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PARA TOMAR EL PULSO

Se colocan dos dedos en las arterias de la muñeca o del cuello. Deben sentirse aproximadamente 60/80 latidos por minuto en adultos, 100/120, y 140 en recién nacidos.

PARA VERIFICAR QUE EL PACIENTE RESPIRA Vease LA RESPIRACIÓN

1.- Acerque su oído a la nariz del lesionado, para oír y sentir el aliento.
2.- Acerque el dorso de su mano a la nariz para sentir el aliento.
3.- Si es posible, coloque su mano bajo el tórax para sentir el movimiento.
4.- Coloque un espejo cerca de la fosa nasal, para ver si se empeña.
5.- El número de respiraciones normales es de 15 a 20 por minuto.

PULSO


El pulso es la trasmisión a todas las arterias del organismo del impulso cardíaco sistólico, esto es, durante la contracción del corazón. Por ello, puede ser apreciado en cualquier parte del cuerpo en que exista una arteria cerca de la superficie de la piel y, mejor aún, si descansa sobre el plano duro de un hueso.


La arteria más utilizada para valorar el pulso es la radial, localizada en la parte externa de la cara anterior de la muñeca.

También puede explorarse en la carótida, a ambos lados de la garganta. Otros puntos utilizados para valorar el pulso son las arterias temporales, sobre las sienes; la femoral, sobre las ingles y la poplítea, en el hueco de la cara posterior de la rodilla.
Por la facilidad de su localización y por su importancia, al informarnos sobre la irrigación sanguínea cerebral, el pulso carotideo es el que debemos valorar en una situación de primeros auxilios. Éste se debe buscar a la altura de las arterias carótidas situadas superficialmente a ambos lados de la línea media del cuello. El auxiliador procederá de la siguiente forma:

- Se colocará al lado de la víctima;
- Situará los dedos índice y medio en la línea media del cuello (a la altura de la laringe), deslizándolos unos dos centímetros a uno de los lados y - Presionará con los dedos suavemente, intentando localizar el pulso.


Conviene señalar que NO se deben palpar ambas carótidas a la vez, puesto que si se interrumpe o dificulta el paso de sangre al cerebro, puede ponerse en peligro al herido. Aunque tres son las características del pulso, a saber, frecuencia, ritmo y amplitud; a nosotros nos interesa fundamentalmente la primera. La FRECUENCIA normal del pulso es muy variable en un adulto sano. En reposo suele ser de 60 a 80 pulsaciones por minuto, con variedades de hasta 44 en individuos robustos y entrenados (Miguel Indurain p.Ej.), y de 90 a 100 en sujetos más débiles o nerviosos, así como en los niños. El aumento de frecuencia se denomina taquicardia: de manera fisiológica se presenta tras el ejercicio, la excitación nerviosa o las comidas abundantes. De forma patológica la fiebre, shock traumático, hemorragias, infarto de miocardio, entre otras causas desencadenan la taquicardia.


El pulso lento se denomina bradicardia, fisiológico durante el sueño y en atletas en reposo. Si es muy lento (inferior a 40 pulsaciones por minuto) debe hacernos pensar en una lesión cardiaca (sobre todo si el individuo sufre desvanecimiento o disnea) o cerebral (en los traumatismos craneoencefálicos).

LA RESPIRACIÓN.

La frecuencia respiratoria normal es de 16 a 20 R.P.M. (se cuenta como una respiración la suma de inspiración y espiración). El aumento de dicha frecuencia, o taquipnea se produce de manera fisiológica tras el ejercicio o la excitación; igualmente, la permanencia en alturas considerables o en grandes profundidades acelera el ritmo respiratorio. La bradipnea, o disminución de la frecuencia respiratoria, se presenta fisiológicamente durante el sueño. Patológicamente lo hace en intoxicaciones por opio, barbitúricos, alcohol, ácido carbónico, ácido cianhídrico; el estado de shock, etc.
La disnea es la dificultad para respirar. Desde el momento en el que la respiración deja de ser un reflejo inconsciente para convertirse en un acto consciente empieza la disnea. Dado que la respiración normal depende de muchos factores, son muchas también las posibles causas de disnea: la falta de oxígeno en el aire, la falta o escasez de hemoglobina en la sangre, la obstrucción de las vías respiratorias, etc.

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