az:V2.5.0 Testscript Ambulanceoverdracht SEH complex addendum: verschil tussen versies

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Regel 1: Regel 1:
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==T1: annulering==
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 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | T1
 +
|}
 +
<section begin="patientT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Patient
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Persoonidentificatie
 +
|style="background-color: white;"|999910553
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Naamgegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="8"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Initialen
 +
|style="background-color: white;"|W.
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Achternaam
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="3"|Soort naam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Voorvoegsels
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Achternaam
 +
|style="background-color: white;"|XXX_Witsiers
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Geslacht
 +
|style="background-color: white;"|M
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Geboortegegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Geboortedatum
 +
|style="background-color: white;"|06-08-1954
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Geschatte leeftijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Adresgegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="10"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Straat
 +
|style="background-color: white;"|Hertog Aalbrechtweg
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Huisnummer
 +
|style="background-color: white;"|8
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Huisnummerletter
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Huisnummertoevoeging
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Postcode
 +
|style="background-color: white;"|1823 DB
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Woonplaats
 +
|style="background-color: white;"|Alkmaar
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Land
 +
|style="background-color: white;"|Nederland
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Locatiebeschrijving
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Overige Contactgegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="15"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Telefoonnummers
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Soort telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Werktelefoon
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|werknummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Soort nummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|EmailAdressen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="5"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Emailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Soort e-mailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Emailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Soort e-mailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"| Ziektekostenverzekering?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Verzekeringsgegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="8"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Verzekeraar
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Naam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Identificatienummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Polis
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"| Polisnummer/Verzekerdenummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Vaste huisarts
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| ZorgverlenerIdentificatienummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Rolcode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Naam
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Achternaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Vaste huisartsenpraktijk
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="27"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Identificatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Naam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|  Adresgegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="9"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Soort adres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Straatnaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Huisnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Huisnummertoevoeging
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Postcode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Gemeente
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Woonplaats
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Land
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|  Overige contactgegevens 
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="13"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Telefoonnummers
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  Soort telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Faxnummers
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  Soort faxnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  Faxnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  E-mailadressen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  Soort e-mailadres 
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  E-mailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Contactpersoon patiënt
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="5"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Achternaam 
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Relatie tot patiënt
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="patientT1" />
 +
 
 +
<section begin="WID-controleT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | WID-controle
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|WID-controle uitgevoerd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|WID controle datum
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Documentnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Document type
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="WID-controleT1" />
 +
 
 +
<section begin="IncidentgegevensT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Incidentgegevens
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Datum/tijd incident
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="IncidentgegevensT1" />
 +
 
 +
<section begin="MeldingsgegevensT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Meldingsgegevens
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Datum/tijd melding
 +
|style="background-color: white;"| T1-15min
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Geplande brengtijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Geplande haaltijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Wzd/Wvggz maatregel
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd aanvang TVZ
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Medische kladblok meldkamer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;
 +
|colspan="5"|Meldkamerurgentie
 +
|style="background-color: white;"| A2
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="MeldingsgegevensT1" />
 +
 
 +
<section begin="ZorgaanvragerT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Zorgaanvrager
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Initialen
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Achternaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Identificatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Type zorgaanvrager
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="ZorgaanvragerT1" />
 +
 
 +
<section begin="RitgegevensT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Ritgegevens
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Ambulancevoorziening
 +
|style="background-color: white;"| 25 (RAV identificatie)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Ritnummer
 +
|style="background-color: white;"| 25-2020-13-1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Ambulancenummer
 +
|style="background-color: white;"| 25190
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Telefoon ambulance
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Ambulanceverpleegkundige identificatie
 +
|style="background-color: white;"| 596
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Ambulancechauffeur identificatie
 +
|style="background-color: white;"| 530
 +
|-style="vertical-align:top; background-color: #E3E3E3;;
 +
|colspan="5"|Datum/tijd ritopdracht
 +
|style="background-color: white;"| T1-10 min
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd uitruk/vertrek
 +
|style="background-color: white;"| T1-10 min
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd aankomst patiënt
 +
|style="background-color: white;"| T1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd vertrek patiënt
 +
|style="background-color: white;"| T1+2 min
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Verwachte  aankomsttijd bestemming
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd aankomst bestemming
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd vrijmelding
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Soort vervoer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="RitgegevensT1" />
 +
 
 +
<section begin="HaalgegevensT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Haalgegevens
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Straat
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisletter
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisnummertoevoeging
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Postcode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Locatiebeschrijving
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Woonplaats
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Land
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Patiënt vervoerd?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Reden geen vervoer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Tijdstip overlijden patiënt
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Advies behandeling tijdens vervoer aanwezig?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Niet reanimeren verklaring aanwezig?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Trialgegevens
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Ambulance-urgentie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Gewondennummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Triageklasse
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Hulpverleners ter plaatse
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|rowspan="9"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Hulpverlenersnaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Type hulpverlener
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|E-mailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|}
 +
<section end="HaalgegevensT1" />
 +
 
 +
<section begin="BestemmingsgegevensT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Bestemmingsgegevens
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Bestemmingsstatus in bericht op T3
 +
|style="background-color: white;"|Overgedragen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Bestemmingscode
 +
|style="background-color: white;"|AGB: 06010860
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Locatie of afdeling
 +
|style="background-color: white;"|LSDV-code: 2.16.840.1.113883.2.4.6.1.6010860.000
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Straat
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisletter
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Huisnummertoevoeging
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Postcode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Locatiebeschrijving
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Woonplaats
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Land
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Bijzonderheden algemeen
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Verwacht specialisme
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Feedback
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|rowspan="9"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Feedback gewenst
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Feedback adres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Feedback methode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|}
 +
<section end="BestemmingsgegevensT1" />
 +
 
 +
<section begin="MechanismeT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Mechanisme
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Mechanisme type
 +
|style="background-color: white;"| 35468003  bekneld geraakt tussen voorwerpen (gebeurtenis)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Vervoermiddel patiënt
 +
|style="background-color: white;"| 71783008 auto (fysiek object)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Patiënt was bestuurder?
 +
|style="background-color: white;"| ja
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Vervoermiddel contra
 +
|style="background-color: white;"| 71783008 auto (fysiek object)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Beschermingsmiddelen patiënt (3x)
 +
|style="background-color: white;"| 285695004 helm (fysiek object) <br/>
 +
60054005 autogordel (fysiek object)<br/>
 +
102384007 airbag van motorvoertuig (fysiek object)
 +
 
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="MechanismeT1" />
 +
 
 +
<section begin="Toestandsbeelden/WerkdiagnoseT1 />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" |Toestandsbeelden/Werkdiagnose
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Toestandsbeeld
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Toestandsbeeld code
 +
|style="background-color: white;"| 125593007 letsel van aangezicht (aandoening)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Toelichting Toestandsbeeld
 +
|style="background-color: white;"| Moeilijk observeren door weersomstandigheden
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|}
 +
<section end="Toestandsbeelden/WerkdiagnoseT1" />
 +
 
 +
<section begin="MeetwaardenT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Meetwaarden
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Bloedsuiker
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Bloedsuiker waarde
 +
|style="background-color: white;"| 6 mmol/L
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|BloedsuikerDatumTijd
 +
|style="background-color: white;"| T3
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Hartritme
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Hartritme observatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|HartritmeDatumTijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Toelichting hartritme/ECG
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|O2Saturatie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|SpO2waarde
 +
|style="background-color: white;"|98%
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|O2SaturatieDatumTijd
 +
|style="background-color: white;"|T3
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Capnometrie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|CO2Waarde
 +
|style="background-color: white;"|35 mm[Hg] <br/>4,7 kPa
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|CO2CapnometrieDatumTijd
 +
|style="background-color: white;"|T3
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Hartfrequentie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|HartfrequentieWaarde
 +
|style="background-color: white;"|90/min
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|HartfrequentieDatumTijd
 +
|style="background-color: white;"|T3
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Bloeddruk
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|SystolischeBloeddruk
 +
|style="background-color: white;"|60 mm[Hg]
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|DiastolischeBloeddruk
 +
|style="background-color: white;"|50 mm[Hg]
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|BloeddrukDatumTijd
 +
|style="background-color: white;"|T3
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Lichaamstemperatuur
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|TemperatuurWaarde
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|TemperatuurDatumTijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Ademhaling
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Ademfrequentie
 +
|style="background-color: white;"|4/min
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|AdemhalingDatumTijd
 +
|style="background-color: white;"|T3
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|GlasgowComaScale
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|GlasgowComaScaleDatumTijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|GCS_Eyes
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|GCS_Motor
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|GCS_Verbal
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|TotaalScore
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Revised Trauma Score
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|RevisedTraumaScoreWaarde
 +
|style="background-color: white;"|8
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|RevisedTraumaScoreTijd
 +
|style="background-color: white;"|T3
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Pediatric Trauma Score
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|PediatricTraumaScoreWaarde
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|PediatricTraumaScoreTijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Pijnschaal
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|PijnschaalWaarde
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|PijnschaalTijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|APGAR-1
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|APGAR-5
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="MeetwaardenT1" />
 +
 
 +
<section begin="BehandelingT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Behandeling
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Ademhaling en beademing (diagnostisch)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Handelingen ademhaling en beademing
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Bewustzijn en neurologische status (diagnostisch) 
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Handelingen bewustzijn en neurologische status
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Overige diagnostische handelingen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Handelingen overige diagnostisch
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Luchtweg management (therapeutisch)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Handelingen luchtweg management
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Moeizame intubatie?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Oxygenatie en ventilatie (therapeutisch)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="7"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Handelingen oxygenatie en ventilatie 
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Beademing machine Fi O2
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Beademing machine AMV
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Beademing machine Freq.
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Beademing machine Peep
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Hoeveelheid zuurstof
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Circulatie (therapeutisch)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="12"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Handelingen circulatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Pacemaker frequentie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Pacemaker stroomsterkte
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Pacemaker modus
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Cardioversies aantal
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Cardioversie maximale energie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Defibrillaties aantal
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Defibrillatie energie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Return Of Spontaneous Circulation (ROSC)
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| AED aangesloten voor aankomst
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| AED-schokken aantal
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Traumatologie (therapeutisch)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Handelingen traumatologie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Koelen tijdsduur
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Obstetrie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Handelingen obstetrie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Wijze van isolatie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Handelingen isolatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Medicatie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="7"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Medicatie toegediend?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Medicatienaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Toegediende hoeveelheid medicatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Tijd medicatietoediening
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Medicatie toedieningsvorm
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| IV medicatiesnelheid
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Infuus
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="5"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Infusen aantal
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Infuusvloeistofcode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Infuusvloeistoftekst
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Infuushoeveelheid
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Extra informatie behandeling
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="BehandelingT1" />
 +
 
 +
<section begin="PatiëntliggingT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Patiëntligging
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Type patiëntligging
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="PatiëntliggingT1" />
 +
 
 +
<section begin="Primary SurveyT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Primary Survey
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Airway
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Airway vrij?
 +
|style="background-color: white;"| Ja
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Stridor
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Breathing
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Breathing sufficient?
 +
|style="background-color: white;"|Ja
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Breathing observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Circulation
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Circulation sufficient?
 +
|style="background-color: white;"| Ja
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Capillaire refill > 2 seconde?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Huid observatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Disability
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="7"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|AVPU
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Duur buiten bewustzijn
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Pupil
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|FAST symptomen aanwezig
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Mogelijk trombolyse/trombectomie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Intoxicatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
 
 +
 
 +
|colspan="5"|Toelichting Primary Survey
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="Primary SurveyT1" />
 +
 
 +
<section begin="Secondary SurveyT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Secondary Survey
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Anamnese
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="7"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Ample
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Code
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Titel
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Omschrijving
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Toelichting anamnese
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Infectierisico
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Verdenking infectieziekten?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Toelichting infectierisico
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Hoofd en gelaat
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Hoofd en gelaat observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Bloedverlies
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Liquorverlies
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Pijnlocatie
 +
|style="background-color: white;"|   
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Nek, hals, CWK
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Nek, hals, CWK observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Thorax
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Thorax observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Pijn bij compressie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Locatie subcutaan emfyseem
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Locatie zwelling / oedeem (2x)
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Rug
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Rug observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Abdomen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Abdomen observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Locatie druk- / loslaatpijn
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Locatie zwelling / oedeem
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Locatie pulserende zwelling
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Bekken
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Bekken observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Extremiteiten Armen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Extremiteit
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Lateraliteit
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Extremiteiten Armen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Extremiteit
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Lateraliteit
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Extremiteiten Benen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Extremiteit
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Lateraliteit
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Observaties (2x)
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Uitscheiding
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Uitscheiding observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Braken
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Incontinent
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Verloskunde/Gynaecologie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Verloskunde/Gynaecologie observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Vruchtwaterverlies
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Weeën
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="Secondary SurveyT1" />
 +
 
 +
<section begin="Consultgever op afstandT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Consultgever op afstand
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Initialen
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Achternaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Identificatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Type consultgever
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Toelichting/Afspraken met consultgever
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="Consultgever op afstandT1" />
 +
 
 +
<section begin="Afspraken met patiëntT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Afspraken met patiënt
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisarts ingelicht
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Afspraken met patiënt
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="Afspraken met patiëntT1" />
 +
 
 +
<section begin="BijlagenT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Bijlagen T3
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Type Bijlage
 +
|style="background-color: white;"|006 intern rapport/overdracht
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Bijlage id
 +
|style="background-color: white;"| 9068
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Versie
 +
|style="background-color: white;"| 6
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Bijlageset id
 +
|style="background-color: white;"| 12
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="BijlagenT1" />
 +
 
 +
<section begin="ToestemmingsgegevensT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Toestemmingsgegevens
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Wetenschappelijk onderzoek
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Beschrijving
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Informed consent
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Toestemming informeren verwanten
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|}
 +
<section end="ToestemmingsgegevensT1" />
 +
 
 +
<section begin="ToelichtingsgegevensT1" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #ED2939;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Toelichtingsgegevens
 +
|-style="background-color: #ED2939;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Toelichting algemeen
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="ToelichtingsgegevensT1" />
 +
 
 +
 
 +
==T2: aankomst bij de patient==
 +
 
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | T2
 +
|}
 +
<section begin="patientT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Patient
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Persoonidentificatie
 +
|style="background-color: white;"|999910553
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Naamgegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="8"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Initialen
 +
|style="background-color: white;"|W.
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Achternaam
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="3"|Soort naam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Voorvoegsels
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Achternaam
 +
|style="background-color: white;"|XXX_Witsiers
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Geslacht
 +
|style="background-color: white;"|M
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Geboortegegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Geboortedatum
 +
|style="background-color: white;"|06-08-1954
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Geschatte leeftijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Adresgegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="10"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Straat
 +
|style="background-color: white;"|Hertog Aalbrechtweg
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Huisnummer
 +
|style="background-color: white;"|8
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Huisnummerletter
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Huisnummertoevoeging
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Postcode
 +
|style="background-color: white;"|1823 DB
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Woonplaats
 +
|style="background-color: white;"|Alkmaar
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Land
 +
|style="background-color: white;"|Nederland
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Locatiebeschrijving
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Overige Contactgegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="15"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Telefoonnummers
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Soort telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Werktelefoon
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|werknummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Soort nummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|EmailAdressen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="5"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Emailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Soort e-mailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Emailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Soort e-mailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"| Ziektekostenverzekering?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Verzekeringsgegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="8"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Verzekeraar
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Naam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Identificatienummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Polis
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"| Polisnummer/Verzekerdenummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Vaste huisarts
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| ZorgverlenerIdentificatienummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Rolcode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Naam
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Achternaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Vaste huisartsenpraktijk
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="27"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Identificatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Naam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|  Adresgegevens
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="9"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Soort adres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Straatnaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Huisnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Huisnummertoevoeging
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Postcode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Gemeente
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Woonplaats
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|  Land
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|  Overige contactgegevens 
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="13"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Telefoonnummers
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  Soort telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Faxnummers
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  Soort faxnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  Faxnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  E-mailadressen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  Soort e-mailadres 
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="2"|  E-mailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Contactpersoon patiënt
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="5"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Achternaam 
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|  Relatie tot patiënt
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="patientT2" />
 +
 
 +
<section begin="WID-controleT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | WID-controle
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|WID-controle uitgevoerd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|WID controle datum
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Documentnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Document type
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="WID-controleT2" />
 +
 
 +
<section begin="IncidentgegevensT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Incidentgegevens
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Datum/tijd incident
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="IncidentgegevensT2" />
 +
 
 +
<section begin="MeldingsgegevensT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Meldingsgegevens
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Datum/tijd melding
 +
|style="background-color: white;"| T1-15min
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Geplande brengtijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Geplande haaltijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Wzd/Wvggz maatregel
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd aanvang TVZ
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Medische kladblok meldkamer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;
 +
|colspan="5"|Meldkamerurgentie
 +
|style="background-color: white;"| A2
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="MeldingsgegevensT2" />
 +
 
 +
<section begin="ZorgaanvragerT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Zorgaanvrager
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Initialen
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Achternaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Identificatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Type zorgaanvrager
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="ZorgaanvragerT2" />
 +
 
 +
<section begin="RitgegevensT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Ritgegevens
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Ambulancevoorziening
 +
|style="background-color: white;"| 25 (RAV identificatie)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Ritnummer
 +
|style="background-color: white;"| 25-2020-13-1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Ambulancenummer
 +
|style="background-color: white;"| 25190
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Telefoon ambulance
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Ambulanceverpleegkundige identificatie
 +
|style="background-color: white;"| 596
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Ambulancechauffeur identificatie
 +
|style="background-color: white;"| 530
 +
|-style="vertical-align:top; background-color: #E3E3E3;;
 +
|colspan="5"|Datum/tijd ritopdracht
 +
|style="background-color: white;"| T1-10 min
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd uitruk/vertrek
 +
|style="background-color: white;"| T1-10 min
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd aankomst patiënt
 +
|style="background-color: white;"| T1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd vertrek patiënt
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Verwachte  aankomsttijd bestemming
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd aankomst bestemming
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Datum/tijd vrijmelding
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Soort vervoer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="RitgegevensT2" />
 +
 
 +
<section begin="HaalgegevensT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Haalgegevens
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Straat
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisletter
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisnummertoevoeging
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Postcode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Locatiebeschrijving
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Woonplaats
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Land
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Patiënt vervoerd?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Reden geen vervoer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Tijdstip overlijden patiënt
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Advies behandeling tijdens vervoer aanwezig?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Niet reanimeren verklaring aanwezig?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Trialgegevens
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Ambulance-urgentie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Gewondennummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Triageklasse
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Hulpverleners ter plaatse
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|rowspan="9"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Hulpverlenersnaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Type hulpverlener
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|E-mailadres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|}
 +
<section end="HaalgegevensT2" />
 +
 
 +
<section begin="BestemmingsgegevensT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Bestemmingsgegevens
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Bestemmingsstatus in bericht op T1
 +
|style="background-color: white;"|Actief
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Bestemmingscode
 +
|style="background-color: white;"|AGB: 06010860
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Locatie of afdeling
 +
|style="background-color: white;"|LSDV-code: 2.16.840.1.113883.2.4.6.1.6010860.000
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Straat
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisletter
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Huisnummertoevoeging
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Postcode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Locatiebeschrijving
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Woonplaats
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Land
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Bijzonderheden algemeen
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Verwacht specialisme
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Feedback
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|rowspan="9"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Feedback gewenst
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Feedback adres
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Feedback methode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|}
 +
<section end="BestemmingsgegevensT2" />
 +
 
 +
<section begin="MechanismeT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Mechanisme
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Mechanisme type
 +
|style="background-color: white;"| 35468003  bekneld geraakt tussen voorwerpen (gebeurtenis)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Vervoermiddel patiënt
 +
|style="background-color: white;"| 71783008 auto (fysiek object)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Patiënt was bestuurder?
 +
|style="background-color: white;"| ja
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Vervoermiddel contra
 +
|style="background-color: white;"| 71783008 auto (fysiek object)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Beschermingsmiddelen patiënt (3x)
 +
|style="background-color: white;"| 285695004 helm (fysiek object) <br/>
 +
60054005 autogordel (fysiek object)<br/>
 +
102384007 airbag van motorvoertuig (fysiek object)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="MechanismeT2" />
 +
 
 +
<section begin="Toestandsbeelden/WerkdiagnoseT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" |Toestandsbeelden/Werkdiagnose
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Toestandsbeeld
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Toestandsbeeld code
 +
|style="background-color: white;"| 125593007 letsel van aangezicht (aandoening)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Toelichting Toestandsbeeld
 +
|style="background-color: white;"| Moeilijk observeren door weersomstandigheden
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|}
 +
<section end="Toestandsbeelden/WerkdiagnoseT2" />
 +
 
 +
<section begin="MeetwaardenT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Meetwaarden
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Bloedsuiker
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Bloedsuiker waarde
 +
|style="background-color: white;"| 6 mmol/L
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|BloedsuikerDatumTijd
 +
|style="background-color: white;"| T1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Hartritme
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Hartritme observatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|HartritmeDatumTijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Toelichting hartritme/ECG
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|O2Saturatie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|SpO2waarde
 +
|style="background-color: white;"|99%
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|O2SaturatieDatumTijd
 +
|style="background-color: white;"|T1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Capnometrie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|CO2Waarde
 +
|style="background-color: white;"|60 mm[Hg] <br/>8,0 kPa
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|CO2CapnometrieDatumTijd
 +
|style="background-color: white;"|T1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Hartfrequentie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|HartfrequentieWaarde
 +
|style="background-color: white;"|120/min
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|HartfrequentieDatumTijd
 +
|style="background-color: white;"|T1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Bloeddruk
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|SystolischeBloeddruk
 +
|style="background-color: white;"|90 mm[Hg]
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|DiastolischeBloeddruk
 +
|style="background-color: white;"|60 mm[Hg]
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|BloeddrukDatumTijd
 +
|style="background-color: white;"|T1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Lichaamstemperatuur
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|TemperatuurWaarde
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|TemperatuurDatumTijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Ademhaling
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Ademfrequentie
 +
|style="background-color: white;"|4/min
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|AdemhalingDatumTijd
 +
|style="background-color: white;"|T1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|GlasgowComaScale
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|GlasgowComaScaleDatumTijd
 +
|style="background-color: white;"|T1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|GCS_Eyes
 +
|style="background-color: white;"|4
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|GCS_Motor
 +
|style="background-color: white;"|6
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|GCS_Verbal
 +
|style="background-color: white;"|5 (uit 2.16.840.1.113883.2.4.3.11.60.40.4.2.3)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|TotaalScore
 +
|style="background-color: white;"|15
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Revised Trauma Score
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|RevisedTraumaScoreWaarde
 +
|style="background-color: white;"|8
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|RevisedTraumaScoreTijd
 +
|style="background-color: white;"|T1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Pediatric Trauma Score
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|PediatricTraumaScoreWaarde
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|PediatricTraumaScoreTijd
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Pijnschaal
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|PijnschaalWaarde
 +
|style="background-color: white;"|3
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|PijnschaalTijd
 +
|style="background-color: white;"|T1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|APGAR-1
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|APGAR-5
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="MeetwaardenT2" />
 +
 
 +
<section begin="BehandelingT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Behandeling
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Ademhaling en beademing (diagnostisch)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Handelingen ademhaling en beademing
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Bewustzijn en neurologische status (diagnostisch) 
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Handelingen bewustzijn en neurologische status
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Overige diagnostische handelingen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Handelingen overige diagnostisch
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Luchtweg management (therapeutisch)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Handelingen luchtweg management
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Moeizame intubatie?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Oxygenatie en ventilatie (therapeutisch)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="7"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Handelingen oxygenatie en ventilatie 
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Beademing machine Fi O2
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Beademing machine AMV
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Beademing machine Freq.
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Beademing machine Peep
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Hoeveelheid zuurstof
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Circulatie (therapeutisch)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="12"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Handelingen circulatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Pacemaker frequentie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Pacemaker stroomsterkte
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Pacemaker modus
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Cardioversies aantal
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Cardioversie maximale energie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Defibrillaties aantal
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Defibrillatie energie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Return Of Spontaneous Circulation (ROSC)
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| AED aangesloten voor aankomst
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| AED-schokken aantal
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Traumatologie (therapeutisch)
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Handelingen traumatologie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Koelen tijdsduur
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Obstetrie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Handelingen obstetrie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Wijze van isolatie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="2"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Handelingen isolatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Medicatie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="7"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Medicatie toegediend?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Medicatienaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Toegediende hoeveelheid medicatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Tijd medicatietoediening
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Medicatie toedieningsvorm
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| IV medicatiesnelheid
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Infuus
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="5"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Infusen aantal
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Infuusvloeistofcode
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Infuusvloeistoftekst
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Infuushoeveelheid
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Extra informatie behandeling
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="BehandelingT2" />
 +
 
 +
<section begin="PatiëntliggingT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Patiëntligging
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Type patiëntligging
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="PatiëntliggingT2" />
 +
 
 +
<section begin="Primary SurveyT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Primary Survey
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Airway
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Airway vrij?
 +
|style="background-color: white;"| Ja
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Stridor
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Breathing
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Breathing sufficient?
 +
|style="background-color: white;"|Ja
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Breathing observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Circulation
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Circulation sufficient?
 +
|style="background-color: white;"| Ja
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Capillaire refill > 2 seconde?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Huid observatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Disability
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="7"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|AVPU
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Duur buiten bewustzijn
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Pupil
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|FAST symptomen aanwezig
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Mogelijk trombolyse/trombectomie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Intoxicatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Toelichting Primary Survey
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="Primary SurveyT2" />
 +
 
 +
<section begin="Secondary SurveyT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Secondary Survey
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Anamnese
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="7"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Ample
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Code
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Titel
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Omschrijving
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Toelichting anamnese
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Infectierisico
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Verdenking infectieziekten?
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Toelichting infectierisico
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Hoofd en gelaat
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Hoofd en gelaat observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Bloedverlies
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Liquorverlies
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Pijnlocatie
 +
|style="background-color: white;"|   
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Nek, hals, CWK
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Nek, hals, CWK observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Thorax
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Thorax observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Pijn bij compressie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Locatie subcutaan emfyseem
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Locatie zwelling / oedeem (2x)
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Rug
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Rug observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Abdomen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Abdomen observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Locatie druk- / loslaatpijn
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Locatie zwelling / oedeem
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Locatie pulserende zwelling
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Bekken
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Bekken observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"| Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Extremiteiten Armen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Extremiteit
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Lateraliteit
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Extremiteiten Armen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Extremiteit
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Lateraliteit
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Extremiteiten Benen
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="6"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Extremiteit
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Lateraliteit
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Observaties (2x)
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="3"|Wond
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Uitscheiding
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Uitscheiding observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Braken
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Incontinent
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="6"|Verloskunde/Gynaecologie
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|rowspan="4"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Verloskunde/Gynaecologie observaties
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Vruchtwaterverlies
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="4"|Weeën
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="Secondary SurveyT2" />
 +
 
 +
<section begin="Consultgever op afstandT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Consultgever op afstand
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Initialen
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Achternaam
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Telefoonnummer
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Identificatie
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Type consultgever
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Toelichting/Afspraken met consultgever
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="Consultgever op afstandT2" />
 +
 
 +
<section begin="Afspraken met patiëntT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Afspraken met patiënt
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Huisarts ingelicht
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Afspraken met patiënt
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="Afspraken met patiëntT2" />
 +
 
 +
<section begin="Bijlagen T2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Bijlagen
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Type Bijlage
 +
|style="background-color: white;"|006 intern rapport/overdracht
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Bijlage id
 +
|style="background-color: white;"| 9068
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Versie
 +
|style="background-color: white;"| 1
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Bijlageset id
 +
|style="background-color: white;"| 12
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="BijlagenT2" />
 +
 
 +
<section begin="ToestemmingsgegevensT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Toestemmingsgegevens
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="6"|Wetenschappelijk onderzoek
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|rowspan="3"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Beschrijving
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="4"|Informed consent
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|colspan="5"|Toestemming informeren verwanten
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|}
 +
<section end="ToestemmingsgegevensT2" />
 +
 
 +
<section begin="ToelichtingsgegevensT2" />
 +
{| class="wikitable" width="85%"
 +
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Toelichtingsgegevens
 +
|-style="background-color: #1F497D;; color: white; text-align:left;"
 +
|colspan="5" width="25%"| Gegevenselement
 +
|| Waarde
 +
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 +
|colspan="5"|Toelichting algemeen
 +
|style="background-color: white;"|
 +
|-style="vertical-align:top; background-color: #E3E3E3;;"
 +
|}
 +
<section end="ToelichtingsgegevensT2" />

Versie van 7 apr 2025 om 11:29

T1: annulering

T1
Patient
Gegevenselement Waarde
Persoonidentificatie 999910553
Naamgegevens
Initialen W.
Achternaam
Soort naam
Voorvoegsels
Achternaam XXX_Witsiers
Geslacht M
Geboortegegevens
Geboortedatum 06-08-1954
Geschatte leeftijd
Adresgegevens
Straat Hertog Aalbrechtweg
Huisnummer 8
Huisnummerletter
Huisnummertoevoeging
Postcode 1823 DB
Woonplaats Alkmaar
Land Nederland
Locatiebeschrijving
Overige Contactgegevens
Telefoonnummers
Telefoonnummer
Soort telefoonnummer
Werktelefoon
werknummer
Soort nummer
EmailAdressen
Emailadres
Soort e-mailadres
Emailadres
Soort e-mailadres
Ziektekostenverzekering?
Verzekeringsgegevens
Verzekeraar
Naam
Identificatienummer
Polis
Polisnummer/Verzekerdenummer
Vaste huisarts
ZorgverlenerIdentificatienummer
Rolcode
Naam
Achternaam
Vaste huisartsenpraktijk
Identificatie
Naam
Adresgegevens
Soort adres
Straatnaam
Huisnummer
Huisnummertoevoeging
Postcode
Gemeente
Woonplaats
Land
Overige contactgegevens
Telefoonnummers
Soort telefoonnummer
Telefoonnummer
Faxnummers
Soort faxnummer
Faxnummer
E-mailadressen
Soort e-mailadres
E-mailadres
Contactpersoon patiënt
Achternaam
Telefoonnummer
Relatie tot patiënt


WID-controle
Gegevenselement Waarde
WID-controle uitgevoerd
WID controle datum
Documentnummer
Document type


Incidentgegevens
Gegevenselement Waarde
Datum/tijd incident


Meldingsgegevens
Gegevenselement Waarde
Datum/tijd melding T1-15min
Geplande brengtijd
Geplande haaltijd
Wzd/Wvggz maatregel
Datum/tijd aanvang TVZ
Medische kladblok meldkamer
Meldkamerurgentie A2


Zorgaanvrager
Gegevenselement Waarde
Initialen
Achternaam
Telefoonnummer
Identificatie
Type zorgaanvrager


Ritgegevens
Gegevenselement Waarde
Ambulancevoorziening 25 (RAV identificatie)
Ritnummer 25-2020-13-1
Ambulancenummer 25190
Telefoon ambulance
Ambulanceverpleegkundige identificatie 596
Ambulancechauffeur identificatie 530
Datum/tijd ritopdracht T1-10 min
Datum/tijd uitruk/vertrek T1-10 min
Datum/tijd aankomst patiënt T1
Datum/tijd vertrek patiënt T1+2 min
Verwachte aankomsttijd bestemming
Datum/tijd aankomst bestemming
Datum/tijd vrijmelding
Soort vervoer


Haalgegevens
Gegevenselement Waarde
Straat
Huisnummer
Huisletter
Huisnummertoevoeging
Postcode
Locatiebeschrijving
Woonplaats
Land
Patiënt vervoerd?
Reden geen vervoer
Tijdstip overlijden patiënt
Advies behandeling tijdens vervoer aanwezig?
Niet reanimeren verklaring aanwezig?
Trialgegevens
Ambulance-urgentie
Gewondennummer
Triageklasse
Hulpverleners ter plaatse
Hulpverlenersnaam
Type hulpverlener
Telefoonnummer
E-mailadres


Bestemmingsgegevens
Gegevenselement Waarde
Bestemmingsstatus in bericht op T3 Overgedragen
Bestemmingscode AGB: 06010860
Locatie of afdeling LSDV-code: 2.16.840.1.113883.2.4.6.1.6010860.000
Straat
Huisnummer
Huisletter
Huisnummertoevoeging
Postcode
Locatiebeschrijving
Woonplaats
Land
Bijzonderheden algemeen
Verwacht specialisme
Feedback
Feedback gewenst
Feedback adres
Feedback methode


Mechanisme
Gegevenselement Waarde
Mechanisme type 35468003 bekneld geraakt tussen voorwerpen (gebeurtenis)
Vervoermiddel patiënt 71783008 auto (fysiek object)
Patiënt was bestuurder? ja
Vervoermiddel contra 71783008 auto (fysiek object)
Beschermingsmiddelen patiënt (3x) 285695004 helm (fysiek object)

60054005 autogordel (fysiek object)
102384007 airbag van motorvoertuig (fysiek object)


Toestandsbeelden/Werkdiagnose
Gegevenselement Waarde
Toestandsbeeld
Toestandsbeeld code 125593007 letsel van aangezicht (aandoening)
Toelichting Toestandsbeeld Moeilijk observeren door weersomstandigheden


Meetwaarden
Gegevenselement Waarde
Bloedsuiker
Bloedsuiker waarde 6 mmol/L
BloedsuikerDatumTijd T3
Hartritme
Hartritme observatie
HartritmeDatumTijd
Toelichting hartritme/ECG
O2Saturatie
SpO2waarde 98%
O2SaturatieDatumTijd T3
Capnometrie
CO2Waarde 35 mm[Hg]
4,7 kPa
CO2CapnometrieDatumTijd T3
Hartfrequentie
HartfrequentieWaarde 90/min
HartfrequentieDatumTijd T3
Bloeddruk
SystolischeBloeddruk 60 mm[Hg]
DiastolischeBloeddruk 50 mm[Hg]
BloeddrukDatumTijd T3
Lichaamstemperatuur
TemperatuurWaarde
TemperatuurDatumTijd
Ademhaling
Ademfrequentie 4/min
AdemhalingDatumTijd T3
GlasgowComaScale
GlasgowComaScaleDatumTijd
GCS_Eyes
GCS_Motor
GCS_Verbal
TotaalScore
Revised Trauma Score
RevisedTraumaScoreWaarde 8
RevisedTraumaScoreTijd T3
Pediatric Trauma Score
PediatricTraumaScoreWaarde
PediatricTraumaScoreTijd
Pijnschaal
PijnschaalWaarde
PijnschaalTijd
APGAR-1
APGAR-5


Behandeling
Gegevenselement Waarde
Ademhaling en beademing (diagnostisch)
Handelingen ademhaling en beademing
Bewustzijn en neurologische status (diagnostisch)
Handelingen bewustzijn en neurologische status
Overige diagnostische handelingen
Handelingen overige diagnostisch
Luchtweg management (therapeutisch)
Handelingen luchtweg management
Moeizame intubatie?
Oxygenatie en ventilatie (therapeutisch)
Handelingen oxygenatie en ventilatie
Beademing machine Fi O2
Beademing machine AMV
Beademing machine Freq.
Beademing machine Peep
Hoeveelheid zuurstof
Circulatie (therapeutisch)
Handelingen circulatie
Pacemaker frequentie
Pacemaker stroomsterkte
Pacemaker modus
Cardioversies aantal
Cardioversie maximale energie
Defibrillaties aantal
Defibrillatie energie
Return Of Spontaneous Circulation (ROSC)
AED aangesloten voor aankomst
AED-schokken aantal
Traumatologie (therapeutisch)
Handelingen traumatologie
Koelen tijdsduur
Obstetrie
Handelingen obstetrie
Wijze van isolatie
Handelingen isolatie
Medicatie
Medicatie toegediend?
Medicatienaam
Toegediende hoeveelheid medicatie
Tijd medicatietoediening
Medicatie toedieningsvorm
IV medicatiesnelheid
Infuus
Infusen aantal
Infuusvloeistofcode
Infuusvloeistoftekst
Infuushoeveelheid
Extra informatie behandeling


Patiëntligging
Gegevenselement Waarde
Type patiëntligging


Primary Survey
Gegevenselement Waarde
Airway
Airway vrij? Ja
Stridor
Breathing
Breathing sufficient? Ja
Breathing observaties
Circulation
Circulation sufficient? Ja
Capillaire refill > 2 seconde?
Huid observatie
Disability
AVPU
Duur buiten bewustzijn
Pupil
FAST symptomen aanwezig
Mogelijk trombolyse/trombectomie
Intoxicatie
Toelichting Primary Survey


Secondary Survey
Gegevenselement Waarde
Anamnese
Ample
Code
Titel
Omschrijving
Toelichting anamnese
Infectierisico
Verdenking infectieziekten?
Toelichting infectierisico
Hoofd en gelaat
Hoofd en gelaat observaties
Bloedverlies
Liquorverlies
Pijnlocatie
Wond
Nek, hals, CWK
Nek, hals, CWK observaties
Wond
Thorax
Thorax observaties
Pijn bij compressie
Locatie subcutaan emfyseem
Locatie zwelling / oedeem (2x)
Wond
Rug
Rug observaties
Wond
Abdomen
Abdomen observaties
Locatie druk- / loslaatpijn
Locatie zwelling / oedeem
Locatie pulserende zwelling
Wond
Bekken
Bekken observaties
Wond
Extremiteiten Armen
Extremiteit
Lateraliteit
Observaties
Wond
Extremiteiten Armen
Extremiteit
Lateraliteit
Observaties
Wond
Extremiteiten Benen
Extremiteit
Lateraliteit
Observaties (2x)
Wond
Uitscheiding
Uitscheiding observaties
Braken
Incontinent
Verloskunde/Gynaecologie
Verloskunde/Gynaecologie observaties
Vruchtwaterverlies
Weeën


Consultgever op afstand
Gegevenselement Waarde
Initialen
Achternaam
Telefoonnummer
Identificatie
Type consultgever
Toelichting/Afspraken met consultgever


Afspraken met patiënt
Gegevenselement Waarde
Huisarts ingelicht
Afspraken met patiënt


Bijlagen T3
Gegevenselement Waarde
Type Bijlage 006 intern rapport/overdracht
Bijlage id 9068
Versie 6
Bijlageset id 12


Toestemmingsgegevens
Gegevenselement Waarde
Wetenschappelijk onderzoek
Beschrijving
Informed consent
Toestemming informeren verwanten


Toelichtingsgegevens
Gegevenselement Waarde
Toelichting algemeen


T2: aankomst bij de patient

T2
Patient
Gegevenselement Waarde
Persoonidentificatie 999910553
Naamgegevens
Initialen W.
Achternaam
Soort naam
Voorvoegsels
Achternaam XXX_Witsiers
Geslacht M
Geboortegegevens
Geboortedatum 06-08-1954
Geschatte leeftijd
Adresgegevens
Straat Hertog Aalbrechtweg
Huisnummer 8
Huisnummerletter
Huisnummertoevoeging
Postcode 1823 DB
Woonplaats Alkmaar
Land Nederland
Locatiebeschrijving
Overige Contactgegevens
Telefoonnummers
Telefoonnummer
Soort telefoonnummer
Werktelefoon
werknummer
Soort nummer
EmailAdressen
Emailadres
Soort e-mailadres
Emailadres
Soort e-mailadres
Ziektekostenverzekering?
Verzekeringsgegevens
Verzekeraar
Naam
Identificatienummer
Polis
Polisnummer/Verzekerdenummer
Vaste huisarts
ZorgverlenerIdentificatienummer
Rolcode
Naam
Achternaam
Vaste huisartsenpraktijk
Identificatie
Naam
Adresgegevens
Soort adres
Straatnaam
Huisnummer
Huisnummertoevoeging
Postcode
Gemeente
Woonplaats
Land
Overige contactgegevens
Telefoonnummers
Soort telefoonnummer
Telefoonnummer
Faxnummers
Soort faxnummer
Faxnummer
E-mailadressen
Soort e-mailadres
E-mailadres
Contactpersoon patiënt
Achternaam
Telefoonnummer
Relatie tot patiënt


WID-controle
Gegevenselement Waarde
WID-controle uitgevoerd
WID controle datum
Documentnummer
Document type


Incidentgegevens
Gegevenselement Waarde
Datum/tijd incident


Meldingsgegevens
Gegevenselement Waarde
Datum/tijd melding T1-15min
Geplande brengtijd
Geplande haaltijd
Wzd/Wvggz maatregel
Datum/tijd aanvang TVZ
Medische kladblok meldkamer
Meldkamerurgentie A2


Zorgaanvrager
Gegevenselement Waarde
Initialen
Achternaam
Telefoonnummer
Identificatie
Type zorgaanvrager


Ritgegevens
Gegevenselement Waarde
Ambulancevoorziening 25 (RAV identificatie)
Ritnummer 25-2020-13-1
Ambulancenummer 25190
Telefoon ambulance
Ambulanceverpleegkundige identificatie 596
Ambulancechauffeur identificatie 530
Datum/tijd ritopdracht T1-10 min
Datum/tijd uitruk/vertrek T1-10 min
Datum/tijd aankomst patiënt T1
Datum/tijd vertrek patiënt
Verwachte aankomsttijd bestemming
Datum/tijd aankomst bestemming
Datum/tijd vrijmelding
Soort vervoer


Haalgegevens
Gegevenselement Waarde
Straat
Huisnummer
Huisletter
Huisnummertoevoeging
Postcode
Locatiebeschrijving
Woonplaats
Land
Patiënt vervoerd?
Reden geen vervoer
Tijdstip overlijden patiënt
Advies behandeling tijdens vervoer aanwezig?
Niet reanimeren verklaring aanwezig?
Trialgegevens
Ambulance-urgentie
Gewondennummer
Triageklasse
Hulpverleners ter plaatse
Hulpverlenersnaam
Type hulpverlener
Telefoonnummer
E-mailadres


Bestemmingsgegevens
Gegevenselement Waarde
Bestemmingsstatus in bericht op T1 Actief
Bestemmingscode AGB: 06010860
Locatie of afdeling LSDV-code: 2.16.840.1.113883.2.4.6.1.6010860.000
Straat
Huisnummer
Huisletter
Huisnummertoevoeging
Postcode
Locatiebeschrijving
Woonplaats
Land
Bijzonderheden algemeen
Verwacht specialisme
Feedback
Feedback gewenst
Feedback adres
Feedback methode


Mechanisme
Gegevenselement Waarde
Mechanisme type 35468003 bekneld geraakt tussen voorwerpen (gebeurtenis)
Vervoermiddel patiënt 71783008 auto (fysiek object)
Patiënt was bestuurder? ja
Vervoermiddel contra 71783008 auto (fysiek object)
Beschermingsmiddelen patiënt (3x) 285695004 helm (fysiek object)

60054005 autogordel (fysiek object)
102384007 airbag van motorvoertuig (fysiek object)


Toestandsbeelden/Werkdiagnose
Gegevenselement Waarde
Toestandsbeeld
Toestandsbeeld code 125593007 letsel van aangezicht (aandoening)
Toelichting Toestandsbeeld Moeilijk observeren door weersomstandigheden


Meetwaarden
Gegevenselement Waarde
Bloedsuiker
Bloedsuiker waarde 6 mmol/L
BloedsuikerDatumTijd T1
Hartritme
Hartritme observatie
HartritmeDatumTijd
Toelichting hartritme/ECG
O2Saturatie
SpO2waarde 99%
O2SaturatieDatumTijd T1
Capnometrie
CO2Waarde 60 mm[Hg]
8,0 kPa
CO2CapnometrieDatumTijd T1
Hartfrequentie
HartfrequentieWaarde 120/min
HartfrequentieDatumTijd T1
Bloeddruk
SystolischeBloeddruk 90 mm[Hg]
DiastolischeBloeddruk 60 mm[Hg]
BloeddrukDatumTijd T1
Lichaamstemperatuur
TemperatuurWaarde
TemperatuurDatumTijd
Ademhaling
Ademfrequentie 4/min
AdemhalingDatumTijd T1
GlasgowComaScale
GlasgowComaScaleDatumTijd T1
GCS_Eyes 4
GCS_Motor 6
GCS_Verbal 5 (uit 2.16.840.1.113883.2.4.3.11.60.40.4.2.3)
TotaalScore 15
Revised Trauma Score
RevisedTraumaScoreWaarde 8
RevisedTraumaScoreTijd T1
Pediatric Trauma Score
PediatricTraumaScoreWaarde
PediatricTraumaScoreTijd
Pijnschaal
PijnschaalWaarde 3
PijnschaalTijd T1
APGAR-1
APGAR-5


Behandeling
Gegevenselement Waarde
Ademhaling en beademing (diagnostisch)
Handelingen ademhaling en beademing
Bewustzijn en neurologische status (diagnostisch)
Handelingen bewustzijn en neurologische status
Overige diagnostische handelingen
Handelingen overige diagnostisch
Luchtweg management (therapeutisch)
Handelingen luchtweg management
Moeizame intubatie?
Oxygenatie en ventilatie (therapeutisch)
Handelingen oxygenatie en ventilatie
Beademing machine Fi O2
Beademing machine AMV
Beademing machine Freq.
Beademing machine Peep
Hoeveelheid zuurstof
Circulatie (therapeutisch)
Handelingen circulatie
Pacemaker frequentie
Pacemaker stroomsterkte
Pacemaker modus
Cardioversies aantal
Cardioversie maximale energie
Defibrillaties aantal
Defibrillatie energie
Return Of Spontaneous Circulation (ROSC)
AED aangesloten voor aankomst
AED-schokken aantal
Traumatologie (therapeutisch)
Handelingen traumatologie
Koelen tijdsduur
Obstetrie
Handelingen obstetrie
Wijze van isolatie
Handelingen isolatie
Medicatie
Medicatie toegediend?
Medicatienaam
Toegediende hoeveelheid medicatie
Tijd medicatietoediening
Medicatie toedieningsvorm
IV medicatiesnelheid
Infuus
Infusen aantal
Infuusvloeistofcode
Infuusvloeistoftekst
Infuushoeveelheid
Extra informatie behandeling


Patiëntligging
Gegevenselement Waarde
Type patiëntligging


Primary Survey
Gegevenselement Waarde
Airway
Airway vrij? Ja
Stridor
Breathing
Breathing sufficient? Ja
Breathing observaties
Circulation
Circulation sufficient? Ja
Capillaire refill > 2 seconde?
Huid observatie
Disability
AVPU
Duur buiten bewustzijn
Pupil
FAST symptomen aanwezig
Mogelijk trombolyse/trombectomie
Intoxicatie
Toelichting Primary Survey


Secondary Survey
Gegevenselement Waarde
Anamnese
Ample
Code
Titel
Omschrijving
Toelichting anamnese
Infectierisico
Verdenking infectieziekten?
Toelichting infectierisico
Hoofd en gelaat
Hoofd en gelaat observaties
Bloedverlies
Liquorverlies
Pijnlocatie
Wond
Nek, hals, CWK
Nek, hals, CWK observaties
Wond
Thorax
Thorax observaties
Pijn bij compressie
Locatie subcutaan emfyseem
Locatie zwelling / oedeem (2x)
Wond
Rug
Rug observaties
Wond
Abdomen
Abdomen observaties
Locatie druk- / loslaatpijn
Locatie zwelling / oedeem
Locatie pulserende zwelling
Wond
Bekken
Bekken observaties
Wond
Extremiteiten Armen
Extremiteit
Lateraliteit
Observaties
Wond
Extremiteiten Armen
Extremiteit
Lateraliteit
Observaties
Wond
Extremiteiten Benen
Extremiteit
Lateraliteit
Observaties (2x)
Wond
Uitscheiding
Uitscheiding observaties
Braken
Incontinent
Verloskunde/Gynaecologie
Verloskunde/Gynaecologie observaties
Vruchtwaterverlies
Weeën


Consultgever op afstand
Gegevenselement Waarde
Initialen
Achternaam
Telefoonnummer
Identificatie
Type consultgever
Toelichting/Afspraken met consultgever


Afspraken met patiënt
Gegevenselement Waarde
Huisarts ingelicht
Afspraken met patiënt


Bijlagen
Gegevenselement Waarde
Type Bijlage 006 intern rapport/overdracht
Bijlage id 9068
Versie 1
Bijlageset id 12


Toestemmingsgegevens
Gegevenselement Waarde
Wetenschappelijk onderzoek
Beschrijving
Informed consent
Toestemming informeren verwanten


Toelichtingsgegevens
Gegevenselement Waarde
Toelichting algemeen
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