Aanbevelingen voor de behandeling van urgente aandoeningen in de eerste lijn: acuut cardiogeen longoedeem, acuut coronair syndroom en hypoglykemie met verminderd bewustzijn

Abstract

Recommendations for the treatment of emergencies in primary care: acute cardiogenic pulmonary oedema, acute coronary syndrome and acute hypoglycaemia with reduced consciousness General practitioners are frequently confronted with urgent medical situations both during and outside office hours, requiring a quick and accurate response. This article presents a summary of the recommendations for the treatment of emergencies (part 2), specifically addressing the management of acute cardiogenic pulmonary oedema, acute coronary syndrome (ACS) and acute hypoglycaemia with reduced consciousness. These recommendations are an update of the 2008 guidelines of Domus Medica and were developed by the national Working Group for the Development of Guidelines in Primary Care (WOREL) according to internationally recognized methods for guideline development. The focus of the recommendations is the pharmacological management by the general practitioner. If necessary, diagnostics are briefly discussed. The aim is to inform general practitioners about the recommended content of the emergency kit, as well as the recommended dosages and administration routes for the most common indications. For the 3 topics discussed, an emergency intervention is generally indicated. In the meantime, the general practitioner can already administer medication. For acute cardiogenic pulmonary oedema, the use of intravenous diuretics and oxygen is necessary. Opiates are not routinely administered. Nitrates can be considered when blood pressure is elevated. For the treatment of ACS, acetylsalicylic acid should be administered. Oxygen is recommended only if there are signs of respiratory distress or hypoxemia. Morphine is indicated if analgesia is required. In cases of acute hypoglycaemia with decreased consciousness, intravenous glucose is the first choice. Referral is not always necessary when the patient recovers consciousness after adequate management. This decision should be based on clinical judgment. Via https://www.ebp-guidelines.be/home the English guideline is available.