Traumatismo de Extremidades

<br /> <div style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"> <span style="font-family: Verdana, sans-serif;"><img alt="Resultado de imagen para Traumatismo de Extremidades blogspot" src="https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcS3mU_mmpIaNwbu6MbOz6IC6oXYA4z2whJrdVyPDFhJlrdSZ7Y" /></span></div> <br /> <div class="MsoNormal" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em; margin-top: 5pt; text-align: justify;"> </div> <b style="text-align: justify;"><span lang="ES-MX" style="font-family: Verdana, sans-serif;"><span style="line-height: 150%;">1 </span><span style="line-height: 24px;">DEFINICIÓN</span><span style="line-height: 150%;"> </span></span></b><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;"> <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 de extremidades puede representar una amenaza para la vida cuando produce pérdida sanguínea severa, tanto externamente como internamente dentro de una extremidad.</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 FISIOPATOLOGÍA </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;">El técnico debe ser capaz de identificar fácilmente una hemorragia externa en los primeros segundos de la evaluación primaria, ya sea condicionada por una fractura expuesta o por una lesión de tejidos blandos. Deben tenerse cuidado de no dejar pasar en Las fracturas cerradas pueden producir un efecto de tercer espacio formación de un espacio patológico, la cual puede contener cantidad considerable de sangre. El técnico de urgencias médicas debe rápidamente evaluar la potencial perdida de sanguínea que tales lesiones puede condicionar.</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;">Las hemorragias externas que ocurren pueden habitualmente estimarse a la inspección del área. Cuando la pérdida sanguínea es enmascarada por ropa oscura o impermeable, absorbida por la superficie sobre la que se encuentra el paciente, lavada por lluvia o por agua. Los hallazgos durante la evaluación primaria deben alertar al técnico a sospechar la presencia de shock y ser los indicadores de que le paciente se encuentra críticamente lesionado y requiere de una intervención sistémica inmediata, así como la rápida detección de la fuente de sangrado:</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;">LESIONES ESPECÍFICAS</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;"> <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 potenciales a músculos, tejidos conectivos y hueso incluyendo en las 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></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-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;">fracturas.</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 lfo1; tab-stops: list 36.0pt; 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;">Luxaciones,</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 lfo1; tab-stops: list 36.0pt; 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;">Fracturas-luxaciones.</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: l0 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;">Torceduras.</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: l0 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;">Desgarros.</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: l0 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;">Aplastamientos.</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: l0 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;">lesiones de tejidos blandos.</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: l0 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;">Amputaciones.</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: 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;">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></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 signos y síntomas primarios de una extremidad traumatizada son: </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: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l3 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;">deformidad, dolor, sangrado y actitud de defensa.</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: l3 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;">dolor a la 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: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l3 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;">edema.</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: l3 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;">Presencia de crepitación.</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: l3 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;">Disminución de la capacidad motora o a la movilidad articular.</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: l3 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;">Incremento en el rango de movilidad de una articulación.</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: l3 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;">Disminución o ausencia de la percepción sensorial dístales a la lesión.</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: l3 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;">Circulación disminuida o ausente distal a la lesión, evidencia por alteración en el color y temperatura de la piel, de los pulso dístales y del llenado capilar.</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: 5.0pt; margin-left: 0cm; margin-right: 0cm; margin-top: 5.0pt; text-align: justify;"> <span style="font-family: Verdana, sans-serif;"><br /></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 ACTIVIDADES DE ENFERMERÍA</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: .0001pt; margin-bottom: 0cm; margin-left: 7.9pt; margin-right: 0cm; margin-top: 0cm; mso-list: l1 level1 lfo4; 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;">Elementos de bioseguridad</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: l1 level1 lfo4; 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;">Evaluar y asegurar la escena</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: l1 level1 lfo4; 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;">Deben considerarse las siguientes condiciones:</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: l1 level1 lfo4; 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;">Primera tratar las condiciones que ponen en peligro la 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: l1 level1 lfo4; 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;">Segunda tratar las condiciones que ponen en peligro la extremidad.</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 lfo4; 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;">Tratar todas las otras condiciones.</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 lfo4; 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;">Las extremidades lesionadas deben ser inmovilizadas tan pronto como sea posible. Sin embargo si una extremidad está bajo tensión debido a la posición del paciente o a una angulación patológica entonces la extremidad debe ser colocada en posición neutral.</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 lfo4; 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;">Detener el sangrado y tratar el shock.</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 lfo4; 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;">Asegurar de que área lesionada no esté bajo 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></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 lfo4; 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;">Proporcionar soporte al área lesionada.</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: l1 level1 lfo4; 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;">Inmovilizar la extremidad lesionada.</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: l1 level1 lfo4; 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;">Reevaluar la extremidad lesionada después de la inmovilización. Para asegurarse de cualquier cambio de la función neurovascular distal.</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: l1 level1 lfo4; 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;">tener acceso venoso.</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: l1 level1 lfo4; 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;">Aplicar analgesia por orden del CRUE.</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: l1 level1 lfo4; 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;">Realizar traslado según indicaciones del CRUE</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: l1 level1 lfo4; 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: l1 level1 lfo4; 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: l1 level1 lfo4; 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> <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: l1 level1 lfo4; 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;">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></span></div> <span style="font-family: Verdana, sans-serif;"><br /></span> <div class="MsoNormal" style="line-height: 150%; margin-bottom: 5.0pt; margin-left: 7.9pt; margin-right: 0cm; margin-top: 5.0pt; mso-list: l1 level1 lfo4; 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;">·<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;">Arreglar la ambulancia para el siguiente traslado</span></span><span lang="ES-MX"><o:p></o:p></span></div>

Traumatismo de Extremidades

1  DEFINICIÓN   El trauma de extremidades puede representar una amenaza para la vida cuando produce pérdida sanguínea severa, tanto ...

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Trauma Craneoencefálico

<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;"> <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 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;">La lesión de cuero cabelludo, cara, cráneo, duramadre o cerebro causado por un cambio brusco de energía cinética. Su importancia radica en que se convierten en la primera causa de muerte tramautica en menores de 15 años y causa orden de retraso mental, epilepsia e incapacidad física.</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 craneoencefálico es la causa principal de muerte en pacientes traumatizados. La víctima de trauma craneoencefálico habitualmente corresponde a un adulto joven involucrado en un accidente vehicular motorizado, frecuentemente con historia de intoxicación por alcohol o drogas. La mayor parte de las víctimas de accidentes de vehículos motorizados presentan algún grado de lesión craneoencefálico. Entre las otras causas de lesiones craneoencefálicas se encuentran las caídas, heridas por arma de fuego, asaltos y lesiones en actividades deportivas.</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><span lang="ES-MX"><span style="line-height: 150%;">2 </span><span style="line-height: 24px;">FISIOPATOLOGÍA </span><span style="line-height: 150%;"> </span></span></b><span lang="ES-MX" style="font-size: 12pt; line-height: 150%;"><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 súbita del estado de conciencia es provocada por lesión encefálica en cualquier de las dos siguientes estructuras anatómicas: corteza cerebral y sistema reticular activador. Por otra parte, la disminución progresiva del estado de conciencia puede ser provocada por incremento en la PIC y por la disminución en el flujo sanguíneo cerebral, independientemente de la causa de ello.</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 incremento en la presión intracaneana produce complicaciones debido a que el encéfalo se encuentra alojado en una cavidad cerrada y rígida.</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 0.0001pt 36pt; text-align: justify; text-indent: -36pt;"> <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</span></b><span lang="ES-MX" style="font-size: 7pt; line-height: 150%;"> </span><b><span lang="ES-MX"><span style="line-height: 150%;">ACTIVIDADES DE </span><span style="line-height: 24px;">ENFERMERÍA</span><span style="line-height: 150%;"> </span></span></b><span lang="ES-MX" style="font-size: 12pt; line-height: 150%;"><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: l3 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;">Atienda el llamado del CRUE</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: l3 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;">Elementos de Bioseguridad</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: l3 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;">Evaluar y asegurar la escena</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 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;">Efectuar inmovilización cervical con collar cervical rígido.</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: l0 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;">Inmovilización del paciente en decúbito supino sobre una tabla rígida en una posición neutral alineada. La cabeza, el cuello el tronco y la pelvis deben ser específicamente inmovilizados en una posición neutral alineada.</span><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: l5 level1 lfo4; 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;">Evaluar ABC, la necesidad de RCP inmediata y de valorar escala de Glasgow</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: l5 level1 lfo4; 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;">Manejo de la vía aérea. Los pacientes con traumatismo cráneo- encefálico tiene predisposición a presentar emesis. Debe protegerlo contra riesgo de broncoaspiración. Tener disponible equipo de succión y cánula o catéter grueso de aspiración</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: l4 level1 lfo5; 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;">Colocar oxigeno al 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: l4 level1 lfo5; tab-stops: list 36.0pt; 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;">Escala de Glasgow</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 lfo6; 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;">Tomar signos vitales e informar.</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 lfo6; 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;">Tener una vía de acceso endovenoso de buen 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></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 lfo6; 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;">Trasladar según indicaciones CRUE</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 lfo6; 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: l1 level1 lfo6; 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: l1 level1 lfo6; 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> <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 lfo6; 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;">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></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 lfo6; 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;">Arreglar la ambulancia para el siguiente traslado </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: l1 level1 lfo6; 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;">Reportar la disponibilidad al CRUE</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>

Trauma Craneoencefálico

1 DEFINICIÓN La lesión de cuero cabelludo, cara, cráneo, duramadre o cerebro causado por un cambio brusco de energía cinética. Su import...

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Shock Neurogénico

<br /> <div style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em; text-align: justify;"> <span style="font-family: Verdana, sans-serif;"><img height="136" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEipaHj99jBjHhEsf7THrgiRGioO3z6vleoKeWxwuPBwhnM3KN9Y88VwkKhDPe12U2NixByaOr4urBV0BLlm3sgvPjMFW0LnMOHG4vktlySzob9G6pAzQrI9SQpV559IlDeOkOyZXxSxTqq6/s200/shock+3.jpg" width="200" /></span></div> <br /> <div class="MsoNormal" style="clear: left; float: left; line-height: 150%; margin-bottom: 1em; margin-right: 1em; margin-top: 5pt;"> </div> <span style="font-family: Verdana, sans-serif;"><b style="line-height: 150%; 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;">1 </span></b><span style="text-align: justify;"><span style="line-height: 24px;"><b>DEFINICIÓN</b></span></span></span><br /> <div class="MsoNormal" style="line-height: 150%; margin-bottom: .0001pt; margin-bottom: 0cm; text-align: justify;"> <div style="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 shock neurogénico se presenta por disfunción o daño del sistema nervioso simpático, bien sea por lesión física o por bloqueo fármaco-lógico a nivel de T6 ó más alto. El cuadro se caracteriza por piel seca, rosada y caliente, pérdida de la regulación de la temperatura que se equilibra a la del ambiente y cambios mentales. La bradicardia e hipotensión por vasodilatación periférica, secundarias a pérdida del efecto simpático en el corazón y en las arteriolas, respectivamente. Cuando la hipotensión se presenta en lesión cerebral o trauma craneano es premonitorio de muerte inminente o extensión al tallo cerebral (en el último caso se acompañará de apnea). No está por demás hacer énfasis en lo importante de la estabilización de las lesiones de la espina cervical y la administración de atropina como parte del manejo de estos pacientes.</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> <div class="MsoNormal" style="margin: 0cm 0cm 0.0001pt 36pt; text-align: justify; text-indent: -36pt;"> <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;"> <div style="text-align: justify;"> <!--[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;">Atienda el llamado del CRUE.</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> <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;"> <div style="text-align: justify;"> <!--[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;">Elementos de Bioseguridad</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> <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;"> <div style="text-align: justify;"> <!--[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;">Evaluar y asegurar la escena.</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> <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;"> <div style="text-align: justify;"> <!--[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;">Efectuar inmovilización cervical con collar cervical rígido.</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> <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;"> <div style="text-align: justify;"> <!--[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;">Inmovilización del paciente en decúbito supino sobre una tabla rígida en una posición neutral alineada. La cabeza, el cuello el tronco y la pelvis deben ser específicamente inmovilizados en una posición neutral alineada.</span><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> <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;"> <div style="text-align: justify;"> <!--[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;">Evaluar ABC, la necesidad de RCP inmediata y de valorar la respuesta motora, sensorial y la circulación en las cuatros extremidades.</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> <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;"> <div style="text-align: justify;"> <!--[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;">Manejo de 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></span></div> </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;"> <div style="text-align: justify;"> <!--[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;">Colocar oxigeno al 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> <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;"> <div style="text-align: justify;"> <!--[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;">Tomar signos vitales e informar.</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> <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;"> <div style="text-align: justify;"> <!--[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;">Tener una vía de acceso endovenoso de buen 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></span></div> </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;"> <div style="text-align: justify;"> <!--[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;">Trasladar inmediato según indicaciones del CRUE.</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> <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;"> <div style="text-align: justify;"> <!--[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> <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;"> <div style="text-align: justify;"> <!--[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> <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;"> <div style="text-align: justify;"> <!--[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> </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;"> <div style="text-align: justify;"> <!--[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;">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></span></div> </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;"> <div style="text-align: justify;"> <!--[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;">Arreglar ambulancia para el siguiente traslado.</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> <div style="text-align: justify;"> <span style="font-family: Verdana, sans-serif;"><br /></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;"> <div style="text-align: justify;"> <!--[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;">Reportar la disponibilidad al CRUE.</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> </div>

Shock Neurogénico

1  DEFINICIÓN El shock neurogénico se presenta por disfunción o daño del sistema nervioso simpático, bien sea por lesión física o p...

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Manejo de trauma Raquimedular

<p align="justify"><img align="left" height="166" src="http://teravida.com.co/wp-content/uploads/2013/05/neurehabraqumedular.jpg" style="margin: 0px 10px 0px 0px; display: inline" width="251" /></p> <p align="justify"><b></b></p> <p align="justify"><b>1 SIGNOS Y SINTOMAS</b></p> <p align="justify">En el examen se encuentra:</p> <p align="justify">· Dolor al movimiento o palpación.</p> <p align="justify">· Obvia deformidad (espalda o columna vertebral).</p> <p align="justify">· Músculos débiles.</p> <p align="justify">· Parálisis.</p> <p align="justify">· Pérdida de la sensibilidad.</p> <p align="justify"><b>2 ACTIVIDADES DE ENFERMERIA</b></p> <p align="justify">· Evaluar y asegurar la escena</p> <p align="justify">· Elementos de bioseguridad.</p> <p align="justify">· Efectuar inmovilización cervical con collar cervical rígido.</p> <p align="justify">· Inmovilización del paciente en decúbito supino sobre una tabla rígida en una posición neutral alineada. La cabeza, el cuello el tronco y la pelvis deben ser específicamente inmovilizados en una posición neutral alineada.</p> <p align="justify">· Evaluar ABC, la necesidad de RCP inmediata y de valorar la respuesta motora, sensorial y la circulación en las cuatros extremidades<b>.</b></p> <p align="justify">· Manejo de la vía aérea</p> <p align="justify">· Colocar oxigeno al 100%</p> <p align="justify">· Control de signos vitales</p> <p align="justify">· Tener acceso venoso en vena de buen calibre.</p> <p align="justify">· Registrar, hacer historias clínicas.</p> <p align="justify">· Entregar al paciente al centro asistencial. Sobre el evento, tiempo que transcurrió, como ocurrió.</p> <p align="justify">· Entregar paciente al médico de la institución o personal encargado.</p> <p align="justify">· Acomodar el paciente<b>.</b></p> <p align="justify">· Hacer firmar registros de historia clínica.</p> <p align="justify">· Arreglar y equipar nuevamente con elementos.</p>

Manejo de trauma Raquimedular

1 SIGNOS Y SINTOMAS En el examen se encuentra: · Dolor al movimiento o palpación. · Obvia deformidad (espalda o columna vertebral)...

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Manejo de Evisceración

<b style="line-height: 150%; 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;">1 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; 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;">Se entiende por evisceración la extrusión de un segmento de intestino o de otro órgano intra-abdominal fuera de la cavidad abdominal a través de una herida abierta.</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;"> <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: Tahoma, sans-serif; line-height: 150%;"> <b>ACTIVIDADES DE </b></span><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: 7.9pt; 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 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: 7.9pt; 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 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;">Cubra órganos con gasa humedecida en solución salina o agua.</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 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;">No<b> </b>intente regresar el órgano extraído nuevamente a la cavidad abdominal.</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 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;">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></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 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;">Solución Salina normal o Ringer lactado para mantener TA (sistólica 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></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 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;">Traslade 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: l0 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: l0 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: l0 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: l0 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: 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 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> <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 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;">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>

Manejo de Evisceración

1 DEFINICIÓN Se entiende por evisceración la extrusión de un segmento de intestino o de otro órgano intra-abdominal fuera de la cavidad ab...

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Trauma de Columna Vertebral

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

Trauma de Columna Vertebral

1 DEFINICIÓN El trauma de columna, cuando no es reconocido y apropiadamente manejado en el escenario, puede condicionar daño irreparable...

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