Lavado Quirúrgico de Manos

LAVADO QUIRÚRGICO DE MANOS, VESTIR Y VESTIRSE ESTÉRIL, PONERSE Y PONER LAVADO GUANTES

LAVADO QUIRÚRGICO DE MANOS VESTIR Y VESTIRSE ESTÉRIL PONERSE Y PONER GUANTES UN INFORME REALIZADO POR: HOIL SOSA, GELEMBER DANIEL INTRODUCCION La inci!ncia ! "a# in$!cci%n!# !n &'!a ()i'*'+ica  n%#%c%-ia"!# #%n )n .'%/"!-a ()! a*n n% !#0& !" 0%% '!#)!"0%, !#0a c%n0in)a #i!n% )na ! "a# c%-."icaci%n!# ! -a%' 'i!#+% !n "%# !#0a/"!ci-i!n0%# 1%#.i0a"a'i%# a .!#a' ! "%# 'i+)'%#%# .'%+'a-a# .a'a !" c%n0'%" ! "a in$!cci%n!#2 E#0% #)c!! .%' 3a'ia# 'a4%n!#: !#0a5a# -&# c%'0a#, "% c)a" #i+ni6ca ()! "%# .aci!n0!# ()! #! ()!an -&# 0i!-.% !n !" 1%#.i0a" #%n "%# -&# !n$! !n$!''-%# %#77 "%# "%# .aci .aci!n !n0!# 0!# #%n #%n -a -an0 n0!n !ni i%# %# c%n c%n 3ia 3ia )'an )'an0! 0! -& -&## 0i!0i!-.% .%,, "% ()! ()! #! 0'a 0'a)c )c! ! !n ()! "a -a -a %'5a %'5a ! !#0% !#0%## .aci aci!n0! !n0!## #%n #%n .!'#% !'#%na na## -a% a%'!#  -&# #)#c!.0i/"!# a "a# in$!cci%n!#7  !n !" &'!a ()i'*'+ica .'%$!#i%na" ()! n% !#0&n !/ia !/ia-!n -!n0! 0! .'!.a .'!.a'a 'a%# %# .a'a ic1% ic1% #!'3ici #!'3ici%, %, a ()! '!()i! '!()i!'! '! c%n0a' c%n0a' c%n -)c1a# -)c1a# 08cnica# ! a#!.#ia, a ()! !9i#0! #)6ci!n0! c%n0ac0% $5#ic% !" 0'a/aa%' ! "a #a") c%n "%# .aci!n0!#, a!-&# ! "a -ani.)"aci;n ! !()i.%# % .'%)c0%# -8ic%#2 T%a# "a# 'a4%n!# -!nci%naa# 1ac!n ! "%# .'%c!i-i!n0%# ! "a# Técnicas Asépticas )na !#0'a0!+ia i-.%'0an0! .a'a .'!3!ni' in$!cci%n!#, .!'% n%# !n$%ca'!-%# !n !" &-/i0% ()i'*'+ic%7 !n0'% ! "a# c)a"!# !" "a3a% ! -an%#, !" )#% c%''!c0% ! "%# +)an0!#,  "a a!c)aa $%'-a ! 3!#0i'#!, c%n0in*an #i!n% "a .'&c0ica ini#c)0i/"!-!n0! ! -a%' '!"!3ancia,  %n! !/!n '!a"i4a'#! "%# !#$)!'4%# n!c!#a'i%# .a'a ()! !" E()i.% ! Sa") Sa")  a1i a1i!'a !'a $)!'0 $)!'0!!-!n !n0! 0! !#0a !#0a .'&c .'&c0i 0ica ca22 La T8cnic 8cnica a a#8. a#8.0i 0ica ca "a c%n#0 c%n#0i0 i0) )!n !n

)n c%n)n0% ! .'%c!i-i!n0%#  ac0i3ia!# ()! #! '!a"i4an c%n !" 6n ! i#-in)i' a" -5ni-% "a# .%#i/i"ia!# ! c%n0a-inaci;n -ic'%/iana )'an0! "a a0!nci;n ()i'*'+ica a .aci!n .aci!n0!# 0!#22 L%# .'%c! .'%c!ii-i!n i!n0%# 0%# ()! inc") inc")! ! "a T8cnica 8cnica A#8.0i A#8.0ica, ca, #%n .a'0! .a'0! ! "a# -!ia# +!n!'a"!# c%-.'%/aa-!n0! !$!c0i3a# ()! !/!n !#0a' #i!-.'! .'!#!n0!#, a" -%-!n0% ! '!a"i4a' .'%c!i-i!n0%# in3a#i3%# )'an0! "a a0!nci;n ()i'*'+ica2 L%# .'%c!i-i!n0%# ()! inc")! "a T8cnica A#8.0ica #%n: < La3a% ! -an%# < C%"%caci;n ! /a''!'a# ! a"0a !6ci!ncia: c%-% +)an0!#, /a0a#, -a#ca'i""a#, +%''%#, /%0a#, !0c2 < U#% ! an0i#8.0ic%# < U#% ! -a0!'ia" !#0!'i"i4a% !#0!' i"i4a% % #%-!0i% !#in$!cci;n ! a"0% ni3!" =DAN> OB?ETIVOS < E"i-ina' "a #)ci!a 3i#i/"!, +'a0i0), @%'a 0'an#i0%'ia a()i'ia !n !" 1%#.i0a", "a c)a" !# +!n! +!n!'a" 'a"-! -!n0 n0!, !, !" .'%c .'%c! !ii-i! i!n0 n0% % !/! !/! %/! %/!!c !c!' !' a )na )na .'&c .'&c0i 0ica ca -& -&## !"a/ !"a/%' %'a aa a !n%-inaa La3a% C"5nic% ! Man%#2 < Q)! !" !#0)ian0! !9."i()! "a# 08cnica# ci!n056ca# #%/'! !" c%n0'%" ! -ic'%%'+ani#-%# !n #i0)aci%n!# -!ic% ()i'*'+ica#2 < Q)! !" !#0)ian0! !-)!#0'! "a #i0)aci;n ! "a# 08cnica# -!ic% ()i'*'+ica#2 < Di# Di#-in -in)ci )ci;n ;n !" 'i! 'i!#+% #+% ! in$ in$!cc !cci;n i;n .a' .a'a a !" .ac .aci!n i!n0!, 0!, !" .!' .!'#%n #%na" a" #an #ani0a i0a'i% 'i%  "%# 3i#i0an0!# -!ian0! "a in0!'').ci;n ! "a ca!na ! 0'an#-i#i;n < Di#-in)ci;n ! "a inci!ncia ! in$!cci%n!# n%#%c%-ia"!#2 < P'!3!nci;n  c%n0'%" ! /'%0!#2 < P%!' .'!#0a' )na a"0a ca"ia ! a0!nci;n2

)n c%n)n0% ! .'%c!i-i!n0%#  ac0i3ia!# ()! #! '!a"i4an c%n !" 6n ! i#-in)i' a" -5ni-% "a# .%#i/i"ia!# ! c%n0a-inaci;n -ic'%/iana )'an0! "a a0!nci;n ()i'*'+ica a .aci!n .aci!n0!# 0!#22 L%# .'%c! .'%c!ii-i!n i!n0%# 0%# ()! inc") inc")! ! "a T8cnica 8cnica A#8.0i A#8.0ica, ca, #%n .a'0! .a'0! ! "a# -!ia# +!n!'a"!# c%-.'%/aa-!n0! !$!c0i3a# ()! !/!n !#0a' #i!-.'! .'!#!n0!#, a" -%-!n0% ! '!a"i4a' .'%c!i-i!n0%# in3a#i3%# )'an0! "a a0!nci;n ()i'*'+ica2 L%# .'%c!i-i!n0%# ()! inc")! "a T8cnica A#8.0ica #%n: < La3a% ! -an%# < C%"%caci;n ! /a''!'a# ! a"0a !6ci!ncia: c%-% +)an0!#, /a0a#, -a#ca'i""a#, +%''%#, /%0a#, !0c2 < U#% ! an0i#8.0ic%# < U#% ! -a0!'ia" !#0!'i"i4a% !#0!' i"i4a% % #%-!0i% !#in$!cci;n ! a"0% ni3!" =DAN> OB?ETIVOS < E"i-ina' "a #)ci!a 3i#i/"!, +'a0i0), @%'a 0'an#i0%'ia a()i'ia !n !" 1%#.i0a", "a c)a" !# +!n! +!n!'a" 'a"-! -!n0 n0!, !, !" .'%c .'%c! !ii-i! i!n0 n0% % !/! !/! %/! %/!!c !c!' !' a )na )na .'&c .'&c0i 0ica ca -& -&## !"a/ !"a/%' %'a aa a !n%-inaa La3a% C"5nic% ! Man%#2 < Q)! !" !#0)ian0! !9."i()! "a# 08cnica# ci!n056ca# #%/'! !" c%n0'%" ! -ic'%%'+ani#-%# !n #i0)aci%n!# -!ic% ()i'*'+ica#2 < Q)! !" !#0)ian0! !-)!#0'! "a #i0)aci;n ! "a# 08cnica# -!ic% ()i'*'+ica#2 < Di# Di#-in -in)ci )ci;n ;n !" 'i! 'i!#+% #+% ! in$ in$!cc !cci;n i;n .a' .a'a a !" .ac .aci!n i!n0!, 0!, !" .!' .!'#%n #%na" a" #an #ani0a i0a'i% 'i%  "%# 3i#i0an0!# -!ian0! "a in0!'').ci;n ! "a ca!na ! 0'an#-i#i;n < Di#-in)ci;n ! "a inci!ncia ! in$!cci%n!# n%#%c%-ia"!#2 < P'!3!nci;n  c%n0'%" ! /'%0!#2 < P%!' .'!#0a' )na a"0a ca"ia ! a0!nci;n2

LAVADO QUIRÚRGICO DE MANOS

LAVADO QUIRURGICO DE MANOS DEFINICION: E" "a3a% ()i'*'+ic% !# !" .'%c!#% ! !"i-ina' !" -a%' n*-!'% ! -ic'%%'+ani#-%# .a0;+!n%# ! "a# -an%#  /'a4%# .%' -!i% ! "a3a% -!c&nic%  !#in$!cci;n c%n .'%)c0%# ()5-ic%# an0!# ! .'ac0ica' .' ac0ica' )na in0!'3!nci;n ()i'*'+ica2 E# "a '!-%ci;n ()5-ica ! -ic'%%'+ani#-%# ()! !#0')!n % -a0an "a @%'a 0'an#i0%'ia '!-)!3! "a# '!#i!n0!# .'!#!n0!# !n "a .i!"2 S! !6n! c%-% )n $'%0! !n8'+ic% ! 0%a# "a# #).!'6ci!# ! "a# -an%# 1a#0a "%# c%%# c%n )na #%" #%")ci )ci;n ;n an0i-i an0i-ic' c'%/i %/iana ana,, #!+)i% #!+)i% ! !n)a+ !n)a+)! )! a" c1%'' c1%''% % ! a+)a2 a+)a2 B)#ca B)#ca !"i-in !"i-ina', a', "a @%'a @%'a 0'an#i 0'an#i0%' 0%'ia ia  i#-in i#-in)i )i'' "a c%nc!n c%nc!n0'a 0'aci; ci;n n ! /ac0!' /ac0!'ia# ia# ! "a @%'a @%'a '!#i!n0!2 La3a%: !# n!c!#a'i% c%n0a' c%n in#0a"aci%n!# a!c)aa# .a'a ()! 0%% !" .!'#%na" ! "a #a"a ! %.!'aci%n!# .)!a '!#0'!+a'#!  "a3a'#! -an%#  an0!/'a4%#2 E" c)a'0% ! "a3a "a3a% % ()i' ()i'*' *'+i +ic% c% #! !nc) !nc)!n !n0' 0'a a )n0 )n0% % a" ()i' ()i';$ ;$an an% % .%' .%' 'a4% 'a4%n!# n!# ! #!+)' #!+)'i ia a  c%-%ia2 E# .'!$!'i/"! )#a' "a3a-an%# ini3i)a"!# c%n ""a3!# ()! .)!an %.!'a'#! c%n "a '%i""a .a'a !"i-ina' !" .!"i+'% ! c%n0a-ina'#! "a# -an%# !#.)8# ! 1a/!'"a# "a3a%2 E" "a3a% !/! #!' a-."i%  0!n!' )na .'%$)nia a!c)aa .a'a n% #a".ica' !" a+)a  c%n0a-ina' %0'%# %/!0%#2 N)nca #! .%n'& )na /a0a !#08'i" #%/'! "a '%.a ! ()i';$an% 1*-!a, .)!# "a c%n0a-ina, .%' "a 1)-!a ()! a/#%'/!2 L%# "a3a-an%# .a'a "a3a% ()i'*'+ic% #! )#an #%"% .a'a '!#0'!+a'#!  "a3a'#! -an%#  an0!/'a4%#7 n% #! )#an .a'a !n)a+a' ! n)a+a' % "i-.ia# in#0')-!n0%#  !()i.% c%n0a-ina%2

OBJETIVO: E" %/!0i3% ()! #! .!'#i+)! c%n !" "a3a% ()i'*'+ic% !# !"i-ina' "a #)ci!a, '!#i)%#, +'a#a# na0)'a"!# ! "a .i!", c'!-a# .a'a "a# -an%#  -ic'%%'+ani#-%# .a0;+!n%# !n "a# -an%#  an0!/'a4%# ! "%# -i!-/'%# ()! in0!+'an !" .!'#%na" ()i'*'+ic%2 D! -an!'a !#.!c56ca, #) 6na"ia c%n#i#0! !n: 2 Di#-in)i' !" n*-!'% ! -ic'%%'+ani#-%# !n "a .i!" a )n -5ni-% i''!)c0i/"!2 2 C%n#!'3a' "a .%/"aci;n ! -ic'%%'+ani#-%# .a0;+!n%# a" -5ni-% )'an0! "a in0!'3!nci;n ()i'*'+ica, in1i/i!n% #) .'%"i$!'aci;n2 2 R!)ci' !" .!"i+'% ! )na c%n0a-inaci;n -ic'%/iana !n "a 1!'ia ()i'*'+ica ca)#aa .%' "a# /ac0!'ia# ! "a @%'a c)0&n!a 2 Di#-in)i' "a c%nc!n0'aci;n ! /ac0!'ia# ! "a @%'a '!#i!n0!  '!-%3!' c%-."!0a-!n0! "a @%'a 0'an#i0%'ia, a()i'ia# .%' c%n0ac0% '!ci!n0! c%n .aci!n0!# % $;-i0!#2 2 R!)ci' !" .!"i+'% ! )na c%n0a-inaci;n -ic'%/iana !n "a 1!'ia ()i'*'+ica ca)#aa .%' /ac0!'ia# ! "a @%'a c)0&n!a2

FUNDAMENTO ANATOMOFISIOLOGICO: La Micr!ra "# $as %ans: E" c%n%ci-i!n0% ! "%# -ic'%%'+ani#-%# ()! #! !nc)!n0'an !n "a# -an%# ! "%# 0'a/aa%'!# ! "a #a") !# !#!ncia" .a'a !n0!n!' a ca/a"ia "a .'inci.a" !0i%"%+5a ! "a# in$!cci%n!# n%#%c%-ia"!#  !#a''%""a' !#0'a0!+ia# ! .'!3!nci;n !$!c0i3a#2

La pi#$ cnsta "# "s capas: 2  La !.i!'-i# !# "a ca.a #).!'i%' ()! c%n#0a ! )na ca.a c%'n!a  )na ca.a +!'-ina0i3a2 La ca.a c%'n!a c%n%cia c%-% S0'a0)- c%'n!)- !#0& $%'-aa .%' c8")"a# -)!'0a# !n $%'-a ! !#ca"a ()! c%n0in)a-!n0! #! !#ca-an a ca)#a ! "a $'icci;n, a

-!ia ()! !#0a# c8")"a# #! '!-)!3!n #%n '!!-."a4aa# .%' c8")"a# ac0i3a# -&# +'an!# ! "a ca.a +!'-ina0i3a2 2  La !'-i# !#0& "%ca"i4aa /a% "a !.i!'-i#  !#0& $%'-aa .%' )na -a0!'ia c%n!c0i3a, 6/'%#a  +')!#a ()! a"-ac!na $%"5c)"%# .i"%#%#, +"&n)"a# ac!i0%#a#  '!c!.0%'a# ! .'!#i;n2

TERMINOLOGIA: F$ra transitria: O'+ani#-%# ()! #! 1an a()i'i% '!ci!n0!-!n0! .%' !" c%n0ac0% c%n %0'a .!'#%na ) %/!0%2 S! a()i!'!n a 0'a38# !" c%n0ac0% c%n "%# .aci!n0!# % .!'#%na" in$!c0a%# % c%"%ni4a%# % c%n "a# #).!'6ci!# c%n0a-inaa#2 L%# %'+ani#-%# 3a'5an  !.!n!n ! #) %'i+!n2 E coli, Pseudomonas, Serratia, Staphylococcus aureus, Bacillus gram negativos, Klebsiella pneumoniae y enterococci #! !nc)!n0'an 0!-.%'a"-!n0! !n

-an%# ! "%# 0'a/aa%'!# ! "a #a")2 E#0%# %'+ani#-%# #%/'!3i3!n !n "a .i!" .%' 3a'i%# .!'i%%# =!#! )n%# -in)0%# 1a#0a 3a'ia# 1%'a# % 5a#>

F$ra r#si"#nt#: O'+ani#-%# ()! 3i3!n  #! -)"0i."ican !n "a .i!"  3a'5an ! )na .!'#%na a %0'a, #%n .%' "% +!n!'a", ! /aa 3i')"!ncia  !n 'a'a# %ca#i%n!# ca)#an in$!cci%n!# "%ca"i4aa# !n "a .i!"2 La -a%'5a ! "%# %'+ani#-%# '!#i!n0!# #! !nc)!n0'an !n "a# ca.a# #).!'6cia"!# ! "a .i!", a.'%9i-aa-!n0! !"  a"  3i3!n !n "a# ca.a# !.i8'-ica# .'%$)na#  .%' "% +!n!'a" n% #%n .a0;+!n%#2 En0'! "%# %'+ani#-%# c%n#i!'a%# c%-% @%'a '!#i!n0! #! inc")!n "%#estaflococos de coagulasa negativa y  “dipteroides”.

 Ja&'n anti(%icr&ian:  ?a/;n ()! c%n0i!n! )n a+!n0! an0i-ic'%/ian% a#%cia%2

La)a" scia$:

S! !6n! c%-% )n $'%0! /'!3! ! 0%a# "a# #).!'6ci!# ! "a# -an%# c%n a/;n, #!+)i% ! !n)a+)! a" c1%''% ! a+)a2 S) %/!0i3% !# '!-%3!' "a #)ci!a,

La)a" c$*nic: S! !6n! c%-% )n $'%0! /'!3!  !n8'+ic% ! 0%a# "a# #).!'6ci!# ! "a# -an%# c%n )na #%")ci;n an0i-ic'%/iana, #!+)i% ! !n)a+)! a" c1%''% ! a+)a2 B)#ca '!-%3!' "a #)ci!a, !" -a0!'ia" %'+&nic%  i#-in)i' "a c%nc!n0'aci;n ! "a @%'a 0'an#i0%'ia, a()i'ia .%' c%n0ac0% '!ci!n0! c%n .aci!n0!# % $;-i0!#2

Saniti+acin: La 1i+i!ni4aci;n #! !6n! c%-% )n $'%0! /'!3! c%n )na #%")ci;n an0i#8.0ica a .a'0i' ! a"c%1%"  !-%"i!n0!#, /)#can% !#0')i' "%# -ic'%%'+ani#-%# ! "a @%'a /ac0!'iana 0'an#i0%'ia, a()i'i%# '!ci!n0!-!n0! .%' c%n0ac0% i'!c0% c%n .aci!n0!#, $a-i"ia'!# % $;-i0!#  i#-in)i' "a @%'a '!#i!n0!2 Si!-.'!  c)an% "a# -an%# #! !nc)!n0'!n "i-.ia#  #in c%n0a-inaci;n c%n -a0!'ia" %'+&nic%2

La)a" ,-ir.r/ic: S! !6n! c%-% )n $'%0! !n8'+ic% ! 0%a# "a# #).!'6ci!# ! "a# -an%# 1a#0a "%# c%%# c%n )na #%")ci;n an0i-ic'%/iana, #!+)i% ! !n)a+)! a" c1%''% ! a+)a2 B)#ca !"i-ina', "a @%'a 0'an#i0%'ia  i#-in)i' "a c%nc!n0'aci;n ! /ac0!'ia# ! "a @%'a '!#i!n0!2

ACCIONES DE ENFERMERIA: < Q)! !" "a3a% ! -an%# #!a c%''!c0%2 < R!)ni' 0%% !" -a0!'ia" a!c)aa .a'a '!a"i4a'#! !" "a3a% ! -an%#2 < U0i"i4a' 08cnica# a!c)aa# .a'a !3i0a' "a i#!-inaci;n ! -ic'%%'+ani#-%# !n "a #a"a2

< A#!% ! "a .i!", !" .!"%  "a# )a# ! -an%#  .i!#, .a'a i#-in)i' "a can0ia ! /ac0!'ia# !n "a .i!"2

0RINCI0IOS 0ARA LOGRAR LA ACCION: < L%# a+!n0!# in$!cci%#%# .)!!n !#0')i'#! c%n #)6ci!n0! ca"%', a+!n0!# ()5-ic%#  %0'%# -!i%# c%n%ci%#2 < La in0!+'ia ! "a .i!" !# "a .'i-!'a "5n!a ! !$!n#a !" c)!'.% c%n0'a in$!cci%n!#  "!#i%n!#2 < D)'an0! "a 3ia %c)''!n ca-/i%# !n "a .i!", "a# -)c%#a#, !" .!"%, "a# )a#  "%# i!n0!#2 < E" c!.i""a% -%3i"i4a "a# +'a#a#, "%# -ic'%%'+ani#-%#  "a# c8")"a# -)!'0a# ! "a !.i!'-i#2 < E" c!.i""a% .'%)c! a/)nan0! !#.)-a $a3%'!ci!n% "a .!n!0'aci;n !" a/;n2

0RINCI0IOS 0ARA EVITAR LA 0ATOLOGIA ADICIONAL: < M)c1%# +8'-!n!# ()! #! !nc)!n0'an n%'-a"-!n0! !n !" a-/i!n0!  !" c)!'.% #%n %.%'0)ni#0a#  #! 0%'nan in$!cci%#%# an0! "a .%#i/i"ia ! 1ac!'"%2 < L%# -%%# ! 0'an#-i#i;n ! "%# a+!n0!# in$!cci%#%# 3a'5a #!+*n #) .)!#0a %'ina'ia ! !n0'aa, "a 35a ! #a"ia  #) ca.acia .a'a 3i3i' $)!'a !" '!#!'3%'i%2 < A"+)n%# ini3i)%# #%n .%'0a%'!# ! a+!n0!# in$!cci%n!#, a)n()! n% 0!n+an #i+n%# ni #5n0%-a# c"5nic%# ! in$!cci;n2 < E" a/;n !-)"#i%na "a# +'a#a#2 < E" a"c%1%" i#)!"3! "a# +'a#a#  c%a+)"a "a# .'%0!5na#2 < La# #%")ci%n!# an0i#8.0ica# in1i/!n "%# +8'-!n!#2

< C%n#!'3a' )n a-/i!n0! $5#ic% #!+)'% .a'a "a '!c).!'aci;n !" .aci!n0!2

0RINCI0IOS 0ARA EVITAR INCOMODIDAD DEL 0ACIENTE: < R!a"i4a' )n a!c)a% "a3a% ()i'*'+ic% .a'a !3i0a' .a0%"%+5a# !n !" %'+ani#-% %J ;'+an%# ()! 3an a #!' in0!'3!ni%# < E" !#0'ic0% c%n0'%" ! 1i+i!n! !3i0a .'%/"!-a# .%#0!'i%'!# !n '!"aci;n c%n "a ci')+5a2

EQUI0O NECESARIO: 2 C!.i""% % !#c%/i""a "i-.ia .a'a )a#2 2 Di#.!n#a%' ! an0i#8.0ic%2 2 A+!n0! an0i#8.0ic% a/%n%#% ! a-."i% !#.!c0'%: C"%'1!9iina , P%3i%na Y%aa !n #%")ci;n a/%n%#a =Di$!9%n>2 Pa'a !" "a3a% ()i'*'+ic%, #! !-."!an c!.i""%# ()! .)!!n !#0!'i"i4a'#! !n )n !9.!i%' -!0&"ic% % 0%')na# !#!c1a/"!#2 L%# .'%)c0%# !#!c1a/"!# #%n )na c%-/inaci;n ! c!.i""%0%')na2 A"+)n%# c%n0i!n!n a+!n0!# an0i#8.0ic%#  !0!'+!n0!#2 L%# c!.i""%# !#!c1a/"!# 3i!n!n !-.aca%# !n $%'-a ini3i)a"2 C)an% )n% 0%-a a"+)n% ! "%# c!.i""%# n% !#!c1a/"!# !" !9.!i%' -!0&"ic% %n! #! !#0!'i"i4an, !/! !90'&!"% #in c%n0a-ina' "%# !- En %ca#i%n!# #)!"!n inc")i'#! !n .a()!0!# ini3i)a"!# !#08'i"!#2 E" c!.i""% n% !/! ca)#a' !'%#i%n!# !n "a .i!"2 S! a."ica "a #%")ci;n an0i#8.0ica #%/'! !" c!.i""% % 0%')na a" .'!#i%na' c%n !" .i! !" .!a" !" '!ci.i!n0! )ni% % aac!n0! a" "a3a-an%#2 E# #)6ci!n0! c%n #!i# +%0i0a#, c!'ca !  a  -" ! #%")ci;n, .a'a $%'-a' "a !#.)-a n!c!#a'ia .a'a !" "a3a%2 E3i0! !#.!'icia' "a #%")ci;n an0i#8.0ica2 S! ()i0an 0%a# "a# .a'05c)"a# '!#i)a"!# !" &'!a #)/)n+)!a"2 S! !-."!an "i-a# !#!c1a/"!# ! ."�ic% % -!0&"ica#2 L%# "i-.ia)a# .a'a )#% '!.!0i0i3% #! !#0!'i"i4an caa 3!4 ()! #! "%# !-."!a

0ROCEDIMIENTO:

0r#paracin#s /#n#ra$#s: 2 La .i!"  )a# !/!n c%n#!'3a'#! "i-.ia#  !n /)!n !#0a%  n% !/!n c%'0a'#! "a# c)05c)"a#2 Si #! )#a "%ci;n ! -an%# .a'a .'%0!+!' "a .i!", #! '!c%-i!na )n .'%)c0% ! /a#! n% ac!i0%#a2 2 La# )a# n% !/!n ""!+a' -&# a""& ! "a .)n0a !" !% .a'a n% .)nci%na' !" +)a0!2 2 N% !/! )#a'#! !#-a"0! .a'a )a#2 E" !#-a"0! .)!! '!#()!/'aa'#!  ca!',  .!'-i0i' ()! ()!!n a"/!'+a%# -ic'%%'+ani#-%# !n "a# +'i!0a#2 2 N% !/!n c)/'i' "a# )a# na0)'a"!# i#.%#i0i3%# a'0i6cia"!#2

0r#paracin#s ant#rir#s a$ $a)a": 2 In#.!cci%n! "a# -an%# .a'a !#c)/'i' c%'0a)'a#  a/'a#i%n!#2 La .i!" ! -an%#  an0!/'a4%# !/! !#0a' in0ac0a, !#0% !#, #in "!#i%n!# a/i!'0a# % +'i!0a# !n "a .i!"2 2 Q)50!#! todas "a# a"1aa# =%a#> ! "%# !%#2 La# a"1aa# a"/!'+an -ic'%%'+ani#-%#2 2 A#!+*'!#! ()! 0%% !" ca/!""% #! !nc)!n0'! c)/i!'0%2 L%# a'!0!# ()! a0'a3i!#an "a %'!a !/!n !#0a' #i!-.'! !n0'% !" +%''%2 C%n#0i0)!n )n c)!'.% !90'a% .%0!ncia" !n "a 1!'ia ()i'*'+ica2 2 A)#0! !" c)/'!/%ca# !#!c1a/"! c)/'i!n% "a na'i4  /%ca2 2 Si #! )#an an0!%%#, #! "i-.ian  a)#0an !#0%# a "%# .'%0!c0%'!# ! %%# !n $%'-a c;-%a !n '!"aci;n c%n !" c)/'!/%ca#2 K2 A!c)! !" a+)a a )na 0!-.!'a0)'a c%n$%'0a/"!2

D-raci'n "#$ c#pi$$a":  Tan0% "a )'aci;n !" c!.i""a% ()i'*'+ic% 3a'5an c%-% !" .'%c!i-i!n0% ! c!.i""a%2 La# 3a'iaci%n!# .)!!n !.!n!' ! "a $'!c)!ncia !" c!.i""a%, "a #)#0ancia ()! #!

)0i"i4a  !" -80%%2 Un c!.i""a% 3i+%'%#% ! cinc% -in)0%# c%n )na #)#0ancia c%n6a/"! .)!! #!' 0an !$!c0i3% c%-% )n c!.i""a% !  -in)0%# ()! #! '!a"i4a c%n -!n%' acci;n -!c&nica2 E" c!.i""a% .%' )n 0i!-.% -a%' !  -in)0%# ""!+a a "%# -ic'%/i%# '!#i!n0!# ! "a# ca.a# 8'-ica# .'%$)na#  .%' "% 0an0% '!#)"0a c%n0'a.'%)c!n0!7 )n c!.i""a% -&# c%'0% .)!! '!#)"0a' i+)a" ! !$!c0i3%2 Caa )n% !/! c!.i""a'#! ! ac)!'% c%n )n .'%c!i-i!n0% !#0ana'i4a% !#c'i0%2 E" 0i!-.% ()! #! '!()i!'! .)!! /a#a'#! !n "a# '!c%-!naci%n!# ! "%# $a/'ican0!# .a'a "a# #)#0ancia# ()! #! )0i"ic!n  !n "a %c)-!n0aci;n ! !6cacia ! .'%)c0%# !n "a "i0!'a0)'a !#.!ci6ca2 En "a .a'! ! caa c)a'0% ! "a3a% !/! .!+a'#! )na c%.ia !" .'%c!i-i!n0%2 L%# c!.i""a%# #)/#!c)!n0!# !/!n #!+)i' !" -i#-% .'%c!i-i!n0% ()! !" .'i-!'% !" 5a2 C)an% #! ()i0an "%# +)an0!# a" 6na" ! "a %.!'aci;n, "a# -an%# #! !nc)!n0'an c%n0a-inaa#2 L%# -ic'%%'+ani#-%# '!#i!n0!# #! -)"0i."ican c%n 'a.i!4 !n !" a-/i!n0! ca"i!n0! ()! #)/ac! a "%# +)an0!#, .%' "% ()! "a# -an%# !/!n "a3a'#! 0an .'%n0% c%-% #! ()i0!n !#0%#, a)n()! #! c%n0a-inan 0an .'%n0% c%-% 0i!n!n c%n0ac0% c%n c)a"()i!' a'05c)"% inani-a%2

0rc#"i%i#nt para #$ $a)a" ,-ir.r/ic: E" .'%c!i-i!n0% .a'a !" "a3a% ()i'*'+ic% .)!! #!' /a% dos métodos, de duracin o de cepillado 2 C)an% #! ""!3an a ca/% !n $%'-a c%''!c0a, a-/%# #%n !6cac!#  caa

)n% !9.%n! 0%a# "a# #).!'6ci!# ! "a -an%  an0!/'a4% .a'a "a "i-.i!4a -!c&nica  a#!.#ia ()5-ica2 N% #! !/! %"3ia' ()! "%# !%#, -an%#  /'a4%# 0i!n!n c)a0'% "a%# % ca'a#2 A-/%# -80%%# #i+)!n )n patrn anatmico para el lavada !uir"rgico#  c)a0'% ca'a# !n caa !%, !-.!4an% c%n !" .)"+a'  !#.)8# ! )n !% a %0'% 1a#0a ""!+a' a" /%'! !90!'n% !" -!i()! #%/'! "a #).!'6ci! %'#a" =.%#0!'i%'> ! "a -an%  "a #).!'6ci! .a"-a' % 3ic!3!'#a !" -!i()! a" .)"+a' #%/! "a -)!ca  1acia !" an0!/'a4%, !n 0!'ci%#, 0!'-inan% cinc% c!n05-!0'%# .%' a''i/a !" c%%2 P)!#0% ()! "a# -an%# 0i!n!n )n c%n0ac0% i'!c0% -a%' c%n !" ca-.% ()i'*'+ic%, 0%%# "%# .a#%# !"

.'%c!i-i!n0% .a'a !" "a3aa ()i'*'+ic% !-.i!4an c%n "a# -an%# .a'a 0!'-ina' c%n "%# c%%#2

NOTA: Ant#s 1 "#sp-és "#$ $a)a" ,-ir.r/ic %ant#n/a $as %ans a %a1r a$t-ra ,-# $s c"s para p#r%itir ,-# #$ a/-a #sc-rra "#$ 2r#a $i%pia3 $as %ans3 #$ 2r#a %ar/ina$ "#$ %i#%&r s-p#rir4 Mét" "# "-raci'n: L%# !%#, -an%#  an0!/'a4%# #! "a3an c'%n%-!0'an% !" 0i!-.% !n caa &'!a ana0;-ica % !n caa .a#% !" .'%c!i-i!n0%2

La)a" ,-ir.r/ic "# cinc %in-ts: 2 M;!#! "a# -an%#  an0!/'a4%#2 2 A."5()!#! #!i# +%0a# ! a+!n0! an0i#8.0ic% #%/'! "a# .a"-a# ! "a# -an%#2 2 L&3!#! -an%#  /'a4%# c%n c)ia% 3a'ia# 3!c!# 1a#0a cinc% c!n05-!0'%# a''i/a !" c%%2 En)&+)!#! c%n #)-% c)ia% /a% a+)a c%''i!n0!, c%n "a -an% 1acia a''i/a .a'a ()! !" a+)a !#c)''a 1acia !" c%% !n @!9i;n2 2 T%-! )n c!.i""% !#08'i" =!" .a()!0! % !9.!i%' -!0&"ic%>  a."5()!"! !" a+!n0! an0i#8.0ic% !n ca#% ! n% 0!n!'"% i-.'!+na%2 C!.5""!#! "a# )a#  -an%# )'an0! -!i% -in)0% caa -an% 2 C%n !" c!.i""% !n "a -an%, "5-.i!#! "a# )a# /a% a+)a c%''i!n0!, )#an% )na "i-a ! ."�ic% !#!c1a/"! % -!0&"ica2 D!#8c1!"a !#.)8# ! )#a'2 K2 N)!3a-!n0!, c!.5""!#! "a# )a#  -an%# )'an0! -!i% -in)0% caa -an% c%n#!'3an% "a !#.)-a2 2 En)&+)!#! "a# -an%#  !" c!.i""% !#!c1an% "a 0%')na % !#0! )"0i-%

2 A."i()! ! n)!3% !0!'+!n0!  "&3!#! "a# -an%#  /'a4%# c%n $'icci;n +a#0a !" c%% )'an0! 0'!# -in)0%#7 !n0'!"ac! "%# !%# .a'a c!.i""a'#! /i!n !n0'! !""%#2

Mét" "# c#pi$$a": Un n*-!'% !0!'-ina% ! +%".!# c%n !" c!.i""% % "a 0%')na #! )#a !n caa #).!'6ci! ! "%# !%#, -an%#  /'a4%#2 Un "a3a% .'!()i'*'+ic% /'!3! !#.'!n! "%# '!#i)%# #).!'6cia"!#  -ic'%%'+ani#-%# 0'an#i0%'i%#2 A" "a3a'#! c%n !" c!.i""% % 0%')na #! !"i-ina "a @%'a '!#i!n0!2 2 M;!#! "a# -an%#  /'a4%# 2 L&3!#! "a# -an%#  /'a4%# c%n #)-% c)ia% 1a#0a cinc% c!n05-!0'%# .%' a''i/a !" c%% c%n )na #%")ci;n an0i#8.0ica2 2 L5-.i!#! "a# )a# /a% a+)a c%''i!n0! )#an% )na "i-a -!0&"ica % ! ."�ic% !#!c1a/"!2 Ti'!"a !#.)8# ! )#a'"a2 2 En)&+)!#! "a# -an%# 1acia a''i/a .a'a ()! !" a+)a !#c)''a 1acia "%# c%%#2 2 T%-! )n c!.i""%0%')na !#08'i" !" .a()!0! % !" !9.!i%' -!0&"ic%2 A."i()! "a #%")ci;n an0i#8.0ica #%/'! !" c!.i""% % "a 0%')na #i !#0! n% !#0& i-.'!+na% K2 L&3!#! "a# )a# ! )na -an% )'an0!  -%3i-i!n0%# ! $'%0a-i!n0%, 0%%# "%# "a%# ! caa !%  -%3i-i!n0%#, !" %'#% ! "a -an%  -%3i-i!n0%#, "a .a"-a ! "a -an%  -%3i-i!n0%#, "%# /'a4%#  -%3i-i!n0%# .%' caa 0!'ci% !" an0!/'a4%  1a#0a  c- .%' a''i/a !" c%%2 2 R!.i0a !" .a#% K .a'a "a %0'a -an%  /'a4% 2 En)&+)!#! c)ia%#a-!n0! "a# -an%#  /'a4%#2

Mét" para s#ca" "# %ans 1 &ra+s:

D!#.)8# ! "a3a'#!, "a# -an%#  /'a4%# #! #!can .!'$!c0a-!n0! an0!# ! c%"%ca'#! "a /a0a !#08'i" .a'a !3i0a' c%n-ina'"a a" '%4a'#! c%n "%# -ic'%%'+ani#-%# ! "a .i!"  '%.a ! ()i';$an%2 E" .a()!0! .a'a "a in#0')-!n0i#0a c%n0i!n! )na /a0a !#08'i" ()! #! %/"a an0!# ! !#0!'i"i4a'#!, !an% "a .a'0! in0!'i%' 1acia $)!'a .a'a n% c%n0a-ina' c%n "a# -an%# "a .a'0! !90!'i%'2 S! c%"%can a!-&#, a" !-.aca'"a, "i!n4%# .!()!%# .a'a #!ca'#! "a# -an%# !n "a .a'0! #).!'i%' ! "a /a0a2 La# -an%# #! #!can ! "a #i+)i!n0! -an!'a2 2 In0'%)4ca "a -an% !n !" .a()!0! !#08'i" a/i!'0%  0%-! !" "i!n4% .a'a -an%#2 T!n+a c)ia% ! n% +%0!a' a+)a #%/'! !" .a()!0!2 P'%c)'! ()! n% 1aa nai! c!'ca ! )#0!2 2 E90i!na !" "i!n4% .%' c%-."!0%  0%-! )n% ! #)# !90'!-%#2 S)80!"%# .a'a ()! n% '%c!n c%n "a '%.a n% !#08'i"2 Inc"5n!#! "i+!'a-!n0! 1acia a!"an0! .a'a !3i0a' ()! "a 0%a""a 0%()! !" a0)!n%2 2 S8()!#! a-/a# -an%# !n $%'-a in!.!ni!n0!  .!'$!c0a2 Pa'a #!ca'#! )n% ! "%# /'a4%#, #%#0!n+a !" "i!n4% c%n "a -an% %.)!#0a  c%n !" -%3i-i!n0% %#ci"an0! !" /'a4% ""!3! !" "i!n4% 1acia !" c%%2 2 V%"0!! !" "i!n4% c%n c)ia% #)!0&n%"% "!%# !" c)!'.%  #8()!#! !" /'a4% %.)!#0% c%n !" /%'! !" "i!n4% #in )#a'2 S!ca' -an%#  /'a4%# c%n )na 0%a""a !#08'i" !#.)8# ! c%-."!0a% !" c!.i""a%2 A" #!ca'#! "a# -an%#, "a !n$!'-!'a -an0i!n! a"!aa ! #) c)!'.% "a c%-.'!#a2 S!ca *nica-!n0! "a# 4%na# #%-!0ia# a" "a3a% ()i'*'+ic%, .'i-!'% "a# -an%#,  !3i0a ()! !#0a# #! c%n0a-in!n c%n !" &'!a .'%9i-a" a "%# c%%#2 L)!+% !#!c1a "a c%-.'!#a2

NOTA: Cn 5r#c-#ncia3 #$ $i#n+ para %ans #s a&sr&#nt# 1 "#s#c6a&$#3 a$/-ns 6spita$#s #%pacan "s pa7s a&sr&#nt#s #n )#+ "# -na ta$$a4 S# c$can #n 5r%a trans)#rsa$ s&r# $a &ata para s#parar$s4 A$ -sar$as3 a&ra

#$ pa,-#t# #stéri$ 1 t%# -n pa7 t#ni#n" c-i"a" "# n /t#ar a/-a4 Mant#n/a $s &ra+s s#para"s "#$ pa73 sé,-#s# -na %an 1 $-#/ #$ &ra+3 "#s#c62n"$ "#sp-és4 Us# #$ s#/-n" pa7 si/-i#n" $s %is%s pass ant#s %#ncina"s para s#cars# $a tra %an 1 &ra+4 C!.i""a% ()i'*'+ic%: A3 -%a' -an%#  /'a4%# c%-."!0a-!n0!, a."ica' !" !0!'+!n0!  "a3a' -an%#  /'a4%#2 B3 !n)a+a'2 C3 )#a' )n c!.i""% % )na !#.%na !#08'i"!# .a'a aai' $'icci;n #)a3!2 D3 )#a' a+)a aici%na" #!+*n #! n!c!#i0! .a'a a)-!n0a' "a !#.)-a2 E3 "i-.ia' )a# c%n )na "i-a !#08'i" % )n .a"i0% ! na'an%2 F3 a."ica' -&# !0!'+!n0!  )#a' %0'% c!.i""% !#08'i" .a'a $'%0a' 0%a# "a# #).!'6ci!# ! -an%#  an0!/'a4%#2 G3 !n)a+a' c%-."!0a-!n0! -an%#  /'a4%#2

NOCIONES SOBRE EL LAVADO DE LAS MANOS

Lavado de manos

Lavado de manos

higiénico médico

quirúrgico

Elemento para el lavado  ?a/;n n%'-a" % an0i#8.0ic% An0i#8.0ic%

Tiempo de lavado

 -in)0%

 -in)0%#

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Dirección del lavado

!%#

Posición de brazos y

C%%# a"0%#, -an%# /aa#

Man%# a"0a#, c%%# /a%#

manos

Ua#, !#.aci%# in0!'i+i0a"!# 

Uso del cepillo en el

O.0a0i3% .a"-a#

lavado

 clarado

A+)a a/)nan0!

A+)a a/)nan0!

!ecado

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T%a""a !#08'i" % ai'! ca"i!n0!

N% inica%

O.0a0i3%

"rema germicida

C%%, .!a" % i#.%#i0i3%  ccionamiento del gri#o C%n 0%a""a !#!c1a/"!

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VESTIR 8  VESTIRSE ESTERIL

VESTIR 8 VESTIRSE ESTERIL

DEFINICION: E" .!'#%na" ()i'*'+ic% !# "a .'inci.a" ca)#a ! c%n0a-inaci;n -ic'%/iana )'an0! "a ci')+5a  .a'a '!)ci' "a# c%nc!n0'aci%n!# ! -ic'%%'+ani#-%# #! '!()i!'! ! )na.'!.a'aci;n c)ia%#a !" !()i.%  !" .!'#%na" n% !#08'i"2 S! 1a !#0aca% )na c%''!"aci;n !n0'! !" n*-!'% ! .!'#%na#, #)# -%3i-i!n0%#  "a can0ia ! /ac0!'ia# 0'an#.%'0aa# .%' !" ai'! !n )n !.a'0a-!n0% ()i'*'+ic%2 Pa'a '!)ci' "a c%n0a-inaci;n )'an0! !" ac0% ()i'*'+ic% #! !/!n #!+)i' .a)0a# !#0'ic0a# '!$!'ia# a" a0a35% ! 0%% !" .!'#%na" !" ()i';$an% =inc")i%# "%# %/#!'3a%'!#>2 En "% .%#i/"!, !" .!'#%na" !" ()i';$an% #! !/!'5a '!#0'in+i' #;"% a "%# in0!+'an0!# !#!ncia"!# .a'a "a an!#0!#ia % a.%% ()i'*'+ic%2  T%a# "a# .!'#%na# ()! in+'!#an !n "a #a"a ! %.!'aci%n!#, #in i-.%'0a' #i #! !#0& '!a"i4an% )na ci')+5a % n%, !/!n !#0a' a.'%.iaa-!n0! a0a3iaa#2 .a'a '!)ci' "a c%n0a-inaci;n -ic'%/iana %'i+inaa a .a'0i' !" .!'#%na", !n "a #a"a ! %.!'aci%n!# #! !/! )0i"i4a' )na in)-!n0a'ia ac%'!2 A" '!#.!c0%, #%n c%n3!ni!n0!# "a# 3!#0i-!n0a# !n %# .i!4a# =a-/%#>, "a ca#aca !/! #!' a -!ia  .)!! i' .%' !n0'% % $)!'a !" .an0a";n2 S)# -an+a# !/!n 0!n!' !" "a'+% #)6ci!n0! .a'a .!'-i0i' !" '!#0'!+a% ! "a# -an%#  an0!/'a4%#2 L%# .an0a"%n!# !/!n 0!n!' )n ci!''! !"�ic% % c%n c%'%n!#2 E" .!'#%na" ()! n% #! "a3a !/! )0i"i4a' c1a()!0i""a# ! -an+a# "a'+a# #%/'! #) 3!#0i-!n0a2 E#0a# c1a()!0a# !/!n !#0a' c!''aa# )'an0! #) !-."!% =c%n /%0%n!# % ci!''!> .a'a !3i0a' !" 'i!#+% ! c%n0a-inaci;n ina3!'0ia ! #).!'6ci!# !#08'i"!# c%n #)# /%'!#2 La in)-!n0a'ia !/! i' a "a "a3an!'5a !n0'! "%# )#%#  ca-/ia'#! #i !#0& 3i#i/"!-!n0! #)cia % 1*-!a .a'a !3i0a' "a 0'an#$!'!ncia ! -ic'%%'+ani#-%# 1acia !" a-/i!n0! ()i'*'+ic%2 E" !-."!% !" a-/% $)!'a !" a-/i!n0! ()i'*'+ic% inc'!-!n0a "a c%n0a-inaci;n -ic'%/iana  !n ca#% ! #!' )0i"i4a% a$)!'a !" ()i';$an%, #! "% !/!'5a c)/'i' c%n +)a'a.%"3% % /a0a ! )n #%"% )#%2 O0'a# 3!#0i-!n0a# ()i'*'+ica# inc")!n "a# c%6a#, c)/'! /%ca, c%/!'0%'!# ! ca"4a%, ca-i#%"in!#  +)an0!#2 E" .!"% !# )n .%'0a%' #i+ni6ca0i3% ! /ac0!'ia#7 c)an% #! "%

!a !#c)/i!'0% ac0*a c%-% 6"0'%  '!c%"!c0a -ic'%%'+ani#-%#2 C%-% "a ca5a !" .!"% 1a !-%#0'a% a$!c0a' "a# 0a#a# ! in$!cci;n ! "a# 1!'ia# ()i'*'+ica#, #! '!()i!'! )na c%/!'0)'a c%-."!0a2 A)n c)an% n% #! 1aa inicia% !" ac0% ()i'*'+ic%, "a# c%6a#  "%# /a'/i%# !/!'5an !#0a' c%"%ca%# !n !" a-/i!n0! ! "a ci')+5a2 La# c%6a# !/!n c)/'i' .%' c%-."!0% 0%a "a ca/!4a  !" .!"% $acia"  !" c)/'! /%ca !/! .'%0!+!' "a /%ca  n% !/!n )0i"i4a'#! c%6a# ()! n% c)/'an !" .!"% .%' !nci-a ! "a# %'!a#  ! "a n)ca2 En !" &'!a ()i'*'+ica #! .)!! )0i"i4a' c)a"()i!' ca"4a% ()! #!a c;-%%2 L%# c%/!'0%'!# !" ca"4a% #! c%"%can .a'a in+'!#a' a" &'!a ()i'*'+ica  #! "%# !/! ""!3a' c)an% #! a/an%na a()!""a .a'a -an0!n!' #) "i-.i!4a2 A" '!0%'na' a" &'!a ()i'*'+ica !/!n c%"%ca'#! n)!3%# c%/!'0%'!#2 L%# c%/!'0%'!# ! ca"4a% !n +!n!'a" #! c%n$!cci%nan c%n -a0!'ia"!# '!)0i"i4a/"!# % !#ca'0a/"!# ()! #%n '!.!"!n0!# !" a+)a  '!#i#0!n0!# a" !#+a#0!2 Si!-.'! ()! #! in+'!#! a )n &'!a !#08'i" #! !/! )0i"i4a' )n c)/'! /%ca c%n$!cci%na% !n -a0!'ia" "i/'! ! 1i"ac1a# ()! c%n0!n+a )n 6"0'% 1i'%$5"ic% !n0'! "a# ca.a# !90!'na#2 S) .'inci.a" $)nci;n !# 6"0'a'  c%n0!n!' "a# +%0i0a# ! -ic'%%'+ani#-%# !9.)"#aa# !#! "a /%ca  na#%$a'in+! )'an0! "a c1a'"a, !#0%'n)%  0%#2 D!/!n a)#0a'#! #%/'! "a /%ca  na'i4  a#!+)'a'#! ! 0a" -an!'a ()! #! .'!3!n+an "a# $)+a#2 La 4%na %'#a" #! a#!+)'a aa.0an% !" /%'! #).!'i%' '!$%'4a% c%n )#0!4a a"'!!%' ! "a na'i42 L%# ca-i#%"in!# ()i'*'+ic%# .)!!n '!)0i"i4a'#!  !#0a' c%n$!cci%na%# c%n -a0!'ia"!# !n0'!0!i%# =.%' "% +!n!'a" a"+%;n> % .)!!n #!' /a0a# !#ca'0a/"!#2 L%# ca-i#%"in!# !#ca'0a/"!# =! )n #%"% )#%> n% #%n !n0'!0!i%#  #! c%n$!cci%nan i'!c0a-!n0! c%n 6/'a# -&# ()! c%n 1i"a%#2 La 0!"a ! a"+%;n ! !n0'!0!i% #)!"0%, 0i.% -)#!"ina  !# ! !-."!% 1a/i0)a" .a'a "%# ca-i#%"in!# '!)0i"i4a/"!#2 E#0a 0!"a a" -%a'#! a()i!'! .!'-!a/i"ia in#0an0&n!a a "a# /ac0!'ia#2 L%# .a%# ! a"+%;n .i-a  ()! 1an #i% 0'a0a%# .a'a "%+'a' )n aca/a% '!.!"!n0! !" a+)a )'a/"! #%n -&# c%#0%#%# .!'% /'inan )na -!%' /a''!'a c%n0'a "a# /ac0!'ia#2 La# 0!"a# ! .%"i8#0!'Ja"+%;n J" !#0&n i#.%ni/"!# c%n !n0'!0!i%# 1!'-80ic%# ()! '!#i#0!n "a .!n!0'aci;n ! "%# -ic'%%'+ani#-%#2

E" "a3a% ! "%# ca-i#%"in!# !n0'!0!i%# !n#anc1a "%# .%'%# ! "a 0!"a i#-in)!n% #) !6cacia c%-% /a''!'a an0i-ic'%/iana2 L%# -a0!'ia"!# ! "a# /a0a# n% !n0'!0!ia# inc")!n %"!6na#  .%"i8#0!'!#2 E" n*-!'% ! -ic'%%'+ani#-%# ai#"a%# !n "%# a-/i!n0!# ()i'*'+ic%# !# -!n%' c)an% #! )0i"i4an -a0!'ia"!# n% !n0'!0!i%# !#ca'0a/"!#2

VESTIMENTA COM0LETA: E$ -s "#$ /rr: E9i#0!n +%''%# ! 0!"a ='!)0i"i4a/"!#>  ! .a.!" =!#!c1a/"!#>2 S! )0i"i4an .'inci.a"-!n0! !n "%# ()i';$an%#, !n "a# )nia!# c%n .aci!n0!# !n #i0)aci;n c'50ica =0'a#."an0a%#, in-)n%!.'i-i%#, !0c2>  !n "%# ai#"a-i!n0%# !#0'ic0%#2 D!/! c)/'i' 0%% !" .!"%2 En !" ca#% ! 0!n!' !" .!"% "a'+%, '!c%+!'"% .a'a !#.)8# c)/'i'"% c%n !" +%''% L%# +%''%# ! 0!"a ""!3an )na# cin0a# ()! #! a0an !n "a .a'0! .%#0!'i%' ! "a ca/!4a2 L%# ! .a.!" ""!3an )n !"�ic% ()! #! a)#0a a" c%n0%'n% ! "a ca/!4a2

E$ -s "# ca$+as: La# ca"4a# #! )0i"i4an .a'a c)/'i' !" ca"4a%2 E9i#0!n  0i.%#:  ! 0!"a ='!)0i"i4a/"!#>7  ! ."�ic% =!#!c1a/"!#>2 H% !n 5a "a# ! 0!"a .'&c0ica-!n0! !#0&n !n !#)#%2

E$ -s "# %ascari$$a: E9i#0!n 3a'i%# 0i.%# ! -a#ca'i""a#2 La# ! 0!"a #%n '!)0i"i4a/"!#, -i!n0'a# ()! "a# ! .a.!" #%n !#!c1a/"!# =!9i#0!n i$!'!n0!# -%!"%#>2 Ac0)a"-!n0! !9i#0!n -a#ca'i""a# ()! 3an .'%3i#0a# ! )n ."�ic% .'%0!c0%' .a'a "%# %%#2 S! )0i"i4an ! a"0% 'i!#+%2

La -a#ca'i""a c%''!c0a-!n0! c%"%caa !/! c)/'i' "a na'i4, "a /%ca  !" -!n0;n2 S! !/! ca-/ia' .%' %0'a #i!-.'! ()! #! 1)-!!4ca .%' !" )#%, a ()! c%n "a 1)-!a .i!'! #) !6cacia c%-% /a''!'a ! ai#"a-i!n0%2 E" )#% ! -a#ca'i""a !# %/"i+a0%'i% !n "a# in0!'3!nci%n!# ()i'*'+ica#, c)an% !" .aci!n0! 0!n+a ()!-a)'a# !90!n#a#, !n "a# c)'a# ! 1!'ia#, !n "%# c)ia%# ! !n$!'-!'5a a .aci!n0!# c%n !n$!'-!a!# c%n0a+i%#a#  !n 0%%# a()!""%# ca#%# !n ()! #! '!()i!'! )n ai#"a-i!n0% '!#.i'a0%'i% .a'a !3i0a' "a 0'an#-i#i;n ! in$!cci%n!# .%' 35a a8'!a2 En0'! "a# n%'-a# ()! #! !/!n %/#!'3a' !n "a c%"%caci;n ! "a -a#ca'i""a, !#0&n "a# #i+)i!n0!#: < La# -an%# 1an ! !#0a' "a3aa# an0!# ! c%"%ca'#! "a -a#ca'i""a < E3i0a' 0%#!' c%n "a -a#ca'i""a .)!#0a < Ha/"a' "% i-.'!#cini/"! c%n "a -a#ca'i""a .)!#0a .%'()!, 0an0% a" 0%#!' c%-% a" 1a/"a', #! $a3%'!c! "a a.a'ici;n ! 1)-!a < N)nca #! !/! c%"%ca' "a -a#ca'i""a #in c)/'i' "a na'i4 < D!/! a)#0a'#! a "a ca'a "% -!%' .%#i/"!, -!ian0! cin0a# % +%-a#

E$ -s "# $as /a5as "# prt#cci'n: S! !#0& +!n!'a"i4an% !" )#% ! +a$a#  .an0a""a# c%-% .'%0!cci;n ! "a -)c%#a c%n)n0i3a"2 S! )#an "a# +a$a#  .an0a""a# c)an% #! )0i"i4an 08cnica# ()! .'%)c!n a!'%#%"!#, c)an% 1a 'i!#+% ! #a".ica)'a# ! #an+'! % ! "5()i%# %'+&nic%#2 En "a 0!'a.8)0ica c%n "&#!', !n "a# !"!c0'%c%a+)"aci%n!#, a" -ani.)"a' ni0';+!n% "5()i%  #i!-.'! ()! #! .'%)4can #)#0ancia# 3%"&0i"!#, .a'05c)"a# 3i'a"!#  -ic'%+%0a# ! #an+'!, !# '!c%-!na/"! !" )#% ! +a$a#  .an0a""a# .a'a !3i0a' in$!cci%n!#2

OBJETIVOS: < V!#0i'  3!#0i'#! !#08'i"2 < E3i0a' "a i#!-inaci;n ! -ic'%%'+ani#-%#2 < E3i0a' "a .'!#!ncia ! .a0;+!n%#2 < P'%0!+!' a" .aci!n0!2 < P'%0!+!' a" !()i.% ! #a")2

TERMINOLOG9A: Dis#%inaci'n: E#.a'ci-i!n0%, i#.!'#i;n ! a"+% .%' i#0in0%# ")+a'!#2 Micrr/anis%: Un -ic'%%'+ani#-%, 0a-/i8n ""a-a% -ic'%/i% ) %'+ani#-% -ic'%#c;.ic%, !# )n #!' 3i3% ()! #;"% .)!! 3i#)a"i4a'#! c%n !" -ic'%#c%.i%2 La ci!ncia ()! !#0)ia a "%# -ic'%%'+ani#-%# !# "a -ic'%/i%"%+5a2 S%n %'+ani#-%# %0a%# ! ini3i)a"ia ()! .'!#!n0an, a i$!'!ncia ! "a# ."an0a#  "%# ani-a"!#, )na %'+ani4aci;n /i%";+ica !"!-!n0a"2 En #) -a%'5a #%n )nic!")"a'!#, a)n()! !n a"+)n%# ca#%# #! 0'a0! ! %'+ani#-%# c!n;0ic%# c%-.)!#0%# .%' c8")"a# -)"0in)c"!aa#, % inc")#% -)"0ic!")"a'!#2

Bca: La /%ca, 0a-/i8n c%n%cia c%-% ca3ia /)ca" % ca3ia %'a", !# "a a/!'0)'a c%'.%'a" .%' "a ()! #! in+i!'!n "%# a"i-!n0%#2 E#0& )/icaa !n "a ca/!4a  c%n#0i0)! !n #) -a%' .a'0! !" a.a'a0% !#0%-a0%+n&0ic%,  a#5 c%-% "a .'i-!'a .a'0! !" #i#0!-a i+!#0i3%2 La /%ca #! a/'! a )n !#.aci% .'!3i% a "a $a'in+! ""a-a% ca3ia %'a", % ca3ia /)ca"2

Bata:

P'!na ! 3!#0i' 1%"+aa, c%n -an+a#  a/i!'0a .%' !"an0!, ()! #! )#a a" "!3an0a'#!  .a'a !#0a' .%' ca#a2

Vir-s: E# )na !n0ia in$!cci%#a -ic'%#c;.ica ()! #;"% .)!! -)"0i."ica'#! !n0'% ! "a# c8")"a# ! %0'%# %'+ani#-%#2 L%# 3i')# in$!c0an 0%%# "%# 0i.%# ! %'+ani#-%#, !#!ani-a"!#  ."an0a# 1a#0a /ac0!'ia#  a'()!a#2 L%# 3i')# #%n !-a#ia% .!()!%# .a'a .%!' #!' %/#!'3a%# c%n "a a)a ! )n -ic'%#c%.i% ;.0ic%, .%' "% ()! #! ic! ()! #%n #)/-ic'%#c;.ic%#2 L%# 3i')# #! 1a""an !n ca#i 0%%# "%# !c%#i#0!-a# ! "a  Ti!''a  #%n !" 0i.% ! !n0ia /i%";+ica -&# a/)nan0!2 E" !#0)i% ! "%# 3i')# '!ci/! !" n%-/'! ! 3i'%"%+5a, )na 'a-a ! "a -ic'%/i%"%+5a2

Est#ri$i"a": La !#0!'i"ia !# )na c)a"ia a0'i/)i/"! a a()!""a# .!'#%na# ) %0'%# %'+ani#-%# /i%";+ic%# ()! n% #! .)!!n '!.'%)ci', /i!n #!a !/i% a" -a" $)nci%na-i!n0% ! #)#;'+an%# #!9)a"!# % a ()! #)# +a-!0%# #%n !$!c0)%#%#2 La# ca)#a# ! "a !#0!'i"ia #%n i3!'#a#  3a'5an !n $)nci;n !" #!9%2 E9i#0! %0'a ac!.ci;n !" 08'-in% !#08'i" ()! #! '!6!'! a "a# c%nici%n!# a-/i!n0a"!#, !n "a# c)a"!# n% 1a c'!ci-i!n0% ! -ic'%%'+ani#-%# ain%#2

Bact#ria: La# /ac0!'ia# #%n -ic'%%'+ani#-%# )nic!")"a'!# ()! .'!#!n0an )n 0a-a% ! a"+)n%#-ic';-!0'%#  ! "a'+% =!n0'! ,   -, .%' "% +!n!'a">  i3!'#a# $%'-a# inc")!n% !#$!'a#, /a''a#  18"ic!#2 La# /ac0!'ia# #%n .'%ca'i%0a# , .%' "% 0an0%, a i$!'!ncia

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ACCIONES DE ENFERMER9A:

< I!n0i6ca' !" 3!#0)a'i% a!c)a%  ! "a 0a""a a!c)aa2 < V!#0i' a!c)aa-!n0! a" .!'#%na" ()! "% n!c!#i0!2 < R!a"i4a' 0%% a!c)aa-!n0! .a'a !3i0a' !''%'!#  .'%3%ca' !" /'%0! ! /ac0!'ia#2

0RINCI0IOS 0ARA LOGRAR LA ACCIN: < Q)! !" .'%$!#i%na" ! !n$!'-!'5a c%n%4ca "a# 08cnica# ! 3!#0i'  3!#0i'#! !#08'i" .a'a !3i0a' "a .'%"i$!'aci;n ! -ic'%%'+ani#-%#2 < La .'!.a'aci;n ! 0%% !()i.% ()i'*'+ic% n!c!#a'ia-!n0! !3i0a !" inc'!-!n0% ! n*-!'% ! -ic'%%'+ani#-%# !n !" a-/i!n0! ()i'*'+ic%2 < E" c)ia% c%''!c0% ! "a '%.a !#08'i" an0! "%# a+!n0!# .a0;+!n%# .!'-i0! .'!3!ni' "a 0'an#-i#i;n ! -ic'%%'+ani#-%#2 < La3a'#! "a# -an%# an0!# ! a/'i' !" .a()!0! ! "a /a0a < D!#%/"a' "a /a0a #in 0%ca' !" !90!'i%' c%n "a# -an%#, a)n()! a 3i!n!n %/"aa# ! $%'-a ()! #! !3i0a !#0%2 A" !#%/"a'"a #! 1a ! .'%c)'a' ()! n% 0%()! !" #)!"% % c)a"()i!' %/!0%2 < Q)i0a'#! "a /a0a !3i0an% 0%ca' !" )ni$%'-!2 La /a0a !n !#0! -%-!n0%, #;"% #! 0%ca .%' $)!'a2 Hac!' )n '%""% c%n !""a ! in0'%)ci'"a !n )na /%"#a ! ."�ic%, a #!a .a'a #) !"i-inaci;n % .a'a #) "a3a% % !#0!'i"i4aci;n, #!+*n #!a !#!c1a/"! % ! 0!"a2

0RINCI0IOS 0ARA EVITAR LA 0ATOLOG9A ADICIONAL:

< E" .!'#%na" !" #a";n !/!'& )#a' "a 3!#0i-!n0a a.'%.iaa .a'a !#0a &'!a  ! i+)a" $%'-a n% )#a'& "a 3!#0i-!n0a $)!'a ! 8#0!2

< E" 0a.a/%ca % na#%/)c% !# ! )#% %/"i+a% !n !" #a";n ! %.!'aci%n!#, .a'a '!)ci' a" -5ni-% "a c%n0a-inaci;n ! -ic'%%'+ani#-%# .'%c!!n0!# ! "a /%ca  "a na#%$a'in+!2 < E# n!c!#a'i% !3i0a' 0%a !#.i'aci;n $%'4aa .%' "a c%n3!'#aci;n, "a 'i#a, !" !#0%'n)%  "a 0%#, .)!# !#0%# !#$)!'4%# !.%#i0an -ic'%%'+ani#-%# aici%na"!# #%/'! "a -a#ca'i""a, "a c)a" .i!'! +'an .a'0! ! #) !6cacia c)an% #! 1)-!!c!7 !" na#%/)c% !/! !#0a' /i!n c%"%ca%, c)/'i!n% na'i4  /%ca2 < E" +%''% !/! c)/'i' c%-."!0a-!n0! !" ca/!""% =!#! "a ca/!4a 1a#0a "a "5n!a !" c)!""%>, .a'a !3i0a' ()! cai+an #%/'! "%# ca-.%# !#08'i"!# .!"%#, +anc1i0%# % .a'05c)"a# ! ca#.a2 < L%# 4a.a0%# !/!n #!' $&ci"!# ! "i-.ia'7 #%/'! !""%# #! c%"%ca'&n /%0a# ! 0!"a, "a# c)a"!# #! )#a'&n )na #%"a 3!4  #! ()i0a'&n a" a/an%na' !" &'!a '!#0'in+ia2 < E" -an!% c%''!c0a-!n0! !" 3!#0i% ()i'*'+ic%, +a'an0i4a "a .'%0!cci;n a" .aci!n0! c%n0'a %0'a# !n$!'-!a!#2 < La !#0!'i"i4aci;n, .'%.%'ci%na a" .aci!n0!  a" .!'#%na" )n #!+)'% ! 3ia2 < E" -an!a' 0%% c%n a#!.#ia a)a a" .aci!n0! .a'a #) '!1a/i"i0aci;n2

0RINCI0IOS 0ARA EVITAR INCOMODIDAD AL 0ACIENTE4 < A" '!a"i4a' )n .'%c!i-i!n0% ()i'*'+ic% an0i#8.0ic% #! 0'a0a ! !3i0a' !" .'%c!#% ! )na !n$!'-!a  .%' c%n#i+)i!n0! "a inc%-%ia !" .aci!n0!2 < A" .'%.%'ci%na' )na a!c)aa .'%0!cci;n a" .aci!n0! c%n0'a %'+ani#-%# .a0;+!n%# in3a#%'!#, #! $aci"i0a ic1a '!c).!'aci;n =c)a"()i!'a>2

3 "a .'!.a'aci;n !" .aci!n0!  !" .!'#%na" )'an0! "a ci')+5a, !# "a /a#! $)na-!n0a" !" '!c1a4% ! "%# -ic'%%'+ani#-%#

EQUI0O NECESARIO:  V!#0i-!n0a# ()i'*'+ica#  Ca-i#%"in!# ()i'*'+ic%#  C%6a#  C)/'! /%ca  C%/!'0%'!# ! ca"4a%  Ca-i#%"in!#  G)an0!#

0ROCEDIMIENTO: E" ca-i#%"5n  "%# +)an0!# !/!n #!' .'!#!n0a%# !n $%'-a a!c)aa .a'a #) $&ci"  '&.ia )0i"i4aci;n2 L%# ca-i#%"in!# #! !#0!'i"i4an !n: 0a-/%'!# ! !#0!'i"i4aci;n % !n .a()!0!#2 D! ac& "%# 0%-a caa -i!-/'% !" !()i.% ()i'*'+ic% !n !" -%-!n0% ! #) c%"%caci;n ")!+% ! 0!'-ina' !" "a3a%  #!ca% ! -an%#2 E9i#0!n 3a'ia# $%'-a# ! ac%nici%na'"%# !n "%# 0a-/%'!#2

D#scri&ir#%s "s "# #$$as:  En "a .'i-!'a #! c%"%ca i'!c0a-!n0! !n !" 0a-/%'2  S! #%#0i!n! !" ca-i#%"5n .%' !" c)!""%  #! "% %/"a .%' "a -i0a ! "a !#.a"a, c%n !" !90!'i%' 1acia a!n0'%, c)ian% ()! "a# -an+a# ()!!n !90!nia#2

 S! "% c%"%ca a#5 %/"a% #%/'! )na -!#a, 3%"3i8n%"% a %/"a' a "% "a'+% )na 3!4 -  La# 0i'i""a# !9i#0!n0!# a 0%% "% "a'+% #! %c)"0an !n "%# %/"!c!#, ()!an% "i/'!# naa -&# ()! "a#  #).!'i%'!# !" c)!""%2  Una 3!4 a#5, c%-i!n4a a !n'%""a'#! !" ca-i#%"5n .%' #) !90'!-% in$!'i%', a%.0an% )na $%'-a ci"5n'ica, c%n "a# %# 0i'i""a# !" c)!""% "i/'!#2

La tra 5r%a3  S! #%#0i!n! !" ca-i#%"5n .%' !" c)!""%  #! "% %/"a .%' "a -i0a ! "a !#.a"a,  c%n !" !90!'i%' 1acia a!n0'%, c)ian% ()! "a# -an+a# ()!!n !90!nia#2  S! "% c%"%ca a#5 %/"a% #%/'! )na -!#a, 3%"3i8n%"% a %/"a' a "% "a'+% )na 3!4 -  La# 0i'i""a# !9i#0!n0!# a 0%% "% "a'+% #! %c)"0an !n "%# %/"!c!#, ()!an% "i/'!# naa -&# ()! "a#  #).!'i%'!# !" c)!""%2  L)!+% #! %/"a !n 4i+4a+  #! "%# !n3)!"3! !n .a.!" -a!'a, .a'a 6na"-!n0! c%"%ca' !n !" 0a-/%' ! !#0!'i"i4aci;n2 "olocación de la bata estéril por la técnica cerrada$

2 In0'%)4ca "a -an% !n !" .a()!0! !#08'i"  "!3an0! "a /a0a %/"aa i'!c0a-!n0! 1acia a''i/a2 2 A"8!#! ! "a -!#a 1acia )n &'!a "i/'! .a'a %/0!n!' )n -a'+!n ! #!+)'ia -a%' a" 3!#0i'#!2 2 S%#0!n+a "a /a0a %/"aa  c%n #)-% c)ia% 0%-! !" /%'! !" c)!""%2 2 C%n a-/a# -an%#, 0%-! "a .a'0! in0!'i%' !"a /a0a !/a% !" /%'! !" c)!""%  !#;/"!"a #)a3!-!n0!, c%n#!'3an% "a .a'0! in0!'na 1acia !" c)!'.%2 N% 0%()! c%n "a# -an%# "a .a'0! !90!'i%' ! "a /a0a2

2 C%n "a# -an%# a" ni3!" ! "%# 1%-/'%#, !#"ic! #i-)"0&n!a-!n0! a-/%# /'a4%# !n0'% ! "a# -an+a# K2 La !n$!'-!'a ci'c)"an0! 0i'a ! "a /a0a .a'a c%"%ca'"a #%/'! "%# 1%-/'%# a" in0'%)ci' "a# -an%# !n !" in0!'i%' 1a#0a "a c%#0)'a ! "a# -an+a#  /'a4%#, !an% "a# -an%# !n0'% ! "%# .)%# !"�ic%#2 D!#.)8#, "a an)a % #)!0a a" ni3!" !" c)!""%  "a cin0)'a 0%can% "a .a'0! !90!'i%' *nica-!n0! %n! !#0&n c%"%caa# "a# cin0a#2

NOTA: Si $a &ata #s #n)$)#nt#3 #$ p$i#/-# #stéri$ ,-# c-&r# $a #spa$"a n s# tca 6asta ,-# $a p#rsna t#r%in# "# c$car$# $a &ata 1 $s /-at#s4 La &ata #stéri$ p-#"# an-"ars# "# "i5#r#nt#s %an#ras: a> C%n "a# -an%# !n+)an0aa#, !#a0! "a# cin0a# % #)!"0! !" #!+)'% !n "a .a'0! !"an0!'a % !'!c1a ! "a /a0a2 D8"! "a cin0a !" "a% !'!c1% a)n -i!-/'% !" .!'#%na" ()i'*'+ic% !#08'i" ()! .!'-an!4ca !n !" ()i';$an%2 D!! )n -a'+!n ! #!+)'ia  3%"08!#! 1acia !" "a% i4()i!'% c)/'i!n% .%' c%-."!0% "a !#.a"a c%n !" ."i!+)! !90!ni% ! "a /a0a2 T%-! "a cin0a !" a)an0!  an)! "a# cin0a# !n !" "a% i4()i!'%2 /> Si !# )#0! "a .'i-!'a .!'#%na !n 3!#0i'#!  c%"%ca'#! "%# +)a0!#,  n% c)!n0a !n !#! -%-!n0% c%n "a a)a ! )n in#0')-!n0% !#08'i" "a cin0a ! "a% !'!c1% )#an%, .%' !!-."%, "a# .in4a# ! A""i#, .!'% n)nca )na .in4a % +'a.a 1!-%#0&0ica2 C%n #)-% c)ia%, !"! !" in#0')-!n0% a "a !n$!'-!'5a ci'c)"an0!2 Mi!n0'a# !""a .!'-an!c! in-;3i", 3%"08!#! 1acia !" "a% i4()i!'%, c*/'a#! "a !#.a"a  0%-! "a cin0a c%n "a -an%2 La !n$!'-!'a ci'c)"an0! ()i0a  !#!c1a !" in#0')-!n0%2 An)! "a# cin0a# !n !" "a% i4()i!'%2 c> A"+)na# /a0a# !#!c1a/"!# 0i!n!n c)/i!'0a "a .)n0a ! "a cin0a c%n )na 0i'a !#!c1a/"!2 D8"! "a 0i'a a "a !n$!'-!'a ci'c)"an0!, 0!ni!n% c)ia% ! n% c%n0a-ina'#! "a# -an%#2 V%"08!#! 1acia !" "a% %.)!#0%, c!''an% "a /a0a2 T%-! "a cin0a  c%n#!'3! a ci!'0a i#0ancia "a .)n0a2 La !n$!'-!'a ci'c)"an0! !!'c! .'!#i;n !n "a 0i'a, !#.'!n! "a .)n0a a)n !#08'i" ! "a cin0a  "a !#!c1a2 An)! "a cin0a .%' "a .a'0! !"an0!'a % a "%# "a%# c%-% #! inica2

D!#!c1! "a /a0a !n ca#% ! ()! !n $%'-a ina3!'0ia #! !a ca!' a" #)!"% "a .a'0! #).!'i%'2 N)nca 3%"0!! )na .i!4a ! '%.a !#08'i", #i !" !90'!-% n% c%''!#.%ni!n0! ca! 1acia !" .i#%2 La in#0')-!n0i#0a 0%-a "a /a0a .%' !/a% !" /%'! !" c)!""%7 "a "!3an0a i'!c0a-!n0! 1acia a''i/a .a'a n% 0%ca' !" /%'! ! "a c)/i!'0a2 O/#8'3!#! ()! "a .a'0! !#08'i" ! "a !n3%"0)'a #%/'! "a -!#a2 La /a0a !#0& %/"aa ! !n0'% 1acia a$)!'a =a" '!38#>2 A" c%"%ca'#! "a /a0a, "a in#0')-!n0i#0a !#1ac! "%# ."i!+)!# a+i0&n%"a #)a3!-!n0!, ")!+% !#"i4a "%# /'a4%# .%' "a# -an+a# #in 0%ca' c%n "a# -an%# !#n)a# "a .a'0! !90!'i%' ! "a /a0a !#08'i" La !n$!'-!'a ci'c)"an0! a)#0a "a /a0a ! "a in#0')-!n0i#0a2 In0'%)c! #)# -an%# 1a#0a "a# c%#0)'a# ! "a# -an+a#  0i'a ! !""a#, !an% "a# -an%# ! a()8""a !n0'% ! "%# .)%# !"�ic%# .a'a ()! #! c%"%()! "%# +)an0!# -!ian0! !" -80%% c!''a%2 La !n$!'-!'a ci'c)"an0! an)a "a# cin0a# c%"%caa# !n "a .a'0! .%#0!'i%' ! "a /a0a  ci!''a !" #)!0a%' a" ni3!" !" c)!""%2

C$caci'n "# &ata pr #$ %ét" a&i#rt: ;4 In0'%)4ca "a -an% !n !" .a()!0! !#08'i"  "!3an0! "a /a0a !#08'i" i'!c0a-!n0! 1acia a''i/a2

4  C%n a-/a# -an%#, 0%-! "a .a'0! in0!'i%' ! "a /a0a !/a% !" c)!""%, !#;/"!"a #)a3!-!n0!  c%n#!'3! "a .a'0! in0!'na 1acia #) c)!'.%2

?4 S%#0!n+a "a# -an%# a" ni3!" ! "%# 1%-/'%#  !#"ic! #i-)"0&n!a-!n0! a-/a# -an%# .%' !" %'i6ci% in0!'i%' ! "a# -an+a#, #in 0%ca' c%n !""a# "a .a'0! !90!'i%'2

@4 La !n$!'-!'a ci'c)"an0! -!0! "a# -an%# !n0'% ! "a /a0a .a'a c%+!' "a# c%#0)'a# ! "a# -an+a#,  0i'a ! !#0a# #%/'! "a# -an%# 1a#0a "a# -)!ca#2 L)!+% "a .a'0! .%#0!'i%' ! "a /a0a #! ci!''a !n "a n)ca  cin0)'a c%n a0a)'a# % #)!0a%'!#, 0%can% !" !90!'i%' !"a /a0a #%"% !n "a# a0a)'a# % #)!0a%'!# !" %'#%2 La !n$!'-!'a ci'c)"an0! an)a "a# cin0a# c%"%caa# !n "a .a'0! .%#0!'i%' ! "a /a0a ! "a in#0')-!n0i#0a7 -80%% a/i!'0%2 O/#!'3! ()! "a# -an%# ()!an $)!'a ! "%# .)%# !"�ic%#2

C$caci'n "# &ata para #$ p#rsna$ %é"ic: Un -i!-/'% !" !()i.% c%n /a0a  +)an0!# !#08'i"!# .)!! a)a' a %0'% a c%"%ca'#! "a /a0a  +)an0!# #i+)i!n% !#0%# .a#%#: 2 A/'a !" "i!n4% .a'a -an%#  c%";()!"% #%/'! "a -an% !" ci')an% #in 0%ca'"%2 2 T%-! "a /a0a .%' !" c)!""%  !#;/"!"a c%n c)ia%2 2 Man0!n+a "a# -an%# !n !" !90!'i%' ! "a /a0a /a% )na c)/i!'0a .'%0!c0%'a !n !" c)!""%  1%-/'%#7 .'!#!n0! a" -8ic% !" in0!'i%' ! "a /a0a .a'a ()! !#"ic! #)# /'a4%#, .%' "%# %'i6ci%# ! "a# -an+a#2 2 S)!"0! "a /a0a2 E" ci')an% c%n#!'3a "%# /'a4%# !90!ni%# -i!n0'a# "a !n$!'-!'a ci'c)"an0! 0i'a ! "a /a0a .%' "%# 1%-/'%#  a)#0a "a# -an+a# .a'a ()! "%# .)%# ()!!n !n #) ")+a'2 A" 1ac!' !#0%, !""a 0%ca #;"% "a .a'0! in0!'i%' a" 0i'a' ! "a# c%#0)'a# ! "a -an+a2

Ca%&i "# &ata "-rant# $a int#r)#nci'n ,-ir.r/ica: En %ca#i%n!#, )na /a0a c%n0a-inaa !/! ca-/ia'#! )'an0! "a in0!'3!nci;n ()i'*'+ica2 La !n$!'-!'a ci'c)"an0! !#a0a "a# cin0a# !" c)!""%  "a cin0)'a2 T%-a "a

/a0a .%' "%# 1%-/'%#  0i'a ! !""a .a'a ()i0&'#!"a a" ci')an%2 D!/! #i!-.'! ()i0a' "a /a0a .'i-!'%7 "%# +)an0!# #! ()i0an !-."!an% "a 08cnica +)an0! a +)an0!  !#.)8#, .i!" a .i!"2 C)an% #%"% "a# -an+a# #! c%n0a-inan, .)!!n .%n!'#! -an+a# !#08'i"!# #%/'! "a# -an+a# c%n0a-inaa#2

0ONERSE  8  0ONER GUANTES

0ONERSE 8 0ONER GUANTES DEFINICIN: E" )#% ! +)an0!# !#08'i"!# $%'-a .a'0! ! )n c%n)n0% ! -!ia# ()! .'!3i!n!n  c%n0'%"an "a# in$!cci%n!# in0'a1%#.i0a"a'ia# ()! 0i!n!n c%-% %/!0i3% i#-in)i' "a 0'an#-i#i;n ! -ic'%%'+ani#-%# ! "a# -an%#, !" .!'#%na" a" .aci!n0! )'an0! "%# .'%c!i-i!n0%# in3a#i3%# ()! n!c!#i0an ! 08cnica !#08'i", .%' "% 0an0% "a c%''!c0a c%"%caci;n  -ani.)"aci;n a#!+)'an "a 08cnica a#8.0ica  "a ca"ia ! a0!nci;n !" .aci!n0!2 L%# +)an0!# !#08'i"!#: !" +)an0! ! "&0!9, ()! !#0&n !n c%nici%n!# ! )#a'#! !n &'!a c'i0ica .%' #!' i-.%'0an0!# .a'a "a .'%0!cci;n !" .aci!n0!  !" 0'a/aa%' ! #a") a ()! .'%3i!n!n ! $&/'ica  #%n ! )n #%"% )#%2 S) c%nici;n ! !#08'i" #i+ni6ca ()! n% .%#!! nin+*n 0i.% ! 3ia -ic'%/iana % c%n0a-inan0!  .%' "% 0an0% ! 'i!#+% .a'a !" .aci!n0!2 En "a .'!3!nci;n  c%n0'%" ! "a# in$!cci%n!# in0'a1%#.i0a"a'ia# #! !nc)!n0'a in#!'0% !" )#% ! +)an0!# !#08'i"!# !" c)a" !# )n .'%c!i-i!n0% $'!c)!n0! !-."!a% !n .'%c!i-i!n0%# in3a#i3%# % ()i'*'+ic%#  #) %/!0i3% !# a#!+)'a' "a 08cnica a#8.0ica, 0!ni!n% !n c%n#i!'aci;n ()! !" )#% ! +)an0!# n% '!!-."a4a !" "a3a% ! -an%#2

L%# +)an0!# 3i!n!n %/"a%# a" .)% .a'a $aci"i0a' ()! #! "%# .%n+an #in c%n0a-ina'"%#2 A" .%n!'#! "%# +)an0!# !#0!'i"i4a%#, 1a ()! a+a''a' !" .'i-!' +)an0! *nica-!n0! .%' "a .a'0! %/"aa2 S! !/! 0%ca' !" #!+)n% +)an0! *nica-!n0! c%n !" %0'% +)an0! !#0!'i"i4a%2

OBJETIVOS: < E"i-ina' "a .i!" c%-% .%#i/"! a+!n0! c%n0a-inan0!, c'!an% )na /a''!'a !n0'! "a# &'!a# #8.0ica#  a#8.0ica#2 < I!n0i6ca' -!ian0! "a %/#!'3aci;n "%# .a#%# ! "a c%"%caci;n ! "%# +)an0!# !#08'i"!#2 < R!c%n%c!' "a i-.%'0ancia ! caa .a#% in3%")c'a% !n ic1% .'%c!i-i!n0% !n !" 89i0% ! "a 08cnica a#8.0ica2 < R!a"i4a' !" .'%c!i-i!n0% c%n 08cnica a#8.0ica i'i+i% a ac0i3ia!# !#.!c56ca#2 < S!a"a' "a i-.%'0ancia ! "a 08cnica a#8.0ica !n "a c%"%caci;n ! "%# +)an0!# a#%cia% a "%# .'%c!i-i!n0%# ()! !""%# 1a'&n2

ACCIONES DE ENFERMERIA: < E"!+i' !" 0a-a% a!c)a% ! "%# +)an0!#2 < E#0a' a0!n0% !n !" -%-!n0% ! c%"%ca'#! "%# +)an0!#2 < U0i"i4a' !#0'ic0a# 08cnica# ! a#!.#ia2 < A!c)a% "a3a% ! -an%# an0!# ! c%"%ca'#! "%# +)an0!# < A!c)a% "a3a% ! -an%# !#.)8# ! 1a/!'#! c%"%ca% "%# +)an0!#2

0RINCI0IOS 0ARA LOGRAR LA ACCIN:

La in0!+'ia ! .i!"  -)c%#a# !# "a .'i-!'a "5n!a ! !$!n#a !" c)!'.% c%n0'a "a in3a#i;n ! a+!n0!# in$!cci%#%#2 > E3i0a' "a c%n0a-inaci;n ! "%# +)an0!#2 > P%n!'#!  .%n!' "%# +)an0!# !#08'i"!# c%''!c0a-!n0! .a'a !3i0a' "a c%n0a-inaci;n ! -ic'%%'+ani#-%#2 > P'%0!+!' "a #!+)'ia !" .aci!n0!  ! #5 -i#-% an0! "%# %'+ani#-%# .a0;+!n%#2

0RINCI0IOS 0ARA EVITAR 0ATOLOG9A ADICIONAL: Pa'a a0!n!' c%n #!+)'ia a "%# .aci!n0!# !# !#!ncia" ()! !" !()i.% !#08 "i-.i%2 > P'%.%'ci%na' a 0%% .!'#%na" !" -a0!'ia" n!c!#a'i% .a'a !3i0a' "a .!n!0'aci;n ! )n a+!n0! ca)#a" ! a"+)na !n$!'-!a2 > U0i"i4a' c%''!c0a-!n0! "%# +)an0!# !#08'i"!# .a'a !3i0a' "a !n0'aa ! "%# -ic'%/i%# a" &'!a ()i'*'+ica2 > S!+)i' "%# .'%c!i-i!n0%# n!c!#a'i% a" .%n!'#! "%# +)an0!# .a'a !3i0a' "a .'%.a+aci;n ! "%# -ic'%%'+ani#-%#2

0ROCEDIMIENTO: C% "#s#n)$)#r $s /-ant#s: A3 '%-.!' !" #!""% !" !n3a#!, %/"a' "a !#()ina ! "a .a'0! #).!'i%' 0'a#!'a  a/'i'"a2 B3!90!n!' "a -an% a"'!!%' !" ca-.% !#08'i" .a'a !#%/"a' "a #i+)i!n0! .a'0! ! "a !n3%"0)'a c%+i!n% !" "a% !90!'n% ! "a -i#-a2 C3 '!0i'a' !" .';9i-% %/"!4 !n $%'-a #i-i"a'2 D3!9.%n!' !" c%n0!ni% !" .a()!0!2

C$caci'n "# /-ant#s pr $a técnica c#rra"a:

2 C%n "a -an% i4()i!'a, !n0'% !" .)% ! "a -an+a, 0%-! !" +)an0! !'!c1% ! "a !n3%"0)'a in0!'na !" .a()!0! c%n !" .)% !" +)an0! %/"a%2 2 E90i!na !" an0!/'a4% !'!c1% c%n "a ca'a .a"-a' 1acia a''i/a2 C%"%()! "a ca'a .a"-a' !" +)an0! $'!n0! a "a ca'a .a"-a' ! "a -an% !'!c1a7 a.'i!0! c%n !#0a !" /%'! #).!'i%' !" .)% #%/'! "a ca'a .a"-a'2 En .%#ici;n c%''!c0a "%# !%# !" +)an0! a.)n0an 1acia )#0!7 ()!a !" .)"+a' 1acia "a !'!c1a  "a ca'a .a"-a' 1acia a/a%2 2 T%-! "a .a'0! .%#0!'i%' !" .)% c%n "a -an% i4()i!'a7 !#;/"!"% #%/'! "a .a'0! in$!'i%' ! "a -an+a  -an% !'!c1a#2 E" .)% !" +)an0! !#0& a1%'a c%"%ca% #%/'! !" .)% !"�ic%, -i!n0'a# "a -an% !#0a a)n !n0'% ! "a -an+a2 2 T%-! "a .a'0! #).!'i%' !" +)an0! !'!c1%  -an+a #)/ac!n0! c%n "a -an% i4()i!'a c)/i!'0a2 Ti'! !" +)an0! #%/'! "%# !%# 1a#0a ()! 8#0! c)/'a .%' c%-."!0% !" .)% !"�ic%2 2 C%";()!#! !" +)an0! !n "a -an% i4()i!'a ! "a -i#-a $%'-a )#an% "a -an% !n+)an0aa .a'a 0i'a' !" +)an0! i4()i!'% P%' !" -80%% c!''a%, c%n "a -an% i4()i!'a !n0'% !" .)% ! "a -an+a, "a in#0')-!n0i#0a 0%-a !" +)an0! !'!c1%2 C%"%ca "a ca'a .a"-a' !" +)an0! c%n0'a "a .a"-a ! "a -an% !'!c1a, 0%-a !" /%'! #).!'i%' !" .)%, #%/'! "a .a"-a, c%n "a -an% !'!c1a2 C%n "a -an% i4()i!'a, 0%-a "a .a'0! .%#0!'i%' !" .)%  #! !#%/"a #%/'! "a -an+a  -an% !'!c1a2 E" /%'! ca'.ian% !" +)an0! ()! !#0a c%n0'a "a -an+a #! 0%-a c%n !" !% ()! #%#0i!n! "a c%#0)'a,  !" /%'! ca'.ian% !" +)an0! #).!'i%', c%n "%# !%# ! "a %0'a -an% c)/i!'0%# .%' "a 0!"a ! "a -an+a2 E" .)% !" +)an0! ()!a c%"%ca% #%/'! !" .)% !"�ic% ! "a -an+a, -i!n0'a# "a -an% a*n .!'-an!c! !n0'% ! !""a2

C%n "a -an% i4()i!'a, 0%-a "a .a'0! #).!'i%' !" +)an0! !'!c1%  -an+a #)/ac!n0!,  a" 0i'a' ! !#0a 1acia a''i/a !" +)an0! #! ac%-%a !n "a -an%2 C%n$%'-! #! in0'%)c! "a -an% !n0'% !" +)an0!, !# !ci', !" .)% !" +)an0! a "a a"0)'a ! "a -)!ca, #! i'i+!n "%# !%# a "%# %'i6ci%# in0!'n%#  #! a)#0a !" +)an0! a "a -an%2 C%n "a -an% !'!c1a !n+)an0aa, 0%-a !" +)an0! i4()i!'%  "% c%"%ca #%/'! "a .a"-a ! "a -an% i4()i!'a2 L)!+%, c%n "a -an% !'!c1a, 0%-a "a .a'0! in$!'i%' !" .)%, .%' a''i/a ! "a .a"-a,  "% !#%/"a #%/'! "a -an+a  -an% i4()i!'a#2 E" .)% !" +)an0! i4()i!'% ()!a c%"%ca% #%/'! !" .)% !"�ic% ! "a -an+a, -i!n0'a# "a -an% .!'-an!c! !n0'% ! !""a2 C%n "a -an% !'!c1a 0%-! "a .a'0! #).!'i%' !" +)an0! i4()i!'%  -an+a , a" 0i'a' 1acia a''i/a, "a -an+a  !" +)an0! #! ac%-%an !n "a -an%2

C$caci'n "# /-ant#s pr $a técnica a&i#rta: E#0! -80%% )#a "a 08cnica .i!" a .i!", +)an0! a +)an0!2 La -an%, a)n()! #! 1a "a3a% /i!n, n% !#0& !#08'i", .%' "% c)a" n% !/! 0%ca' "a .a'0! !90!'i%' ! "%# +)an0!# !#08'i"!#2 L%# .)%# in3!'0i%# ! "%# +)an0!# !an a" !#c)/i!'0% "a #).!'6ci! in0!'na2 E" .'i-!' +)an0! #! c%"%ca .%' -!i% !"a 08cnica .i!" a .i!", 0%can% c%n "a -an% "a .a'0! in0!'na2 L%# !%# !#08'i"!# ! "a -an% !n+)an0aa .)!!n 0%ca' "a .a'0! !90!'i%' !" %0'% +)an0!, !# !ci' .%' "a 08cnica +)an0! a +)an0!2 2 C%n "a -an% i4()i!'a, 0%-! !" %/"!4 !" .)% !" +)an0! !'!c1%2 L!3an0! !" +)an0!  #!.&'!#! ! "a -!#a2 Mi'! 1acia a0'&# an0!# ! -%3!'#!2 2 In0'%)4ca "a -an% !'!c1a !n !" +)an0!  0i'! !an% !" .)% c%"%ca% #%/'! "a -an%2 2 D!#"ic! "%# !%# ! "a -an% !'!c1a !n+)an0aa /a% !" ."i!+)! in3!'0i% !" .)% !" +)an0! i4()i!'%2 L!3an0! !" +)an0!  #!.&'!#! ! "a -!#a2 2 In0'%)4ca "a -an% !n !" +)an0! i4()i!'%  0i'! ! 8" !an% !" .)% c%"%ca% #%/'! "a -an%2

2 C%n "%# !%# ! "a -an% !'!c1a 0i'! !" .)% !" +)an0! i4()i!'% #%/'! !" .)% ! "a -an+a2 Si !" .)% !"�ic% ! "a /a0a n% ()!a a)#0a%, ;/"!"% c%n !" .)"+a' !'!c1% -i!n0'a# 0i'a !" +)an0! #%/'! !" .)%2 E3i0! 0%ca' "a '!+i;n !#c)/i!'0a ! "a -)!ca2 K2 R!.i0a !" -i#-% .a#% c%n !" .)% !'!c1% )#an% "a -an% i4()i!'a, .a'a c%"%ca' .%' c%-."!0% !" +)an0! !n "a -an% !'!c1a

NOTA: La técnica a&i#rta s# #%p$#a s'$ c-an" s# n#c#sita -sar /-ant#s #stéri$#s a$ practicar -na )#n"is#cci'n  &$,-# p#ri"-ra$4 S# -sa #n $s "#parta%#nts "# -r/#ncias c-an" s# c$can /-ant#s #stéri$#s para s-t-rar $ac#racin#s 1 ta%&ién para ca%&iars# $s /-ant#s "-rant# -na int#r)#nci'n ,-ir.r/ica4 C)an% #! c%"%ca .'i-!'% !" +)an0! !'!c1%, "a -an% i4()i!'a 0%-a !" .)% !" +)an0! .%' "a ca'a in0!'na2 La !n$!'-!'a % -8ic% #! c%"%ca !" +)an0! c%n "a -an% !'!c1a -!ian0! "a 08cnica a/i!'0a2 C%n "a -an% i4()i!'a, 0%-a !" +)an0! !'!c1% .%' !" %/"!4 !" .)%  "% "!3an0a i'!c0a-!n0! 1acia a''i/a #!.a'&n%"% ! "a !n3%"0)'a2 In0'%)c! "a -an% !'!c1a !n !" +)an0!, %/#8'3!#! ()! "a -an% i4()i!'a 0%-a #;"% "a .a'0! in0!'i%' !" +)an0!7 08cnica .i!" a .i!"2  T%-a !" +)an0! i4()i!'% ! "a !n3%"0)'a  !#"i4a "%# !%# !n+)an0a%# ! "a -an% !'!c1a .%' !/a% !" .)% .'%0!c0%'7 08cnica +)an0! a +)an0!2 La# -an%# !#n)a# n)nca 0%can "a .a'0! !90!'i%' !" +)an0!2  Ti'a !" .)% !" +)an0! i4()i!'% #%/'! !" .)% ! "a -an+a2 L%# !%# !n+)an0a%# ! "a -an% !'!c1a 0%can #;"% "a .a'0! !90!'i%' !" +)an0! i4()i!'% c!'ca ! "a -)!ca2 Si !" .)% ! "a /a0a n% ()!a a)#0a%, "a !n$!'-!'a "% ."i!+a #%#0!ni8n%"% c%n !" .)"+a' !'!c1%, -i!n0'a# 0i'a !" +)a0! #%/'! 8"2 E" c%n0ac0% c%n c)a"()i!' &'!a ! .i!" c%n0a-ina !" +)an0! !'!c1%2 =E" ."i!+)! n% .)!! 3%"3!'#! a 1ac!' !n ca#% ! 3%"3!'#! a !n+)an0a' .%'()! a #! c%n#i!'a c%n0a-ina%2>

C%n "a -an% i4()i!'a .%' c%-."!0% !n+)an0aa, #! !#"i4an "%# !%# ! "a -an% i4()i!'a .%' !/a% !" %/"!4 !" .)% !" +)an0! !'!c1%  #! 0i'a ! 8" #%/'! !" .)% ! "a -an+a7 08cnica +)an0! a +)an0!2

C$caci'n "# /-ant#s para #$ p#rsna$ %é"ic: 2 T%-! !" +)an0! !'!c1% c%n 6'-!4a, c%n "%# !%# /a% !" .)% !3!'0i%2 Man0!n+a "a ca'a .a"-a' !" +)an0! 1acia !" ci')an%2 2 E90i!na !" .)% "% #)6ci!n0! .a'a ()! !" ci')an% in0'%)4ca "a -an%2 E3i0! 0%ca' "a -an% c%n#!'3an% #)# .)"+a'!# 1acia a$)!'a2 2 Ti'! !" +)an0! 1acia a''i/a, c)an% !" ci')an% in0'%)4ca "a -an%2 2 D!#%/"! !" .)% !" +)an0! #%/'! !" .)% ! "a -an+a2 2 R!.i0a !" -i#-% .a#% !n "a -an% i4()i!'a2 E" !n$!'-!'% a)a a" -8ic% % a)an0! a c%"%ca'#! "%# +)an0!#2 S%#0i!n! !" +)an0! c%n "a ca'a .a"-a' 1acia !" -8ic%, c%n #)# .)"+a'!# #!.a'a%#, .a'a !3i0a' ()! 8" "%# 0%()! c%n #)# -an%# !#n)a#2

Ca%&i "# /-ant#s "-rant# $a int#r)#nci'n ,-ir.r/ica: Si "%# +)an0!# ""!+an a c%n0a-ina'#! .%' c)a"!#()i!'a 'a4%n!# )'an0! !" .'%c!i-i!n0% ()i'*'+ic%, !/!n ca-/ia'#! ! in-!ia0%2 Si n% #! .)!! !0!n!' !n $%'-a in-!ia0a, -an0!n!' "a -an% c%n0a-inaa "!%# !" &'!a !#08'i"2 Pa'a ca-/ia'#! !" +)an0! !/!: 2 R!0i'a'#! !" ca-.% ()i'*'+ic% 2 E90!n!' "a -an% c%n0a-inaa .a'a ()! "a !n$!'-!'a ci'c)"an0! 0%-! "a .a'0! !90!'i%' !" .)% !" +)an0!, c!'ca !  c- a/a% !" /%'! #).!'i%'  0i'! ! 8" .a'a #aca'"%2

2 P%' "% '!+)"a', )n -i!-/'% !" !()i.% a)a a %0'% a ca-/ia'#! "%# +)an0!#2 C)an% n% !# .%#i/"! 1ac!'"%, !" ci')an% % !n$!'-!'a in#0')-!n0i#0a #! a"!an .a'a c%"%ca'#! %0'% +)an0! !#08'i" -!ian0! "a 08cnica a/i!'0a2

NOTA: ;: La técnica c#rra"a n "#&# practicars# "-rant# -na int#r)#nci'n ,-ir.r/ica p-#s si#%pr# s# cnta%ina #$ /-ant# n-#) cn $a %an/a "# $a &ata3  $a %an cn #$ p-7 "#$ /-ant#4 Est# .$ti% n "#&# tirars# pr #nci%a "# $a %an4 Si s# #%p$#a #st# %ét"3 #s n#c#sari ,-itar $a &ata 1 /-ant#s para c$cars# tra &ata #stéri$ ant#s "# pn#rs# $s /-ant#s4 c%n "a -an% i4()i!'a2  B3 0i'a "a /a0a ! #)# /'a4%#, in3i'0i!n% "a -an+a "!%# !" c)!'.%, c%n "%# c%%# @!9i%na%#2 C3 0%-a !" %0'% 1%-/'% c%n "a %0'a -an%  #! ()i0a "a /a0a .%' c%-."!0%, c%n "a .a'0! in0!'na 1acia a$)!'a2 D! !#0! -%%, c%n#!'3a "i-.i%# "%# /'a4%#2 Pa#%# ()! #i+)! "a !n$!'-!'a .a'a ()i0a'#! "%# +)an0!# a" 0!'-ina' "a in0!'3!nci;n ()i'*'+ica2 U#a: A3 08cnica +)an0! a +)a0!7 !#.)8# B3 .i!" a .i!" .a'a .'%0!+!'#! "a# -an%# "i-.ia#  !3i0a' 0%ca' "a .a'0! !90!'i%' c%n0a-inaa ! "%# +)an0!#, a ()!