Manejo de Trauma Abdominal

<b style="line-height: 150%; text-align: justify;"><span style="font-family: Verdana, sans-serif;">DEFINICIÓN</span></b><br /> <div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 5.0pt;"> <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> <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;">1 </span></b><span style="line-height: 24px;"><b>FISIOPATOLÓGICA</b></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;">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> <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;">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> <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;">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> <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;"><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> <div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; margin-left: 18.0pt; 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;">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> <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;"> <!--[if !supportLists]--><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><!--[endif]--><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: l1 level1 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;"> <!--[if !supportLists]--><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><!--[endif]--><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> <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 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;"> <!--[if !supportLists]--><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><!--[endif]--><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> <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 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;"> <!--[if !supportLists]--><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><!--[endif]--><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> <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 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;"> <!--[if !supportLists]--><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><!--[endif]--><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> <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 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;"> <!--[if !supportLists]--><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><!--[endif]--><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> <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 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;"> <!--[if !supportLists]--><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><!--[endif]--><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> <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 lfo2; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;"> <!--[if !supportLists]--><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><!--[endif]--><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> <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;">3 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: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l2 level1 lfo3; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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> <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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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...

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Manejo del Taponamiento Cardíaco

<br /> <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, s...

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Manejo del Hemotórax Masivo

<br /> <div class="MsoNormal" style="clear: left; float: left; line-height: 150%; margin-bottom: 1em; margin-right: 1em; margin-top: 5pt; text-align: justify;"> <img height="143" src="http://www.scielo.sa.cr/img/fbpe/rcc/v6n3/2753i5.JPG" width="320" /></div> <br /> <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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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: 5.0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 5.0pt; text-align: justify;"> <br /></div>

Manejo del Hemotórax Masivo

MANEJO: ·                 Asegure la escena y confirme que no haya nada que arriesgue su vida ·                 Asegure la Vía Aér...

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Manejo del Neumotórax a tensión

<br /> <div class="MsoNormal" style="clear: left; float: left; line-height: 150%; margin-bottom: 1em; margin-right: 1em; text-align: justify;"> <img height="320" src="http://med.unne.edu.ar/enfermeria/catedras/adulto/clases/001_archivos/slide0019_image043.jpg" width="283" /></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><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> <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;">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: 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;">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> <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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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> <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: l1 level1 lfo1; tab-stops: list 36.0pt; text-align: justify; text-indent: 0cm;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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> <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;">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> <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;">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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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> <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;"> <!--[if !supportLists]--><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><!--[endif]--><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...

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Neumotórax abierto

<span style="font-family: Verdana, sans-serif;"><br /></span> <div class="MsoNormal" style="clear: left; float: left; line-height: 150%; margin-bottom: 1em; margin-right: 1em; margin-top: 5pt; text-align: justify;"> </div> <span style="font-family: Verdana, sans-serif;"><br /></span> <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;"><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> <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;">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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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 en...

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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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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;"> <!--[if !supportLists]--><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><!--[endif]--><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

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