kinderdoseringen paracetamol.............................................................................................13
Stap 1b – NSAID’s................................................................................................................................ 14
Stap 1c - NSAID’s in combinatie met paracetamol .............................................................................15
Stap 2 - Toevoegen of overstappen op tramadol ................................................................................15
Stap 3 - Toevoegen of overstappen op opioïd ....................................................................................15
Hoog energetisch trauma (HET-criteria)................................................................................................. 16
Voorbeelden van hoog energetisch trauma.........................................................................................16
Kindermishandeling en ander huiselijk geweld.......................................................................................17
Siganaleren: checklist.......................................................................................................................... 17
Checklist kindermishandeling en ander huiselijk geweld..................................................................18
, Kindcheck............................................................................................................................................ 18
ABCDE-triage.......................................................................................................................................... 19
Korte ABCDE-check................................................................................................................................. 19
Tabel 1: storing/uitval van vitale functies...............................................................................................20
Tabel 2: Bedreiging van vitale functies................................................................................................... 21
Reanimatie............................................................................................................................................. 23
Reanimatie kind...................................................................................................................................... 23
Advies.................................................................................................................................................. 23
Mond-op-mondbeademing.................................................................................................................. 23
Borstcompressie.................................................................................................................................. 24
Mond-op-mondbeademing in combinatie met borstcompressie..........................................................24
Wanneer de situatie verandert............................................................................................................ 24
Reanimatie volwassene.......................................................................................................................... 25
Advies.................................................................................................................................................. 25
Hartmassage....................................................................................................................................... 25
Mond-op-mondbeademing................................................................................................................... 25
Hartmassage in combinatie met mond-op-mondbeademing...............................................................25
Wanneer de situatie verandert........................................................................................................... 26
Overleden............................................................................................................................................... 26
Advies.................................................................................................................................................. 26
Twijfel.................................................................................................................................................. 26
Natuurlijke dood.................................................................................................................................. 26
Algemeen / huid..................................................................................................................................... 27
Algehele malaise volwassene................................................................................................................. 27
Triagecriteria - Algehele Malaise Volwassene......................................................................................27
Advies.................................................................................................................................................. 28
Vragen algehele malaise volwassene.................................................................................................. 28
Achtergrond........................................................................................................................................ 30
Allergische reactie of instectensteek...................................................................................................... 30
Triagecriteria....................................................................................................................................... 30
Advies.................................................................................................................................................. 30
Vragen................................................................................................................................................. 31
Achtergrondinformatie........................................................................................................................ 32
Corpus alienum....................................................................................................................................... 33
Vragen................................................................................................................................................ 33
Triagecriteria....................................................................................................................................... 33
Advies.................................................................................................................................................. 35
Achtergrondinformatie........................................................................................................................ 35
Diabetes ontregeld................................................................................................................................. 37
Triagecriteria....................................................................................................................................... 37
Achtergrondinformatie........................................................................................................................ 37
Advies.................................................................................................................................................. 38
Vragen................................................................................................................................................. 38
, Huidklachten en borstontsteking............................................................................................................ 40
Triagecriteria....................................................................................................................................... 40
Advies.................................................................................................................................................. 41
Vragen................................................................................................................................................. 43
Achtergrondinformatie........................................................................................................................ 44
Intoxicatie............................................................................................................................................... 46
Achtergrondinformatie........................................................................................................................ 46
Algemeen......................................................................................................................................... 46
Veelvoorkomende vergiftigingen bij kinderen.................................................................................46
Alcohol of Drugs............................................................................................................................... 47
Triagecriteria....................................................................................................................................... 48
Advies.................................................................................................................................................. 48
Vragen................................................................................................................................................. 50
Koorts kind............................................................................................................................................. 51
Achtergrondinformatie........................................................................................................................ 51
Mazelen Morbilli - Eerste ziekte - Measles - Masern..........................................................................52
Roodvonk Scarlatina - Tweede ziekte - Scarlett fever -Scharlach....................................................52
Rodehond Rubella - Derde ziekte - German Measles - Röteln...........................................................53
ERYTHEMA INFECTIOSUM – VIJFDE ZIEKTE SLAPPED CHEEK DISEASE – RINGELRÖTELN...................53
EXANTHEMA SUBITUM - ZESDE ZIEKTE - ROSEOLA INFANTUM - DREITAGEFIEBEREXANTHEM.........55
WATERPOKKEN - VARICELLA - CHICKENPOX - WINDPOCKEN............................................................55
HAND-VOET-MONDZIEKTE................................................................................................................ 56
Triagecriteria....................................................................................................................................... 57
Advies.................................................................................................................................................. 58
Vragen................................................................................................................................................. 59
Koorts volwassene.................................................................................................................................. 61
TRIAGECRITERIA.................................................................................................................................. 61
Advies.................................................................................................................................................. 62
Vragen................................................................................................................................................. 62
Achtergrondinformatie........................................................................................................................ 63
Ziek kind................................................................................................................................................. 64
Triagecriteria....................................................................................................................................... 64
Advies.................................................................................................................................................. 65
Vragen................................................................................................................................................. 66
ACHTERGRONDINFORMATIE................................................................................................................ 66
Buik / urogenitaal................................................................................................................................... 69
Braken.................................................................................................................................................... 69
Triagecriteria....................................................................................................................................... 69
Advies.................................................................................................................................................. 69
Vragen................................................................................................................................................. 70
Achtergrondinformatie........................................................................................................................ 71
Buikpijn kind........................................................................................................................................... 73
Triagecriteria....................................................................................................................................... 73
Table of Contents
Inleiding.................................................................................................................................................... 5
Denken in toestandsbeelden.................................................................................................................... 6
Triagegesprek........................................................................................................................................... 6
Intake.................................................................................................................................................... 6
Checklist................................................................................................................................................ 7
Triage....................................................................................................................................................... 7
Valkuilen................................................................................................................................................... 7
Urgentie.................................................................................................................................................... 8
Urgentieclassificatie.............................................................................................................................. 8
Context en alarmsignalen......................................................................................................................... 9
Alarmsignalen ↑↑................................................................................................................................. 9
Risicogroepen ↑.................................................................................................................................... 9
Contextuele factoren ↑,↓...................................................................................................................... 9
Vervolgactie............................................................................................................................................. 9
Advies..................................................................................................................................................... 10
Afronding van het contact...................................................................................................................... 10
Tot slot................................................................................................................................................ 10
Het beoordelen van pijn......................................................................................................................... 11
Numeric Rating Scale (NRS)................................................................................................................ 11
Verbal Rating Scale (VRS).................................................................................................................... 11
Pijngedragsschaal................................................................................................................................ 11
Pijnladder............................................................................................................................................ 11
Invloed van angst en ongerustheid......................................................................................................... 12
Invloed van cultuur................................................................................................................................. 12
Pijnmedicatie.......................................................................................................................................... 13
Algemeen............................................................................................................................................ 13
Stap 1a - Kinderdoseringen paracetamol.............................................................................................13
Stap 1b – NSAID’s................................................................................................................................ 14
Stap 1c - NSAID’s in combinatie met paracetamol .............................................................................15
Stap 2 - Toevoegen of overstappen op tramadol ................................................................................15
Stap 3 - Toevoegen of overstappen op opioïd ....................................................................................15
Hoog energetisch trauma (HET-criteria)................................................................................................. 16
Voorbeelden van hoog energetisch trauma.........................................................................................16
Kindermishandeling en ander huiselijk geweld.......................................................................................17
Siganaleren: checklist.......................................................................................................................... 17
Checklist kindermishandeling en ander huiselijk geweld..................................................................18
, Kindcheck............................................................................................................................................ 18
ABCDE-triage.......................................................................................................................................... 19
Korte ABCDE-check................................................................................................................................. 19
Tabel 1: storing/uitval van vitale functies...............................................................................................20
Tabel 2: Bedreiging van vitale functies................................................................................................... 21
Reanimatie............................................................................................................................................. 23
Reanimatie kind...................................................................................................................................... 23
Advies.................................................................................................................................................. 23
Mond-op-mondbeademing.................................................................................................................. 23
Borstcompressie.................................................................................................................................. 24
Mond-op-mondbeademing in combinatie met borstcompressie..........................................................24
Wanneer de situatie verandert............................................................................................................ 24
Reanimatie volwassene.......................................................................................................................... 25
Advies.................................................................................................................................................. 25
Hartmassage....................................................................................................................................... 25
Mond-op-mondbeademing................................................................................................................... 25
Hartmassage in combinatie met mond-op-mondbeademing...............................................................25
Wanneer de situatie verandert........................................................................................................... 26
Overleden............................................................................................................................................... 26
Advies.................................................................................................................................................. 26
Twijfel.................................................................................................................................................. 26
Natuurlijke dood.................................................................................................................................. 26
Algemeen / huid..................................................................................................................................... 27
Algehele malaise volwassene................................................................................................................. 27
Triagecriteria - Algehele Malaise Volwassene......................................................................................27
Advies.................................................................................................................................................. 28
Vragen algehele malaise volwassene.................................................................................................. 28
Achtergrond........................................................................................................................................ 30
Allergische reactie of instectensteek...................................................................................................... 30
Triagecriteria....................................................................................................................................... 30
Advies.................................................................................................................................................. 30
Vragen................................................................................................................................................. 31
Achtergrondinformatie........................................................................................................................ 32
Corpus alienum....................................................................................................................................... 33
Vragen................................................................................................................................................ 33
Triagecriteria....................................................................................................................................... 33
Advies.................................................................................................................................................. 35
Achtergrondinformatie........................................................................................................................ 35
Diabetes ontregeld................................................................................................................................. 37
Triagecriteria....................................................................................................................................... 37
Achtergrondinformatie........................................................................................................................ 37
Advies.................................................................................................................................................. 38
Vragen................................................................................................................................................. 38
, Huidklachten en borstontsteking............................................................................................................ 40
Triagecriteria....................................................................................................................................... 40
Advies.................................................................................................................................................. 41
Vragen................................................................................................................................................. 43
Achtergrondinformatie........................................................................................................................ 44
Intoxicatie............................................................................................................................................... 46
Achtergrondinformatie........................................................................................................................ 46
Algemeen......................................................................................................................................... 46
Veelvoorkomende vergiftigingen bij kinderen.................................................................................46
Alcohol of Drugs............................................................................................................................... 47
Triagecriteria....................................................................................................................................... 48
Advies.................................................................................................................................................. 48
Vragen................................................................................................................................................. 50
Koorts kind............................................................................................................................................. 51
Achtergrondinformatie........................................................................................................................ 51
Mazelen Morbilli - Eerste ziekte - Measles - Masern..........................................................................52
Roodvonk Scarlatina - Tweede ziekte - Scarlett fever -Scharlach....................................................52
Rodehond Rubella - Derde ziekte - German Measles - Röteln...........................................................53
ERYTHEMA INFECTIOSUM – VIJFDE ZIEKTE SLAPPED CHEEK DISEASE – RINGELRÖTELN...................53
EXANTHEMA SUBITUM - ZESDE ZIEKTE - ROSEOLA INFANTUM - DREITAGEFIEBEREXANTHEM.........55
WATERPOKKEN - VARICELLA - CHICKENPOX - WINDPOCKEN............................................................55
HAND-VOET-MONDZIEKTE................................................................................................................ 56
Triagecriteria....................................................................................................................................... 57
Advies.................................................................................................................................................. 58
Vragen................................................................................................................................................. 59
Koorts volwassene.................................................................................................................................. 61
TRIAGECRITERIA.................................................................................................................................. 61
Advies.................................................................................................................................................. 62
Vragen................................................................................................................................................. 62
Achtergrondinformatie........................................................................................................................ 63
Ziek kind................................................................................................................................................. 64
Triagecriteria....................................................................................................................................... 64
Advies.................................................................................................................................................. 65
Vragen................................................................................................................................................. 66
ACHTERGRONDINFORMATIE................................................................................................................ 66
Buik / urogenitaal................................................................................................................................... 69
Braken.................................................................................................................................................... 69
Triagecriteria....................................................................................................................................... 69
Advies.................................................................................................................................................. 69
Vragen................................................................................................................................................. 70
Achtergrondinformatie........................................................................................................................ 71
Buikpijn kind........................................................................................................................................... 73
Triagecriteria....................................................................................................................................... 73
