2. Distribución anatómica
Lesiónde unaarteria o venapor la acciónde un traumatismo
● Actualmente en los Estados Unidos de Norteamérica, el 3%de todos los casos de trauma mayor se asocian a lesión
vascular o son exclusivamente vasculares
mayor
importancia
trauma cerrado
lesiones iatrogénica
aumento de procedimientos
intravasculares
lesiones vasculares se
atribuye principalmente a
accidentes de Tránsito
menor gradoa procedimientos
laparoscópicos
Extremidades, arteria femoral superficial la más lesionada
selección natural parte más expuesta de nuestro cuerpoal
trauma son las extremidades,
Lesiones vasculares de tórax, abdomen,
cabeza y cuello son altamente letales La gran mayoría de las lesiones vasculares son por trauma
penetrantes
3. Tipos de lesión vascular
LESIONESPENETRANTES
Dependiendodel agente injuriante y de la intensidad del trauma
Laceración Desgarroo rupturaparcial de un vaso, con mayor o
menor pérdidade sustancia dependiendode las
circunstancias de la lesión. .
bala
arma blanca
vidrios
fragmentos
metálicos
por esquirlasóseas
Transección
pérdidacompleta de la continuidad de un vaso.
Se producepor mecanismos similares a la lesión anterior.
Perforació
n
Lesiones puntiformes producidaspor objetos de pequeño calibre, como perdigones.
4. O "pseudoaneurismas".En este caso la lesión vascular no se comunica con el exterior,
formándose un hematoma pulsátil
Mecanismo de la lesión compromete tanto la arteria como la vena paralela a
ella y no se hace el reparovascular inmediato, puedeproducirseuna derivación
del flujo arterial a la vena a través de dicha comunicación, lo cual se denomina
fístula arterio-venosa.
Fístula arterio-venosa
Aneurismasfalsos
no tiene paredespropiascomo el aneurisma arterial propiamente tal
LESIONESNOPENETRANTES
vasoconstricción refleja, segmentaria y reversible producidapor un trauma
menor.
Espasmo segmentario
5. Traumas más severosque no alcanzan a romper toda la paredde un vaso puedenoriginar
disrupciónde la íntima.
Lesión de la íntima
cirugía el aspecto externo del vaso es normal, excepto
por una decoloración azulosa en el sitio correspondiente a la disección de la íntima.
El segmento lesionado es disecadopor el flujo sanguíneo y acaba prolapsándose a la luz
vascular
RESUCITACIÓNEN TRAUMA VASCULAR
Factores críticos en el salvataje son la compensación del shock y la hipoxia junto con reconocer el grado de lesión
vascular.
● básico la evaluación
primaria
poderllevar a cabo la
reparación vascular lo más
rápido posible
manejo acabado del ATLS para
la estabilización
Siempre existe un alto gradode urgencia cuando nos enfrentamos a trauma con compromisovascular.
6. Evaluación del paciente con trauma vascular
Diagnóstico de lesiones vasculares periféricasmayores . examen físico
Presencia de signos duros
son indicación de exploración inmediata ante el riesgo de muerte secundarioa Shock
hipovolémico
se relaciona
alta sospechade lesión vascular
sangrado pulsátil y Hematoma expansivo
Otros signos duros
Ausencia de pulsosdistales
Palidez y frialdad en extremidades
exámenes como
ecodopplero angio TAC
7. Signos blandos
orientan hacia una probable lesión vascular
no son indicación de exploración inmediata.
Déficit neurologico periferico
Antecedentes de sangrados en el sitio del accidente
Pulsodisminuido
Lesión próxima a trayecto arterial
indicación de hospitalización y
observación por24 a 48 horas
lesiones vasculares en tórax y abdomen el diagnóstico de certeza es más difícil de realizar por el
examen físico.
Si el paciente se encuentra hemodinámicamente inestable y se sospechala presencia de
hemotórax o hemoperitoneo, la conducta será la exploración inmediata y evaluación del
daño vascular en forma intraoperatoria.
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9. Our center Key numbers
Patient care Key accomplishments
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Table of contents
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11. Introduction
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12. Our center
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13. Mission Vision
Mercuryisthe closest planet to the Sun and
the smallest one in the Solar System—it’s
only a bit larger than our Moon. The planet’s
name hasnothing to do withthe liquid metal
Venus has a beautiful name and is the second
planet from the Sun. It’s terribly hot—even
hotter than Mercury.It’s the second-brightest
natural object in the night sky after the Moon
14. “This is a quote, words full of wisdom that someone
important said and that can inspire the reader.”
—Someone Famous
15. Key numbers
55,000
This is the total number of visitors we
had last month
20,000
This is the number of patients we had last month
5,000
This is the number of transplants performedso far
16. Our statistics
Jupiter
Jupiter is the biggest planet
of them all
Mars
Despite being red, Mars is
actually a cold place
Earth
Earth is the only planet
known to harbor life
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30%
10%
40%
Saturn
Saturn wasnamed after a
Roman god
20%
17. A brief history
Mercuryisthe closest planet to the Sun and
the smallest one in the Solar System—it’s
only a bit larger than the Moon. The
planet’s name hasnothing to do withthe
liquidmetal, since Mercurywasnamed
after the Roman messenger god
18. Milestones reached
19xx
Mercuryisthe closest
planet to the Sun
19xx
Venus is the second planet
from the Sun
20xx
Saturn is a gas giant with
several rings
20xx
Despite being red, Mars is
actually very cold
20xx
Earth is the only planet
with humanlife
19. Our process
Before
Mercuryis a small planet
During
Venus hasa toxic atmosphere
After
Mars is a cold planet
Process
Earth Mercury
Neptune
Saturn
Ceres
Sun
20. Patient care
Mercuryis the closest planet to the Sun and the
smallest one in the Solar System—it’s only a bit
larger than the Moon. The planet’s name has
nothing to do with the liquidmetal, since Mercury
was named after the Roman messenger god
22. Areas we cover
Mars Earth Venus Jupiter Saturn
Area 1 X X X X
Area 2 X X
Area 3 X X X
Area 4 X
Are 5 X X X
23. Mercury Earth Mars
Services
Mercuryisthe closest planet to
the Sun and also the smallest
one of them all
Earth is the third planet from
the Sun and the only one that
harbors life in the Solar System
Despite being red, Mars isa very
cold place, not hot. It’s full of
iron oxide dust
24. Key accomplishments
20xx 20xx
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25. Mercury is the closest planet to the Sun and the smallest one in
the Solar System—it’s only a bit larger than the Moon
95%
28. Mercury Neptune
Venus Mars Saturn
Jupiter
Quality improvement measures
Mercuryisthe closest
planet to the Sun
Jupiter is the biggest planet
of them all
Venus is the second planet
from the Sun
Despite being red, Mars is
actually a cold place
Saturn is composed of
hydrogenand helium
Neptune isvery far away
from the Sun
29. —Jenna Doe, 25
—John James, 36
“Neptuneis the fourth-largest planet by
diameter in the entire Solar System”
“Mercuryis the closest planet to the Sun and
the smallest one in the Solar System”
Testimonials
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Sarah James
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31. 20xx 20xx 20xx 20xx
Best Center Best staff
Awards
Saturn wasnamed
after a Roman god
Jupiter doesn’t have a
solid surface
Mercuryisthe
smallest planet
Neptune isvery far
away from the Sun
32. Our centers
Saturn
Saturn is a gas giant and
hasseveral rings
Jupiter
Jupiter is a gas giant and
has eighty moons
33. Visit our website
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