El Blog De La Enfermera

Trauma de Columna Vertebral

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<b><span style="font-family: Verdana, sans-serif;">1 DEFINICIÓN</span></b></div>
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<span style="font-family: Verdana, sans-serif;">El trauma de columna, cuando no es reconocido y apropiadamente manejado en el escenario, puede condicionar daño irreparable y dejar al paciente paralizado de por vida, algunos pacientes sufren de lesiones medular inmediata como consecuencia del accidente. Otros pacientes sufren lesiones de la columna que inicialmente no involucra a la médula. Pero que posteriormente con la movilización de la columna provoca lesión medular.</span></div>
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<span style="font-family: Verdana, sans-serif;">El sistema nervioso central no se regenera: no es posible reparar lesiones, pueden ser devastadoras.</span></div>
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<b><span style="font-family: Verdana, sans-serif;">2 FISIOPATOLOGÍA</span></b></div>
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<span style="font-family: Verdana, sans-serif;">Los tipos de lesiones que pueden ocurrir en la columna son variados. Las más comunes son las fracturas por compresión de la vértebra, la cual frecuentemente adopta una forma parecida a una cuña; las fracturas en gota de lágrima, imagen producida por un pequeño fragmento óseo extremadamente agudo que puede proyectarse hacia el canal cerca de la médula; la subluxación; o el sobre-estiramiento o desgarro de los ligamentos y de los músculos, lo cual frecuentemente condiciona pérdida de la capacidad para mantener las vértebras adecuadamente alineadas si el paciente se mueve. Cualquiera de las anteriores lesiones esqueléticas pueden en el momento del daño provocar inmediatamente corte irreversible, pellizcamiento, elongación o contusión de la médula. En muchos paciente sin embargo, el daño a la columna vertebral en el momento de sufrirse la lesión Se limita a inestabilidad de la misma sin lesión medular.</span></div>
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<b><span style="font-family: Verdana, sans-serif;">3 SIGNOS Y SÍNTOMAS</span></b></div>
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<span style="font-family: Verdana, sans-serif;">· Dolor en el cuello o la espalda.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Dolor a la movilización el cuello o la espalda.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Dolor a la palpación del cuello posterior o de la línea media d la espalda.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Cualquier deformidad de la columna vertebral.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Defensa muscular o ferulación del cuello o espalda Parálisis, paresias, entumecimiento u hormigueo en las piernas o en los brazos en cualquier momento posterior a la lesión.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Signos y síntomas de shock.</span></div>
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<span style="font-family: Verdana, sans-serif;">· En hombres priapismo.</span></div>
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<b><span style="font-family: Verdana, sans-serif;">4 ACTIVIDADES DE ENFERMERÍA</span></b></div>
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<span style="font-family: Verdana, sans-serif;">· Evaluar y asegurar la escena</span></div>
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<span style="font-family: Verdana, sans-serif;">· Elementos de bioseguridad.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Efectuar inmovilización cervical con collar cervical rígido.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Inmovilización del paciente en decúbito supino sobre una tabla rígida en una posición neutral alineada. La cabeza, el cuello el tronco y la pelvis deben ser específicamente inmovilizados en una posición neutral alineada.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Evaluar ABC, la necesidad de RCP inmediata y de valorar la respuesta motora, sensorial y la circulación en las cuatros extremidades<b>.</b></span></div>
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<span style="font-family: Verdana, sans-serif;">· Manejo de la vía aérea</span></div>
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<span style="font-family: Verdana, sans-serif;">· Colocar oxigeno al 100%</span></div>
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<span style="font-family: Verdana, sans-serif;">· Control de signos vitales</span></div>
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<span style="font-family: Verdana, sans-serif;">· Tener acceso venoso en vena de buen calibre.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Registrar, hacer historias clínicas.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Entregar al paciente al centro asistencial. Sobre el evento, tiempo que transcurrió, como ocurrió.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Entregar paciente al médico de la institución o personal encargado.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Acomodar el paciente</span></div>
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<span style="font-family: Verdana, sans-serif;">· Hacer firmar registros de historia clínica.</span></div>
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<span style="font-family: Verdana, sans-serif;">· Arreglar y equipar nuevamente con elementos.</span></div>

Trauma de Columna Vertebral

1 DEFINICIÓN El trauma de columna, cuando no es reconocido y apropiadamente manejado en el escenario, puede condicionar daño irreparable y dejar al paciente paralizado de por vida, algunos pacientes sufren de lesiones medular inmediata como consecuencia del accidente. Otros pacientes sufren lesione…

13Mar2014

Manejo de Trauma Abdominal

<b style="line-height: 150%; text-align: justify;"><span style="font-family: Verdana, sans-serif;">DEFINICIÓN</span></b><br />
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<span style="font-family: Verdana, sans-serif;"><span style="line-height: 150%; text-align: justify;">El trauma abdominal es una de las lesiones que
frecuentemente pasan desapercibidas, y cuando esto sucede representan una de
las principales causas de muerte en el paciente traumatizado. Entre las causas
de muerte por trauma es el trauma abdominal una de la segundo más frecuente</span><b style="line-height: 150%; text-align: justify;">.</b></span></div>
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<span style="font-family: Verdana, sans-serif;"><b style="line-height: 150%;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">1 </span></b><span style="line-height: 24px;"><b>FISIOPATOLÓGICA</b></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Las lesiones del abdomen pueden ser causados por
trauma penetrante o por trauma cerrado, el trauma penetrante, tal como heridas
por arma de fuego o arma cortopunzante, es fácilmente visible. Pueden ocurrir
lesiones orgánicas múltiples, pero estas son menos frecuentes en lesiones por
arma blanca que las lesiones por proyectil de arma de fuego, durante la
expiración el diafragma sube hasta el cuarto espacio intercostal en el aspecto
anterior del tórax, de tal manera que el paciente con lesiones penetrantes
torácicas se deben sospechar la posibilidad de una lesión abdominal
concomitante, las heridas penetrantes en los flancos y glúteos pueden también
involucrar órganos de la cavidad abdominal. Las lesiones pueden producir sangrado
como consecuencia de la perforación de grandes vasos o de órganos sólidos, así
como la perforación de un segmento de intestino el cual es el órgano más
frecuentemente lesionado en trauma penetrante.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">El trauma cerrado de los órganos intra-abdominal es
generalmente producido por compresión o cizallamiento o desgarro, provocan
ruptura de los órganos sólidos o ruptura de los vasos sanguíneos en la cavidad,
ello debido a las fuerzas de tracción ejercidas sobre los ligamentos de
fijación y sus vasos.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">La pérdida de sangre dentro de la cavidad
abdominal, independientemente del sitio de sangrado, contribuirá o será
responsable principal del desarrollo del estado de shock, el desgarramiento a
la cavidad peritoneal de ácidos, enzima o contenido bacteriano del tracto
gastrointestinal, producirá peritoneal y lesión orgánica adicional.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><b><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">2 EVALUACIÓN PRIMARIA</span></b><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Evaluación inicial:</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Asegure
la escena y confirme que no haya nada que arriesgue su vida</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Evaluación
rápida del paciente en el escenario Le dará pistas acerca de Tipo de lesión. El
trayecto posible del objeto. Energía aplicada.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Factores
importantes: Arma u objeto involucrado, Distancia, Fuerza aplicada</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">ABC</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Evaluación
Rápida de Trauma: Cabeza, Cuello, Tórax, Abdomen (Inspección visual y
palpación)</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Busque
heridas, evisceración y distensión.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Palpación
</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Sensibilidad
al tacto (Dolor) o rigidez (Abdomen en tabla).</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><b style="line-height: 150%;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">3 ACTIVIDADES DE </span></b><span style="line-height: 24px;"><b>ENFERMERÍA</b></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Asegure
la escena y confirme que no haya nada que arriesgue su vida</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Maneje
problemas encontrados en la evaluación Primaria DEL SOPORTE VITAL BASICO EN
TRAUMA.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">100%
oxígeno.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Sensibilidad
al tacto “REANIMAR Y TRASLADAR”</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Cubra
heridas.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Dos
accesos venosos adecuados. </span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Solución
Salina normal o Ringer lactado para mantener TA (sistolica 90-100 ).</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Registrar,
hacer historias clínicas.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Entregar
al paciente al centro asistencial. Sobre el evento, tiempo que transcurrió,
como ocurrió.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Entregar
paciente al médico de la institución o personal encargado.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<span style="font-family: Verdana, sans-serif;"><br /></span>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Acomodar
el paciente.</span></span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>

Manejo de Trauma Abdominal

DEFINICIÓN El trauma abdominal es una de las lesiones que frecuentemente pasan desapercibidas, y cuando esto sucede representan una de las principales causas de muerte en el paciente traumatizado. Entre las causas de muerte por trauma es el trauma abdominal una de la segundo más frecuente. 1 FISIOPA…

12Mar2014

Manejo del Taponamiento Cardíaco

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<div class="MsoNormal" style="clear: left; float: left; line-height: 24px; margin-bottom: 1em; margin-right: 1em; margin-top: 5pt; text-align: justify;">
</div>
<br />
<div class="MsoNormal" style="line-height: 24px; margin: 5pt 0cm; text-align: justify;">
<span style="font-family: Tahoma, sans-serif;"><b>DEFINICIÓN</b></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 5pt 0cm; text-align: justify;">
<span lang="ES-MX" style="font-family: Tahoma, sans-serif;">Cuando en los traumas penetrantes o cerrados existe desgarro de los vasos miocárdicos sufre una ruptura o es penetrante, se presenta sangrado hacia este espacio. Debido a la falta de elasticidad del pericardio, periférico al corazón, el corazón no puede expanderse para volverse a llenar de sangre y por lo tanto la cantidad de sangre disponible para ser bombeada fuera del corazón será progresivamente menor con cada contracción.</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif; font-size: 12pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 5pt 0cm; text-align: justify;">
<b><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">1 SIGNOS Y SÍNTOMAS</span></b><span lang="ES-MX" style="font-family: Tahoma, sans-serif;"></span><span lang="ES-MX" style="font-family: 'Times New Roman', serif; font-size: 12pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 5pt 0cm; text-align: justify;">
<span lang="ES-MX" style="font-family: Tahoma, sans-serif;">La víctima de trauma con taponamiento cardiaco puede no tener otros signos fuera de los relacionados con la lesión torácica y los asociados con el estado de shock, hay disminución de pulso, la presión del pulso se estrecha y puede hacerse aparente el pulso paradójico.</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif; font-size: 12pt;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 5pt 0cm; text-align: justify;">
<b style="line-height: 24px;"><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">2 ACTIVIDADES DE </span></b><span style="font-family: Tahoma, sans-serif;"><span style="line-height: 24px;"><b>ENFERMERÍA</b></span></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 0cm 0cm 0.0001pt 7.9pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10pt; line-height: 20px;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">                </span></span><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">Asegure la vía aérea.</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 0cm 0cm 0.0001pt 7.9pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10pt; line-height: 20px;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">                </span></span><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">Asegure la escena y confirme que no haya nada que arriesgue su vida</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 0cm 0cm 0.0001pt 7.9pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10pt; line-height: 20px;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">                </span></span><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">Oxígeno 100%.</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 0cm 0cm 0.0001pt 7.9pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10pt; line-height: 20px;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">                </span></span><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">PIDA APOYO MEDICALIZADO Ó Traslade rápidamente.</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 0cm 0cm 0.0001pt 7.9pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10pt; line-height: 20px;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">                </span></span><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">Establezca un acceso IV.</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 0cm 0cm 0.0001pt 7.9pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10pt; line-height: 20px;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">                </span></span><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">Monitorice al paciente.</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 0cm 0cm 0.0001pt 7.9pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10pt; line-height: 20px;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">                </span></span><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">Observe de cerca el posible desarrollo de un hemo-neumotórax a tensión</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 0cm 0cm 0.0001pt 7.9pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10pt; line-height: 20px;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">                </span></span><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">Registrar, hacer historias clínicas.</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 0cm 0cm 0.0001pt 7.9pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10pt; line-height: 20px;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">                </span></span><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">Entregar al paciente al centro asistencial. Sobre el evento, tiempo que transcurrió, como ocurrió.</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 24px; margin: 0cm 0cm 0.0001pt 7.9pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10pt; line-height: 20px;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">                </span></span><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">Entregar paciente al médico de la institución o personal encargado.</span><span lang="ES-MX" style="font-family: 'Times New Roman', serif;"><o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 24px; margin: 0cm 0cm 0.0001pt 7.9pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10pt; line-height: 20px;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">                </span></span><span lang="ES-MX" style="font-family: Tahoma, sans-serif;">Acomodar el paciente.</span></div>

Manejo del Taponamiento Cardíaco

DEFINICIÓN Cuando en los traumas penetrantes o cerrados existe desgarro de los vasos miocárdicos sufre una ruptura o es penetrante, se presenta sangrado hacia este espacio. Debido a la falta de elasticidad del pericardio, periférico al corazón, el corazón no puede expanderse para volverse a llenar …

11Mar2014

Manejo del Hemotórax Masivo

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<img height="143" src="http://www.scielo.sa.cr/img/fbpe/rcc/v6n3/2753i5.JPG" width="320" /></div>
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<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 5.0pt; text-align: justify;">
<b><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">MANEJO:</span></b><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Asegure
la escena y confirme que no haya nada que arriesgue su vida</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Asegure
la Vía Aérea.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Oxígeno
100%.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Transporte
inmediatamente.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">LEV con
cuidado—pulso periférico 90-100mmHg</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; text-align: justify;">
<br /></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Observe
de cerca el posible desarrollo de un hemo-neumotórax a tensión.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Registrar,
hacer historias clínicas.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Entregar
al paciente al centro asistencial. Sobre el evento, tiempo que transcurrió,
como ocurrió.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Entregar
paciente al médico de la institución o personal encargado.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Acomodar
el paciente.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Hacer
firmar registros de historia clínica.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Arreglar
y equipar nuevamente con elementos.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
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<br /></div>

Manejo del Hemotórax Masivo

MANEJO: · Asegure la escena y confirme que no haya nada que arriesgue su vida · Asegure la Vía Aérea. · Oxígeno 100%. · Transporte inmediatamente. · LEV con cuidado—pulso periférico 90-100mmHg · Observe d…

11Mar2014

Manejo del Neumotórax a tensión

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<img height="320" src="http://med.unne.edu.ar/enfermeria/catedras/adulto/clases/001_archivos/slide0019_image043.jpg" width="283" /></div>
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<b><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">DEFINICIÓN</span></b><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 5.0pt; text-align: justify;">
<span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Cuando se crea un mecanismo de válvula
unidireccional que permite la entrada de aire al espacio pleural, pero no la
salida se estable una condición critica que en peligro la vida.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
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<b><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">1 SIGNOS Y SÍNTOMAS</span></b><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
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<span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Los pacientes con neumotórax a tensión presenta
grados variables de presión intratorácica; los signos y síntomas son extrema
ansiedad, cianosis, taquipnea, ruidos respiratorios disminución o ausentes en
lado lesionado, abultamiento de los músculos intercostales, distensión de la
venas yugulares, taquicardia, presión estrecha del pulso, hipotensión, enfisema
subcutáneo y desviación traqueal.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin: 5pt 0cm 5pt 36pt; text-align: justify; text-indent: -36pt;">
<b style="line-height: 150%;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">2</span></b><span lang="ES-MX" style="font-family: 'Times New Roman', serif; font-size: 7pt; line-height: 150%;"> </span><b style="line-height: 150%;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">ACTIVIDADES DE </span></b><span style="font-family: Tahoma, sans-serif;"><span style="line-height: 24px;"><b>ENFERMERÍA</b></span></span></div>
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<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Asegure
la escena y confirme que no haya nada que arriesgue su vida</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Establezca
una vía aérea abierta.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Oxígeno
100%.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Trasladar
tan rápido como es posible.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
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<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">pida
apoyo medicalizado</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">inicie
líquidos endovenosas calibre.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
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<b><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">3 INDICACIONES PARA REALIZAR UNA DECOMPRENSIÓN</span></b><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
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<span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">La presencia de un neumotórax a tensión y
cualquiera de los siguientes:</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Cianosis
y/o Compromiso Respiratorio.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Pérdida
de pulso radial (hipotensión—shock tardío).</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
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<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Pérdida
del conocimiento.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>

Manejo del Neumotórax a tensión

DEFINICIÓN Cuando se crea un mecanismo de válvula unidireccional que permite la entrada de aire al espacio pleural, pero no la salida se estable una condición critica que en peligro la vida. 1 SIGNOS Y SÍNTOMAS Los pacientes con neumotórax a tensión presenta grados variables de presión intratorácic…

10Mar2014

Neumotórax abierto

<span style="font-family: Verdana, sans-serif;"><br /></span>
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</div>
<span style="font-family: Verdana, sans-serif;"><br /></span>
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<span style="font-family: Verdana, sans-serif;"><b><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">DEFINICIÓN</span></b><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
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<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Las heridas penetrantes en el tórax pueden producir
lesiones abiertas de la pared torácica, cuando la pared torácica se encuentra
abierta se abre una vía preferencial de aire desplazándose del medio ambiente
externo hacia adentro del tórax. El oxigeno en el aire que entra al tórax de
esta manera no llega al pulmón, no se puede por ello ser expuesto a los
capilares alveolares, por lo tanto no es difundido al torrente sanguíneo para
proporcionar oxigenación a la células corporales.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; margin-left: 36.0pt; margin-right: 0cm; margin-top: 5.0pt; text-align: justify; text-indent: -36.0pt;">
<span style="font-family: Verdana, sans-serif;"><b><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">1</span></b><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 7.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> </span><b><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">SIGNOS Y SÍNTOMAS</span></b><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 5.0pt; text-align: justify;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Los síntomas provocados por la condición son dolor
en el sitio de lesión y falta de respiración. Los signos pueden incluir un
sonido burbujéate o de aspirado húmedo provocado por el aire que se desplaza
hacia adentro y fuera del espacio pleural, a través del defecto en la pared
torácica.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin: 5pt 0cm; text-align: justify;">
<span style="font-family: Verdana, sans-serif;"><b style="line-height: 150%;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">2</span></b><span lang="ES-MX" style="font-size: 7pt; line-height: 150%;"> </span><b style="line-height: 150%;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">ACTIVIDADES DE </span></b><span style="line-height: 24px;"><b>ENFERMERÍA</b></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Asegure
la escena y confirme que no haya nada que arriesgue su vida</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Vía aérea
permeable.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Control
de signos vitales.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">monitorizar</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Oxigeno
por mascara</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Inicie
líquidos endovenosos de grueso calibre durante la estabilización.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Registrar,
hacer historias clínicas.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Entregar
al paciente al centro asistencial. Sobre el evento, tiempo que transcurrió,
como ocurrió.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Entregar
paciente al médico de la institución o personal encargado.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></span></div>
<span style="font-family: Verdana, sans-serif;"><br /></span>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span style="font-family: Verdana, sans-serif;"><span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Acomodar
el paciente.</span></span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>

Neumotórax abierto

DEFINICIÓN Las heridas penetrantes en el tórax pueden producir lesiones abiertas de la pared torácica, cuando la pared torácica se encuentra abierta se abre una vía preferencial de aire desplazándose del medio ambiente externo hacia adentro del tórax. El oxigeno en el aire que entra al tórax de est…

09Mar2014

Neumotorax en politraumatizados

<br />
<div class="MsoNormal" style="clear: left; float: left; line-height: 150%; margin-bottom: 1em; margin-right: 1em; text-align: justify;">
<img height="294" src="http://zl.elsevier.es/imatges/63/63v38n06/grande/63v38n06-13020961fig03.jpg" width="320" /></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">DEFINICIÓN</span></b></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">El
neumotórax simple es causado por la presencia del aire en el espacio pleural.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;">
<b><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">1 SIGNOS
Y SÍNTOMAS</span></b><span lang="ES-MX" style="font-family: "Times New Roman","serif"; font-size: 12.0pt; line-height: 150%; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Los
signos y síntomas de un neumotórax puede incluir dolor torácico pleurítico y
respiración rápida y difícil. El signo clásico lo constituye los ruidos
respiratorios decremento o ausentes, presencia de timpanismo a la perfusión.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt; text-align: justify;">
<b style="line-height: 150%;"><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">2
ACTIVIDADES DE </span></b><span style="font-family: Tahoma, sans-serif;"><span style="line-height: 24px;"><b>ENFERMERÍA</b></span></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Asegure
la escena y confirme que no haya nada que arriesgue su vida.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Coloca el
paciente en una posición confortable (semisentado).</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Asegure
la vía aérea. </span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Tomar
signos vitales.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Oxígeno
100%.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Monitorizar.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">La
administración de líquidos endovenosos.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Transporte
de inmediata.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Informe
al CRU ó su central. </span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Si el
paciente se complica pida apoyo medicalizada.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Registrar,
hacer historias clínicas.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Hacer
firmar registros de historia clínica.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Arreglar
y equipar nuevamente con elementos</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Entregar
al paciente al centro asistencial. Sobre el evento, tiempo que transcurrió,
como ocurrió.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Entregar
paciente al médico de la institución o personal encargado.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"> <o:p></o:p></span></div>
<br />
<div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.05pt; margin-right: 0cm; margin-top: 0cm; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;">
<span lang="ES-MX" style="font-family: Symbol; font-size: 10.0pt; line-height: 150%; mso-bidi-font-family: Symbol; mso-bidi-font-size: 11.0pt; mso-fareast-font-family: Symbol; mso-fareast-language: ES-MX;">·<span style="font-family: 'Times New Roman'; font-size: 7pt; line-height: normal;">               
</span></span><span lang="ES-MX" style="font-family: "Tahoma","sans-serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;">Acomodar
el paciente.</span><span lang="ES-MX" style="font-family: "Times New Roman","serif"; mso-fareast-font-family: "Times New Roman"; mso-fareast-language: ES-MX;"><o:p></o:p></span></div>

Neumotorax en politraumatizados

DEFINICIÓN El neumotórax simple es causado por la presencia del aire en el espacio pleural. 1 SIGNOS Y SÍNTOMAS · Los signos y síntomas de un neumotórax puede incluir dolor torácico pleurítico y respiración rápida y difícil. El signo clásico lo constituye los ruidos respiratorios dec…

08Mar2014