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Propedeutica Luc De Wolf RZ TIENEN From Touch to Screentouch Wrong direction? From the 1960 untill 2014 From Pincus to Peter Sagan From clinic to.

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Presentation on theme: "Propedeutica Luc De Wolf RZ TIENEN From Touch to Screentouch Wrong direction? From the 1960 untill 2014 From Pincus to Peter Sagan From clinic to."— Presentation transcript:

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2 Propedeutica Luc De Wolf

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4 RZ TIENEN

5 From Touch to Screentouch Wrong direction? From the 1960 untill 2014 From Pincus to Peter Sagan From clinic to technicity

6 Keyboard The clinical examination is the keyboard to good clinical practice EINDTERMEN

7 Doelstellingen Accuratere en betere geneeskunde Minder techniciteiten Efficienter: tijd besparend Prijs- kwaliteit

8 Klinische evaluatie Anamnese : listen to the patient he will tell you the diagnosis Inspektie: l ook to the patient you will see the diagnosis Palpatie en Percussie: feel and find the diagnosis Auscultatie: listen and hear the diagnosis

9 Kliniek onderzoek tot Diagnose Diagnose -symptoom- behandeling Symptoom - diagnose- behandeling Symptoom -behandeling -diagnose

10 ACUUT-NIET ACUUT Niet vitale parameters Vitale parameters

11 Niet vitale parameters eindtermen Systematiek Modulatie Anamnese Inspectie Leeftijd Geslacht Geassocieerde pathologie

12 Vitale parameters - Anamnese :PIJN - Klinische parameters Pols Bloeddruk Ademhalingsfrequentie Bewustzijn Temperatuur

13 Anamnese Akute pijn : Thoracaal Abdominaal Cerebraal

14 Anamnese : Pijn Acuut coronair syndroom Time is muscle

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17 Thrombosis Influences the Severity of a Cardiovascular Event Nonocclusive thrombusOcclusive thrombus Unstable angina Non—Q-wave MI Q-wave MI Sudden death Minor plaque disruption High flow Low thrombotic tendency Major plaque disruption Low flow or vasospasm Thrombotic tendency Kullo IJ, et al. Ann Intern Med. 1998;129: Factors favoring thrombosis:Factors limiting thrombosis:

18 Progression of the disease ACS Troponine – Stable angina exercise Unstable angina rest prolonged progressive Troponine + Nstemi ST segment depression Neg T wave Stemi ST segment elevation

19 INFLUENCE OF TIME-TO-TREATMENT ON THE ODDS RATIO (OR) OF MORTALITY Boersma et al. Lancet 1996; 348: 771–775. ABSOLUTE BENEFIT PER 1,000 TREATED PATIENTS TREATMENT DELAY IN HOURS PATHOPHYSIOLOGY + EPIDEMIOLOGY THROMBOLYSIS IN CLINICAL TRIALS AND REGISTRIES NEW TRIALS/ REGISTRIES MANAGEMENT OF ACUTE MI AND THE RATIONALE FOR EARLY REPERFUSION CLINICAL QUESTIONS METALYSE (+ PRESCRIBING INFORMATION) COSTS REFERENCES SYSTEM REQUIREMENTS IMPRESSUM The “golden hour”: 65 lives are saved for every 1,000 patients treated when the treatment is initiated within the first hour of symptom onset!


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