Cambios en Las Guías 2015 ASHI

download Cambios en Las Guías 2015 ASHI

of 46

Transcript of Cambios en Las Guías 2015 ASHI

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    1/46

    Summary DocumentSummary Document

    Protecting and Saving Lives Made Easy

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    2/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    ": ; 0 < *

    "#$%& '( )'*+&*+,

    !"#$%&'(#)%" =================================================================================================================================================== *

    ,-%'# ./01#2 3 405/#6 !"7#)#'#/ 8.4!9 =========================================================================================================== *

    !"#/:$0#)": *; 0"& B')&/1)"/7 ================================================== *

    CD&0#/ 4'-E/(#7 -6 F$0"& ============================================================================================================================= G

    >/*1(?0, .08*52 7 4*0+56 9,-5(5'5* @>.49A ======================================================================================== H

    BCD9E F(1-5 >() ================================================================================================================================== H

    CD&0#/ 4'-E/(#7 -6 ,$/0 0"& ?$0)")": I/J/1

    ?,FIK CD ============================================================================================ M

    ?,FIK GL H02I*1-G, ;*)(051(? E;J 0,) >CD ====================================================================================== () ============================================================================================================================== )'+5 LH. =========================================================================================== GG

    ?,FIK OL4*0+56?01* ;1GK()*1 ;*)(051(? LH. ====================================================================================== HG

    .4! ,&J)7%$6 B$%'D ======================================================================================================================================== H=

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    3/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    M: ; 0 < *

    -*+.'/01+2'*

    N6* I'1IG-* G8 56* )G?'/*,5 (- 5G 6(--G?(05(G,P 9,?= @>4>A 1*+*0-*) 'I)05*) 51*05/*,5 () N0-U FG1?* 0+-G 1*+*0-*) 56* !"#$

    &'()*'+(,-'+. /-'0)'010 -' @,*0( A,2 ;7,)'7) *)+(4)'( 6)7-44)'2+(,-'0 R6(?6 ?G(,?()*) R(56 56* 1*+*0-* G8 56*

    !"#$ A4)*,7+' B)+*( A00-7,+(,-' +'2 A4)*,7+' 6)2 /*-00 C1,2).,')0 D32+() E-* @,*0( A,2? N6* EG,-*,-'- G, .?(*,?*

    I1G?*--P R6(?6 -I0,,*) 0 8(K* 2*01 I*1(G)P R0- )*-(.49 0,) BCD9E F(1-5 >() 510(,(,< /05*1(0+-=

    3$'0+ 4%+5 6 7#(&+8 -*,+2+0+& 947-:4.9 ',(5*- 56* 1*?G/*1(?0, .08*52 7 4*0+56 9,-5(5'5* 0,) BCD9E F(1-5 >() 5G ?1*05* 56*

    +01

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    4/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    ^: ; 0 < *

    XI)05*) >.49 0,) BCD9E F(1-5 >() 510(,(,< I1G

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    5/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    %: ; 0 < *

    3A&.21#* 7#(&+8 6 4%+5 -*,+2+0+& ".#2*2*; H.';.#A,

    !5 6%' #/0(2L A/10#/& (20":/7 0$/ )"L

    E;Jd>CD N0S+*- $P "P M

    L0-(? F(1-5 >() N0S+*- $P "P MP ^

    L0-(? Q(+)*1,*-- 7 Q(+)*1,*-- F(1-5 >() N0S+*- $P "P MP ^

    E6(+) 0,) L0S2-(55(,< .08*52 N0S+*- $P "P MP ^

    C/*1CD 0,) F(1-5 >() 8G1 E6(+)1*,P 9,80,5-P 0,) >)'+5- N0S+*- $P "P MP ^

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    6/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    :; < 0 = *

    !"#$% '( %)*+,-./0

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    E0-(A F(8* .'@@?15

    >10(,(,=

    G@)05*) E*A0'-* *H*, /(,(/0+ 510(,(,=

    (, IJK '-* 60- L**, -6?M, 5?

    (/@1?H* @*18?1/0,A* (,

    -(/'+05*) A01)(0A 011*-5-N

    510(,(,= ?@@?15',(5(*- -6?'+)

    L* /0)* 0H0(+0L+* 0,)

    @1?/?5*) 8?1 +02 1*-A'*1-O

    .P""

    I A?/L(,05(?, ?8 -*+8Q(,-51'A5(?, 0,)

    (,-51'A5?1Q+*) 5*0A6(,= M(56 60,)-Q?,

    510(,(,= A0, L* A?,-()*1*) 0- 0,

    0+5*1,05(H* 5? 510)(5(?,0+ (,-51'A5?1Q+*)

    A?'1-*- 8?1 +02 @1?H()*1-O 98 (,-51'A5?1Q

    +*) 510(,(,= (- ,?5 0H0(+0L+*N -*+8Q)(1*A5*)

    510(,(,= /02 L* A?,-()*1*) 8?1 +02

    @1?H()*1- +*01,(,= IJK -R(++- SD+0-- 99LN

    FTJ DQJTUO .%:V

    I+56?'=6 IJK- 01* +?A05*) (, @'L+(A 01*0-

    0,) ',510(,*) @1?H()*1- 01* *,A?'10=*) 5?

    '-* 56*/N *H*, /(,(/0+ 510(,(,= A0,

    (/@1?H* 0A5'0+ @*18?1/0,A*O .*+8Q)(1*A5*)

    510(,(,= A0, @1?H()* /?1* 510(,(,=

    ?@@?15',(5(*- 8?1 +02 1*-A'*1- M6? 52@(A0++2

    M?'+) ,?5 055*,) 0 510)(5(?,0+ 510(,(,=

    A?'1-*O

    E0-(A F(8* .'@@?15

    >10(,(,=

    G@)05*) .6?15 H()*? (,-51'A5(?,

    A?/L(,*) M(56 -2,A61?,?'-

    60,)-Q?, @10A5(A* (- 0,

    *88*A5(H* 0+5*1,05(H* 5?

    (,-51'A5?1Q+*) EF. A?'1-*-O

    .P""

    D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    7/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    [; < 0 = *

    !"#$% '( %)*+,-./0

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    E0-(A F(8* .'@@?15

    >10(,(,=

    G@)05*) >6* '-* ?8 0 D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    8/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    _; < 0 = *

    !"#$% '( %)*+,-./0

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    .@*A(0+

    D?,-()*105(?,-

    ^*M D?//',(5(*- /02 A?,-()*1 510(,(,=

    L2-50,)*1- (, A?/@1*--(?,Q?,+2 D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    9/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    P; < 0 = *

    !"#$% '( $)*+,-./0 "1234 567 )01 "%8

    >?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    G,510(,*) F02

    C*-A'*1

    G@)05*) E*A0'-* (5 (- *0-(*1 8?1

    1*-A'*1- 1*A*(H(,= 5*+*@6?,*

    D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    10/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    $#; < 0 = *

    !"#$% '( $)*+,-./0 "1234 567 )01 "%8

    >?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    F02@*1-?,e

    D?/@1*--(?,Q T,+2

    D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    11/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    $$; < 0 = *

    !"#$% '( $)*+,-./0 "1234 567 )01 "%8

    >?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D01)(0A ?1

    C*-@(105?12 I11*-5

    I--?A(05*) `(56

    T@(?() TH*1)?-*

    ^*M

    0,)

    G@)05*)

    >6*1* 01* ,? )050 5? -'@@?15

    56* '-* ?8 -@*A(8(A 0,5()?5*- (,

    56* -*55(,= ?8 A01)(0A 011*-5

    )'* 5? ?@(?() ?H*1)?-*O._V#

    J/@(1(A 0)/(,(-5105(?, ?8 9\ ?1 9^

    ,0+?f?,* 5? 0++ ',1*-@?,-(H* ?@(?()

    0--?A(05*) +(8*Q561*05*,(,= */*1=*,A2

    @05(*,5- /02 L* 1*0-?,0L+* 0- 0,

    0)a',A5 5? -50,)01) 8(1-5 0() 0,) ,?,g

    6*0+56A01* @1?H()*1 EF. @1?5?A?+- SD+0--

    99LN FTJ DQJTUO .%#%

    9, 6(=6 )?-*-N ?@(?()- -'A6 0- /?1@6(,*N

    6*1?(,N 510/0)?+N ?f2A?)?,*N 0,)

    /*560)?,* A0, A0'-* 1*-@(105?12

    )*@1*--(?, 0,) )*056O T@(?() ?H*1)?-* (-

    0 @'L+(A 6*0+56 A1(-(-O ^0+?f?,* (- 0,

    0,5()?5* 5? ?@(?() ?H*1)?-* 0,) A0,

    A?/@+*5*+2 1*H*1-* (5- *88*A5- (8

    0)/(,(-5*1*) (, 5(/*O ^0+?f?,*

    0)/(,(-5*1*) L2 L2-50,)*1- Q @015(A'+01+2

    L2 80/(+2 /*/L*1- 0,) 81(*,)- ?8 56?-*

    R,?M, 5? L* 0))(A5*) (- 0 @?5*,5(0++2 +(8*Q

    -0H(,= 51*05/*,5O

    D01)(0A ?1

    C*-@(105?12 I11*-5

    I--?A(05*) `(56

    T@(?() TH*1)?-*

    ^*M G,+*-- 56* @05(*,5 1*8'-*- 8'156*1 A01*N

    H(A5(/- M6? 1*-@?,) 5? ,0+?f?,*

    0)/(,(-5105(?, -6?'+) 0AA*-- 0)H0,A*)

    6*0+56A01* -*1H(A*- SD+0-- 9N FTJ DQJTU

    .%#:O C*-@?,)*1- -6?'+) ,?5 )*+02

    0AA*-- 5? /?1*Q0)H0,A*) /*)(A0+

    -*1H(A*- M6(+* 0M0(5(,= 56* @05(*,5h-

    1*-@?,-* 5? ,0+?f?,* ?1 ?56*1

    (,5*1H*,5(?,- SD+0-- 9N FTJ DQJTUO .%#%

    `6(+* ,0+?f?,* 0)/(,(-5*1*) L2

    L2-50,)*1- (- 0 @?5*,5(0++2 +(8*Q-0H(,=

    51*05/*,5N (5 -6?'+) ,?5 L* -**, 0- 0

    1*@+0A*/*,5 8?1 /?1* 0)H0,A*) /*)(A0+

    A01*O >6* "#$% *H()*,A* *H0+'05(?,

    )*5*1/(,*) 5605 ,0+?f?,* 0)/(,(-5105(?,

    (/@1?H*- -@?,50,*?'- L1*056(,= 0,)

    A?,-A(?'-,*-- (, 56* /0a?1(52 ?8 @*1-?,-

    51*05*)N 0,) A?/@+(A05(?, 105*- 01* +?MO4?M*H*1N 0A5(H05(?, ?8 J\. 0,) D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    12/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    $"; < 0 = *

    !"#$% '( $)*+,-./0 "1234 567 )01 "%8

    >?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D01)(0A ?1

    C*-@(105?12 I11*-5

    I--?A(05*) `(56

    T@(?() TH*1)?-*

    ^*M X(A5(/- M6? 1*-@?,) 5? ,0+?f?,*

    0)/(,(-5105(?, -6?'+) 0AA*-- 0)H0,A*)

    6*0+56A01* -*1H(A*- SD+0-- 9N FTJ DQJTUO

    C*-@?,)*1- -6?'+) ,?5 )*+02 0AA*-- 5?

    /?1*Q0)H0,A*) /*)(A0+ -*1H(A*- M6(+*

    0M0(5(,= 56* @05(*,5h- 1*-@?,-* 5?

    ,0+?f?,* ?1 ?56*1 (,5*1H*,5(?,- SD+0-- 9N

    FTJ DQJTUO .%#%

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    13/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    $Y; < 0 = *

    !"#$% '( $)*+,-./0 "1234 567 )01 "%8

    >?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D6*-5 D?/@1*--(?,

    K*@56

    G@)05*) >6* 0)'+5 -5*1,'/ -6?'+) L*

    )*@1*--*) 05 +*0-5 " (,A6*- S%

    A/U SD+0-- 990N FTJ EU .:P#

    K'1(,= /0,'0+ D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    14/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    $V; < 0 = *

    !"#$% '( $)*+,-./0 "1234 567 )01 "%8

    >?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D6*-5 `0++ C*A?(+ G@)05*) I++?M 56* A6*-5 5? A?/@+*5*+2

    1*A?(+ 085*1 *0A6 A?/@1*--(?,

    SD+0-- 990N FTJ EUO .:P#

    95 (- 1*0-?,0L+* 8?1 1*-A'*1- 5? 0H?()

    +*0,(,= ?, 56* A6*-5 L*5M**,

    A?/@1*--(?,- 5? 0++?M 8'++ A6*-5 M0++

    1*A?(+ 8?1 0)'+5- (, A01)(0A 011*-5 SD+0--

    990N FTJ DQFKUO .V"#

    E*55*1 )*-A1(L(,= A6*-5 1*A?(+ (, 5*1/- ?8

    6?M 0 1*-A'*1 /?-5 +(R*+2 A0'-*- (5 5?

    60@@*,N /02 6*+@ 5? 1*)'A* (5-

    ?AA'11*,A*O C*-A'*1- A0, A?,A*,5105* ?,

    0++?M(,= 8'++ *f@0,-(?, ?8 56* A6*-5 (8 56*2

    )? ,?5 8**+ +(R* 56*2 01* +*0,(,= ?, 56*

    A6*-5 05 56* 5?@ ?8 *0A6 A?/@1*--(?,O

    \(,(/(i(,=

    9,5*11'@5(?,- (, D6*-5

    D?/@1*--(?,-

    ^*M 9, 0)'+5 A01)(0A 011*-5 M(56 0,

    ',@1?5*A5*) 0(1M02N (5 /02 L*

    1*0-?,0L+* 5? @*18?1/ D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    15/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    $%; < 0 = *

    !"#$% '( $)*+,-./0 "1234 567 )01 "%8

    >?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    \(,(/(i(,=

    9,5*11'@5(?,- (, D6*-5

    D?/@1*--(?,-

    G@)05*) K*+(H*1 *0A6 1*-A'* L1*056

    ?H*1 $ -*A?,) SD+0-- 990N FTJ

    DUO .:__

    k?1 0)'+5- (, A01)(0A 011*-5 1*A*(H(,= D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    16/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    $:; < 0 = *

    !"#$% 9( $)*+,-./0 6,1:)4-:; 567 )01 "%8

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D?/@?,*,5- ?8 4(=6Q

    l'0+(52 D? /0f(/(i* -(/@+(A(52 (, D6*1* M0- H*12 +(55+* A60,=* (, 56*

    @*)(051(A A?/@1*--(?, )*@56

    1*A?//*,)05(?, 81?/ 56* @1*H(?'-

    1*A?//*,)05(?, (, "#$#O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    17/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    $[; < 0 = *

    !"#$% 9( $)*+,-./0 6,1:)4-:; 567 )01 "%8

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D?/@?,*,5- ?8 4(=6Q

    l'0+(52 D6* 0-@62f(0+ ,05'1* ?8 56*

    /0a?1(52 ?8 @*)(051(A A01)(0A 011*-5-

    ,*A*--(505*- H*,5(+05(?, 0- @015 ?8

    *88*A5(H* D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    18/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    $_; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    E'1,- G@)05*) D??+ 56*1/0+ L'1,- M(56 A?+)

    S$%n 5? "%nDU 50@ M05*1 0- -??,

    0- @?--(L+* 0,) A?,5(,'*

    A??+(,= 05 +*0-5 ',5(+ @0(, (-

    1*+(*H*) SD+0-- 9N FTJ EUO .PY[

    D??+ 56*1/0+ L'1,- M(56 A??+ ?1 A?+)

    @?50L+* M05*1 0- -??, 0- @?--(L+* 0,) 8?1 05

    +*0-5 $# /(,'5*- SD+0-- 9N FTJ EQ^CUO .%_#

    J01+2 A??+(,= ?8 0 L'1, 60- L**, 8?',)

    5? /(,(/(i* 56* 1(-R 0,) )*@56 ?8

    (,a'12O E?56 A??+ 0,) A?+) M05*1 A0,

    L* *88*A5(H*O >6* '-* ?8 (A* (- ,?5

    1*A?//*,)*) 0,) 56* 5(/* 5? A??+ 0

    L'1, 60- L**, /?1* A+*01+2 )*8(,*)O

    E'1,- G@)05*) F??-*+2 A?H*1 L'1, L+(-5*1-

    M(56 0 -5*1(+* )1*--(,= L'5

    +*0H* L+(-5*1- (,50A5 L*A0'-*

    56(- (/@1?H*- 6*0+(,= 0,)

    1*)'A*- @0(, SD+0-- 990N FTJ EUO

    .PY[

    I85*1 A??+(,= ?8 0 L'1,N (5 /02 L*

    1*0-?,0L+* 5? +??-*+2 A?H*1 56* L'1, M(56 0

    -5*1(+*N )12 )1*--(,= SD+0-- 99LN FTJ DQFKUO

    .%_#

    >6* '-* ?8 0 )12N -5*1(+* )1*--(,= ?, 0

    L'1, 085*1 A??+(,= /02 L* 1*0-?,0L+*

    5? 6*+@ R**@ 56* L'1, A+*0,O

    E'1,- ^*M 98 A??+ ?1 A?+) M05*1 (- ,?5 0H0(+0L+*N 0 A+*0,

    A??+ ?1 A?+)N L'5 ,?5 81**i(,=N A?/@1*-- A0,

    L* '-*8'+ 0- 0 -'L-5(5'5* 8?1 A??+(,= 56*1/0+

    L'1,- SD+0-- 990N FTJ EQ^CUO .%_#

    J01+2 A??+(,= ?8 0 L'1, 60- L**, 8?',)

    5? /(,(/(i* 56* 1(-R 0,) )*@56 ?8

    (,a'12O D+*0,N A??+N ?1 A?+) S,?5 81?i*,U

    )1*--(,=- A0, L* '-*) 0- 0 -'L-5(5'5*

    M6*, 1',,(,= M05*1 (- ,?5

    (//*)(05*+2 0H0(+0L+*O

    E'1,- ^*M D01* -6?'+) L* 50R*, 5? /?,(5?1 8?162@?56*1/(0 M6*, A??+(,= +01=* L'1,-

    SD+0-- 9N FTJ DQJTUO .%_#

    k?1 +01=*1 0,) )**@*1 L'1,-N A??+(,=A?'+) 60H* 0 -*A?,)012 *88*A5 ?8

    A??+(,= 56* L?)2 ?H*10++ 0,) A0'-(,=

    62@?56*1/(0O >6(- (- *-@*A(0++2 51'*

    8?1 A6(+)1*,O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    19/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    $P; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    E'1,- ^*M 9, =*,*10+N (5 /02 L* 1*0-?,0L+* 5? 0H?()

    ,05'10+ 1*/*)(*-N -'A6 0- 6?,*2 ?1 @?505?

    @**+ )1*--(,=- SD+0-- 99LN FTJ DQFKUO

    4?M*H*1N (, 1*/?5* ?1 M(+)*1,*-- -*55(,=-

    M6*1* A?//*1A(0++2 /0)* 5?@(A0+

    0,5(L(?5(A- 01* ,?5 0H0(+0L+*N (5 /02 L*

    1*0-?,0L+* 5? A?,-()*1 0@@+2(,= 6?,*2

    5?@(A0++2 0- 0, 0,5(/(A1?L(0+ 0=*,5 SD+0-- 99LN

    FTJ DQFKUO .%_#

    4?,*2 60- -6?M, (, -?/* -5')(*- 5?

    0A5'0++2 )*A1*0-* 56* 1(-R ?8 (,8*A5(?,

    0,) 6*0+(,= 5(/* 8?1 L'1,-O 4?M*H*1N

    56* -5')(*- M*1* ]'*-5(?,*) (, 1*=01)

    5? 56* ]'0+(52 ?8 56* (,8?1/05(?,O I5

    56(- 5(/*N (5 (- =*,*10++2 1*A?//*,)*)

    5? 0H?() ,05'10+ 1*/*)(*- 8?1 L'1,

    )1*--(,=-O G-(,= 6?,*2 0- 0 5?@(A0+

    0=*,5 (, 0 1*/?5* ?1 M(+)*1,*--

    -*55(,= M6*, 0,5(L(?5(A ?(,5/*,5- 01*

    ,?5 0H0(+0L+* /02 L* 0 1*0-?,0L+*

    A?,-()*105(?, 8?1 1*)'A(,= 56* 1(-R ?8

    (,8*A5(?,O

    E'1,- ^*M E'1,- 0--?A(05*) M(56 ?1 (,H?+H(,= S$U

    L+(-5*1(,= ?1 L1?R*, -R(,o S"U )(88(A'+52

    L1*056(,=o SYU 56* 80A*N ,*ARN 60,)-N ?1

    =*,(50+-o SVU 0 +01=*1 -'180A* 01*0N -'A6 0-

    51',R ?1 *f51*/(5(*-o ?1 S%U ?56*1 A0'-* 8?1

    A?,A*1, -6?'+) L* *H0+'05*) L2 0

    6*0+56A01* @1?H()*1 SD+0-- 9N FTJ DQJTUO .%_#

    E'1,- /?-5 +(R*+2 5? 60H* -*A?,)012

    A?/@+(A05(?,- -'A6 0- (,8*A5(?,N

    1*-51(A5(?,- ?, 8',A5(?,N ?1 @??1

    6*0+(,= )'* 5? -'180A* A?,50A5 ?1

    1*@*05*) /?H*/*,5-N -6?'+) L*

    *H0+'05*) L2 0 6*0+56A01* @1?H()*1O

    K*,50+ 9,a'12 ^*M k?++?M(,= )*,50+ 0H'+-(?,N (5 (- *--*,5(0+ 5?

    -**R 10@() 0--(-50,A* M(56 1*(/@+0,505(?,

    SD+0-- 9N FTJ DQJTUO .%_#

    9//*)(05* 1*(/@+0,505(?, ?8 0,

    0H'+-*) 5??56 (- 8*+5 5? @1?H()* 56*

    L*-5 A60,A* ?8 -'1H(H0+ 8?1 56* 5??56O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    20/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    "#; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    K*,50+ 9,a'12 G@)05*)

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    21/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    "$; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    \*)(A0+ J/*1=*,A(*-d

    I,0@62+0f(-

    G@)05*) 9, ','-'0+ A(1A'/-50,A*-N

    M6*, 0)H0,A*) /*)(A0+

    0--(-50,A* (- ,?5 0H0(+0L+*N 0

    -*A?,) )?-* ?8 *@(,*@61(,*

    /02 L* =(H*, (8 -2/@5?/- ?8

    0,0@62+0f(- @*1-(-5O .PY:

    `6*, 0 @*1-?, M(56 0,0@62+0f(- )?*- ,?5

    1*-@?,) 5? 56* (,(5(0+ )?-*N 0,) 011(H0+ ?8

    0)H0,A*) A01* M(++ *fA**) % 5? $# /(,'5*-N

    0 1*@*05 )?-* /02 L* A?,-()*1*) SD+0-- 99LN

    FTJ DQFKUO .%[[

    !1*05*1 A+01(8(A05(?, ?8 56* ,**) 0,)

    5(/(,= 8?1 0 -*A?,) )?-* ?8

    *@(,*@61(,* M6*, 56* -2/@5?/- ?8

    0,0@62+0f(- )? ,?5 1*-@?,) 5? 56*

    8(1-5 )?-* 0,) 0)H0,A*) /*)(A0+ A01*

    (- -5(++ ,?5 0H0(+0L+*O

    \*)(A0+ J/*1=*,A(*-d

    I-56/0

    G@)05*) k(1-5 0() @1?H()*1- 01* ,?5

    *f@*A5*) 5? /0R* 0 )(0=,?-(-

    ?8 0-56/0N L'5 56*2 /02 0--(-5

    56* H(A5(/ (, '-(,= 56* H(A5(/h-

    @1*-A1(L*) L1?,A6?)(+05?1

    /*)(A05(?, SD+0-- 990N FTJ EU

    ',)*1 56* 8?++?M(,= A?,)(5(?,-d

    p >6* H(A5(/ -505*- 5605 6* ?1

    -6* (- 60H(,= 0, 0-56/0 0550AR

    ?1 -2/@5?/- 0--?A(05*) M(56 0

    @1*H(?'-+2 )(0=,?-*) L1*056(,=

    )(-?1)*1N 0,) 56* H(A5(/ 60-

    56* @1*-A1(L*) /*)(A05(?,- ?1

    (,60+*1 (, 6(- ?1 6*1 @?--*--(?,O

    p >6* H(A5(/ ()*,5(8(*- 56*/*)(A05(?, 0,) (- ',0L+* 5?

    0)/(,(-5*1 (5 M(56?'5

    0--(-50,A*O .PY:

    95 (- 1*0-?,0L+* 8?1 8(1-5 0() @1?H()*1- 5? L*

    80/(+(01 M(56 56* 0H0(+0L+* (,60+*)

    L1?,A6?)(+05?1 )*H(A*- 0,) 5? 0--(-5 0-

    ,**)*) M(56 56* 0)/(,(-5105(?, ?8

    @1*-A1(L*) L1?,A6?)(+05?1- M6*, 0 @*1-?,

    M(56 0-56/0 (- 60H(,= )(88(A'+52 L1*056(,=

    SD+0-- 990N FTJ EQCUO .%[:

    9,60+*) L1?,A6?)(+05?1- 60H* -6?M,

    5? L* 0, *88*A5(H* 51*05/*,5 8?1

    0-56/0 0,) ?56*1 L1*056(,= )(-?1)*1-

    1*+05*) 5? 56* ,011?M(,= ?8 56* -/0++

    L1*056(,= @0--0=*- (, 56* +',=-O >6*

    1(-R ?8 0)H*1-* 1*0A5(?,- 81?/ '-(,=

    56*-* /*)(A05(?,- (- +?MO E*(,=

    80/(+(01 M(56 56* '-* ?8 56*-* )*H(A*-

    0,) L*(,= 0L+* 5? 0--(-5 -?/*?,* (,

    '-(,= ?,* 01* 1*0-?,0L+* 510(,(,=

    =?0+- 8?1 0 8(1-5 0() @1?H()*1O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    22/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    ""; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    \*)(A0+ J/*1=*,A(*-d

    D6*/(A0+ J2* 9,a'12

    ^*M k(1-5 0() @1?H()*1- A01(,= 8?1 (,)(H()'0+- M(56

    A6*/(A0+ *2* (,a'12 -6?'+) A?,50A5 56*(1

    +?A0+ @?(-?, A?,51?+ A*,5*1 ?1N (8 0 @?(-?,

    A?,51?+ A*,5*1 (- ,?5 0H0(+0L+*N -**R 6*+@

    81?/ 0 /*)(A0+ @1?H()*1 ?1 PQ$Q$ SD+0-- 9N

    FTJ DQJTUO .%[_

    F?A0+ @?(-?, A?,51?+ A*,5*1- 1*0A6*)

    561?'=6 56*

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    23/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    "Y; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    \*)(A0+ J/*1=*,A(*-d

    42@?=+2A*/(0

    ^*M 98 0 @*1-?, M(56 )(0L*5*- 1*@?15- +?M L+??)

    -'=01 ?1 *f6(L(5- -(=,- ?1 -2/@5?/- ?8 /(+)

    62@?=+2A*/(0 0,) (- 0L+* 5? 8?++?M -(/@+*

    A?//0,)- 0,) -M0++?MN ?10+ =+'A?-* -6?'+)

    L* =(H*, 5? 055*/@5 5? 1*-?+H* 56*

    62@?=+2A*/(0O !+'A?-* 50L+*5-N (8 0H0(+0L+*N

    -6?'+) L* '-*) 5? 1*H*1-* 62@?=+2A*/(0 (, 0

    @*1-?, M6? (- 0L+* 5? 50R* 56*-* ?10++2

    SD+0-- 9N FTJ EQCUO 95 (- 1*0-?,0L+* 5? '-*

    )(*5012 -'=01- 0- 0, 0+5*1,05(H* 5? =+'A?-*

    50L+*5- SM6*, ,?5 0H0(+0L+*U 8?1 1*H*1-0+ ?8

    /(+) -2/@5?/05(A 62@?=+2A*/(0 SD+0-- 990N

    FTJ EQCUO k?1 )(0L*5(A- M(56 -2/@5?/- ?8

    62@?=+2A*/(0N -2/@5?/- /02 ,?5 1*-?+H*

    ',5(+ $# 5? $% /(,'5*- 085*1 (,=*-5(,=

    =+'A?-* 50L+*5- ?1 )(*5012 -'=01-O k(1-5 0()

    @1?H()*1- -6?'+) 56*1*8?1* M0(5 05 +*0-5 $#

    5? $% /(,'5*- L*8?1* A0++(,= J\. 0,) 1*Q

    51*05(,= 0 )(0L*5(A M(56 /(+) -2/@5?/05(A

    62@?=+2A*/(0 M(56 0))(5(?,0+ ?10+ -'=01-

    SD+0-- 9N FTJ EQCUO 98 56* @*1-?,h- -505'-

    )*5*1(?105*- )'1(,= 5605 5(/* ?1 )?*- ,?5(/@1?H*N 56* 8(1-5 0() @1?H()*1 -6?'+) A0++

    J\. SD+0-- 9N FTJ DQJTUO .%[[Q.%[_

    98 0 )(0L*5(A @*1-?, (- -'-@*A5*) 5?

    60H* +?M L+??) -'=01 0,) (- 0L+* 5?

    -M0++?M -08*+2N (5 (- 1*A?//*,)*) 5?

    '-* ?10+ =+'A?-* 50L+*5- 5? 1*H*1-*

    *01+2 /(+) -2/@5?/- ?8 62@?=+2A*/(0O

    98 =+'A?-* 50L+*5- 01* ,?5 0H0(+0L+*N

    -@*A(8(A )(*5012 -'=01- 01*

    1*A?//*,)*) 8?1 '-* (,-5*0)O

    E*A0'-* -2/@5?/- M(++ )(/(,(-6

    =10)'0++2N (5 (- 1*A?//*,)*) 5605 8(1-5

    0() @1?H()*1- M0(5 $# 5? $% /(,'5*-

    L*8?1* 0A5(H05(,= J\. 0,) @1?H()(,=

    0))(5(?,0+ ?10+ =+'A?-* ?1 )(*5012

    -'=01-O 98 0 @*1-?,Z- A?,)(5(?,

    )*5*1(?105*- 05 0,2 5(/*N (5 (-

    1*A?//*,)*) 5605 J\. L* 0A5(H05*)

    (//*)(05*+2O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    24/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    "V; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    \*)(A0+ J/*1=*,A(*-d

    .51?R*

    ^*M >6* '-* ?8 0 -51?R* 0--*--/*,5 -2-5*/ L2

    8(1-5 0() @1?H()*1- (- 1*A?//*,)*) SD+0-- 9N

    FTJ EQ^CUO .%[[

    4?-@(50+QL0-*) 0)H0,A*) 51*05/*,5-

    8?1 -51?R*- 01* 0H0(+0L+*N L'5 56* 5(/*

    5? =*5 5? 56*/ (- 0 L(= 80A5?1 (,

    *88*A5(H*,*-- 0,) -'1H(H0+O J01+2 '-* ?8

    0 -51?R* 0--*--/*,5 L2 0 8(1-5 0()

    @1?H()*1 60- -6?M, 5? -(=,(8(A0,5+2

    )*A1*0-* 56* 5(/* L*5M**, 56* ?,-*5

    ?8 56* -51?R* 0,) )*8(,(5(H* 51*05/*,5

    (, 0 6?-@(50+O

    \*)(A0+ J/*1=*,A(*-d

    >?f(A J2* 9,a'12

    G@)05*) C(,-* *2*- *f@?-*) 5? 5?f(A

    -'L-50,A*- (//*)(05*+2 M(56 0

    A?@(?'- 0/?',5 ?8 M05*1 SD+0--

    9N FTJUN ',+*-- 0 -@*A(8(A

    0,5()?5* (- 0H0(+0L+*O .PV#

    95 A0, L* L*,*8(A(0+ 5? 1(,-* *2*- *f@?-*) 5?

    5?f(A A6*/(A0+- (//*)(05*+2 0,) M(56 0

    A?@(?'- 0/?',5 ?8 50@ M05*1 8?1 05 +*0-5 $%

    /(,'5*- ?1 ',5(+ 0)H0,A*) /*)(A0+ A01*

    011(H*- SD+0-- 990N FTJ DQFKUO 98 50@ M05*1 (-

    ,?5 0H0(+0L+*N ,?1/0+ -0+(,* ?1 0,?56*1

    A?//*1A(0++2 0H0(+0L+* *2* (11(=05(?,

    -?+'5(?, /02 L* 1*0-?,0L+* SD+0-- 99LN FTJ

    DQFKUO .%[_

    >6* (//*)(05* 8+'-6(,= ?8 *2*- 5605

    60H* L**, *f@?-*) 5? 5?f(A

    -'L-50,A*- M(56 A?@(?'-N ?1 +01=*N

    H?+'/*- ?8 50@ M05*1 60- L**, 8?',)

    5? L* 56* *0-(*-5 0,) L*-5 0@@1?0A6O

    E*A0'-* -?/* 5?f(A -'L-50,A*- 50R*

    +?,=*1 5? L*A?/* )(+'5*) 560, ?56*1-N

    (5 (- 1*A?//*,)*) 5? 8+'-6 8?1 05 +*0-5

    $% /(,'5*- ?1 ',5(+ 0)H0,A*) 6*+@

    011(H*-O `6*, 50@ M05*1 (- ,?5

    (//*)(05*+2 0H0(+0L+*N ,?1/0+ -0+(,*

    ?1 0,?56*1 A?//*1A(0++2 0H0(+0L+* *2*(11(=05(,= -?+'5(?, A0, L* '-*)O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    25/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    "%; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    \'-A'+?-R*+*50+

    >10'/0

    G@)05*) K? ,?5 /?H* ?1 512 5?

    -510(=65*, 0, (,a'1*) *f51*/(52

    SD+0-- 999N FTJ DUO Jf@*15

    ?@(,(?, -'==*-5- 5605 -@+(,5(,=

    /02 1*)'A* @0(, 0,) @1*H*,5

    8'156*1 (,a'12O .?N (8 2?' 01* 801

    81?/ )*8(,(5(H* 6*0+56 A01*N

    -50L(+(i* 56* *f51*/(52 M(56 0

    -@+(,5 (, 56* @?-(5(?, 8?',)

    SD+0-- 990N FTJ DUO .PY_

    9, =*,*10+N 8(1-5 0() @1?H()*1- -6?'+) ,?5

    /?H* ?1 512 5? -510(=65*, 0, (,a'1*)

    *f51*/(52 SD+0-- 999d 401/N FTJ DQJTUO E0-*)

    ?, 510(,(,= 0,) A(1A'/-50,A* S-'A6 0-

    1*/?5* )(-50,A* 81?/ J\. ?1 M(+)*1,*--

    -*55(,=-N @1*-*,A* ?8 H0-A'+01 A?/@1?/(-*UN

    -?/* 8(1-5 0() @1?H()*1- /02 ,**) 5? /?H*

    0, (,a'1*) +(/L ?1 @*1-?,O 9, -'A6 -(5'05(?,-N

    @1?H()*1- -6?'+) @1?5*A5 56* (,a'1*) @*1-?,N

    (,A+')(,= -@+(,5(,= (, 0 M02 5605 +(/(5- @0(,N

    1*)'A*- 56* A60,A* 8?1 8'156*1 (,a'12N 0,)

    80A(+(505*- -08* 0,) @1?/@5 510,-@?15 SD+0--

    9N FTJ DQJTUO .%_#

    I- 0 =*,*10+ 0@@1?0A6N (5 (- L*-5 5? ,?5

    /?H* ?1 -510(=65*, 0, (,a'1*)

    *f51*/(52 5605 (- ',,05'10++2 L*,5 ?1

    0,='+05*)O 4?M*H*1N 56*1* /02 L*

    0))(5(?,0+ 510(,(,= ,*A*--012 ?,

    /?H(,= 0,) -@+(,5(,= (, -@*A(8(A A0-*-N

    -'A6 0- (, 1*/?5* -*55(,=- ?1 (8

    ,*'1?+?=(A0+WH0-A'+01 A?/@1?/(-* (-

    -'-@*A5*)O >10(,(,= (, /?H(,= 0,)

    -@+(,5(,= 0, (,a'1*) *f51*/(52 -6?'+)

    */@60-(i* 56* @1?5*A5(?, ?8 56*

    088*A5*) @*1-?,N +(/(5(,= @0(,N

    1*)'A(,= 56* A60,A* 8?1 8'156*1 (,a'12N

    0,) 80A(+(505(,= ]'(AR 0,) -08*

    510,-@?1505(?, 5? 0 6*0+56A01* 80A(+(52O

    \'-A'+?-R*+*50+

    >10'/0

    ^*M 98 0, (,a'1*) *f51*/(52 (- L+'* ?1 *f51*/*+2

    @0+*N 0A5(H05* J\. (//*)(05*+2 SD+0-- 9N FTJ

    DQJTUO .%_#

    `6*, 56* -R(, A?+?1 ?8 0, (,a'1*)

    *f51*/(52 (,)(A05*- 0 +0AR ?8 ?f2=*, (,

    56* L+??) SL+'*U ?1 0 +0AR ?8 L+??)

    8+?M S@0+*UN 56*1* (- 0 +(R*+2 @?--(L(+(52

    5605 56* H0-A'+01 -2-5*/ 60- L**,

    A?/@1?/(-*) L2 56* (,a'12O J01+21*A?=,(5(?, 0,) J\. 0A5(H05(?, L2 0

    8(1-5 0() @1?H()*1 A0, 6*+@ 5? @1*H*,5

    0))(5(?,0+ (,a'12O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    26/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    ":; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    Tf2=*, G-* (, k(1-5

    I()

    G@)05*) >6*1* (- ,? *H()*,A* 8?1 ?1

    0=0(,-5 56* 1?'5(,* '-* ?8

    ?f2=*, 0- 0 8(1-5 0() /*0-'1*

    8?1 H(A5(/- *f@*1(*,A(,=

    -6?15,*-- ?8 L1*056 ?1 A6*-5

    @0(,O Tf2=*, /02 L* L*,*8(A(0+

    8?1 8(1-5 0() (, )(H*1- M(56 0

    )*A?/@1*--(?, (,a'12O .PY%Q

    .PY:

    >6* '-* ?8 -'@@+*/*,5012 ?f2=*, L2 8(1-5

    0() @1?H()*1- M(56 -@*A(8(A 510(,(,= (-

    1*0-?,0L+* 8?1 A0-*- ?8 )*A?/@1*--(?,

    -(AR,*-- SD+0-- 990N FTJ DQFKUO k?1 8(1-5 0()

    @1?H()*1- M(56 -@*A(8(A 510(,(,= (, 56* '-* ?8

    ?f2=*,N 56* 0)/(,(-5105(?, ?8

    -'@@+*/*,5012 ?f2=*, 5? @*1-?,- M(56

    R,?M, 0)H0,A*) A0,A*1 M(56 )2-@,*0 0,)

    62@?f*/(0 /02 L* 1*0-?,0L+* SD+0-- 99LN

    FTJ EQCUO I+56?'=6 ,? *H()*,A* M0-

    ()*,5(8(*) 5? -'@@?15 56* '-* ?8 ?f2=*,N (5

    /(=65 L* 1*0-?,0L+* 5? @1?H()* ?f2=*, 5?

    -@?,50,*?'-+2 L1*056(,= @*1-?,- M6? 01*

    *f@?-*) 5? A01L?, /?,?f()* M6(+* M0(5(,=

    8?1 0)H0,A*) /*)(A0+ A01* SD+0-- 99LN FTJ DQ

    JTUO .%[:

    JH*, 56?'=6 -'@@+*/*,5012 ?f2=*, (-

    '-*) A?//?,+2 (, 6*0+56A01*

    *,H(1?,/*,5-N 56*1* M0- ,?5 /'A6

    *H()*,A* ?8 (5- L*,*8(A(0+ '-* (, 56*

    8(1-5 0() -*55(,=O >6* '-* ?8

    -'@@+*/*,5012 ?f2=*, (, 8(1-5 0()

    -(5'05(?,- (- ,?5 0 -50,)01) -R(++O

    4?M*H*1N 56*1* M*1* 0 8*M -@*A(8(A

    A(1A'/-50,A*- (, M6(A6 56* L*,*8(5 ?8

    -'@@+*/*,50+ ?f2=*, M0- -6?M,O 9,

    0))(5(?,N (5 M0- 8*+5 5? L* 1*0-?,0L+*

    5? @1?H()* ?f2=*,N M6(+* M0(5(,= 8?1

    0)H0,A*) /*)(A0+ A01*N 8?1 (,)(H()'0+-

    M6? 60) L**, *f@?-*) 5? A01L?,

    /?,?f()*O .@*A(0+(i*) 510(,(,= (, 56*

    '-* ?8 ?f2=*, )*+(H*12 -2-5*/- (-

    1*]'(1*) M6*, (5 (- /0)* 0H0(+0L+*O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    27/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    "[; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    28/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    "_; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    >10'/0 J/*1=*,A(*-d

    D?,A'--(?,

    ^*M I,2 @*1-?, M(56 0 6*0) (,a'12 5605 60-

    1*-'+5*) (, 0 A60,=* (, +*H*+ ?8

    A?,-A(?'-,*--N 60- @1?=1*--(H*

    )*H*+?@/*,5 ?8 -(=,- ?1 -2/@5?/- 0-

    )*-A1(L*) 0L?H*N ?1 (- ?56*1M(-* 0 A0'-* 8?1

    A?,A*1, -6?'+) L* *H0+'05*) L2 0

    6*0+56A01* @1?H()*1 ?1 J\. @*1-?,,*+ 0-

    -??, 0- @?--(L+* SD+0-- 9N FTJ DQJTUO .%[P

    IH0(+0L+* 5M?Q-50=* 0--*--/*,5

    @1?A*--*- 8?1 ()*,5(82(,= A?,A'--(?,-

    01* ,?5 0@@1?@1(05* 8?1 '-* (, 8(1-5 0()

    -*55(,=- L*A0'-* 56*2 1*]'(1* 0,

    0--*--/*,5 @1(?1 5? (,a'12 8?1

    A?/@01(-?,O I, 0@@1?@1(05* -(,=+*

    -50=* 0--*--/*,5 8?1 8(1-5 0() (-

    A'11*,5+2 ,?5 0H0(+0L+*O >6* 8(1-5 0()

    1*A?//*,)05(?, (- 5? -'-@*A5 56*

    @?--(L(+(52 ?8 0 A?,A'--(?, M6*,*H*1

    56*1* (- 0 A60,=* (, 56* +*H*+ ?8

    A?,-A(?'-,*-- ?1 (8 56*1* (- 0

    @1?=1*--(H* )*H*+?@/*,5 ?8 -(=,-

    -'A6 0- 8**+(,= -5',,*) ?1 )0i*)N

    *f@*1(*,A(,= 6*0)0A6*N ,0'-*0N

    )(ii(,*-- ?1 )(88(A'+52 (, L0+0,A*N ?1

    -6?M(,= H(-'0+ )(-5'1L0,A*N A?,8'-(?,N

    ?1 +?-- ?8 /*/?12 S81?/ *(56*1 L*8?1*

    ?1 085*1 56* (,a'12UO 98 0 A?,A'--(?, (-

    -'-@*A5*)N (5 (- 0@@1?@1(05* 8?1 56*

    088*A5*) @*1-?, 5? L* *H0+'05*) L2

    J\. ?1 0,?56*1 6*0+56A01* @1?H()*10- -??, 0- @?--(L+*O

    >10'/0 J/*1=*,A(*-d

    D?,A'--(?,

    ^*M G-(,= 0,2 /*A60,(A0+ /0A6(,*12N )1(H(,=N

    A2A+(,=N ?1 A?,5(,'(,= 5? @015(A(@05* (, -@?15-

    085*1 0 6*0) (,a'12 -6?'+) L* )*8*11*) L2

    56*-* (,)(H()'0+- ',5(+ 56*2 01* 0--*--*) L2

    0 6*0+56A01* @1?H()*1 0,) A+*01*) 5?

    @015(A(@05* (, 56?-* 0A5(H(5(*- SD+0-- 9N FTJ DQ

    JTUO .%[P

    E*A0'-* ?8 56* @1?=1*--(H* ,05'1* ?8

    A?,A'--(?,N (5 (- L*-5 ,?5 5? 0++?M 0,

    088*A5*) @*1-?, 5? @*18?1/ 0A5(?,-

    5605 A?'+) @?-* 0 1(-R 8?1 0))(5(?,0+

    (,a'12N ',5(+ 6* ?1 -6* A0, 0)*]'05*+2

    L* 0--*--*) L2 0 6*0+56A01* @1?H()*1O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    29/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    "P; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    >10'/0 J/*1=*,A(*-d

    D?,51?+ ?8 E+**)(,=

    G@)05*) E+**)(,= (- L*-5 A?,51?++*) L2

    0@@+2(,= @1*--'1* ',5(+

    L+**)(,= -5?@- ?1 J\. 1*-A'*1-

    011(H* SD+0-- 9N FTJ IUO .PY:

    >6* -50,)01) /*56?) 8?1 8(1-5 0() @1?H()*1-

    5? A?,51?+ ?@*, L+**)(,= (- 5? 0@@+2 )(1*A5

    @1*--'1* 5? 56* L+**)(,= -(5* ',5(+ (5 -5?@-O

    D?,51?+ ?@*, L+**)(,= L2 0@@+2(,= )(1*A5

    @1*--'1* 5? 56* L+**)(,= -(5* SD+0-- 9N FTJ EQ

    ^CUO .%[_

    k'156*1 A+01(8(A05(?, ?8 )(1*A5 @1*--'1*

    0- 56* -50,)01) /*56?) ?8 L+**)(,=

    A?,51?+ 8?1 ?@*, L+**)(,=O

    >10'/0 J/*1=*,A(*-d

    D?,51?+ ?8 E+**)(,=

    ^*M F?A0+ A?+) 56*10@2N -'A6 0- 0, (,-50,5 A?+)

    @0ARN A0, L* '-*8'+ 8?1 56*-* 52@*- ?8

    (,a'1(*- 5? 56* *f51*/(52 ?1 -A0+@ SD+0-- 990N

    FTJ DQFKUO D?+) 56*10@2 -6?'+) L* '-*) M(56

    A0'5(?, (, A6(+)1*, L*A0'-* ?8 56* 1(-R ?8

    62@?56*1/(0 (, 56(- @?@'+05(?, SD+0-- 9N FTJ

    DQJTUO .%[_

    I+56?'=6 56*1* (- +(/(5*) )050 ?, 56*

    L*,*8(5N +?A0+ A??+(,= ?8 0 A+?-*)

    (,a'12N -'A6 0- L1'(-(,=N A0, L* '-*8'+

    M6*, 56* -A0+@ ?1 0, *f51*/(52 (-

    (,a'1*)O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    30/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    Y#; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    >10'/0 J/*1=*,A(*-d

    D?,51?+ ?8 E+**)(,=

    G@)05*) E*A0'-* ?8 56* @?5*,5(0+

    0)H*1-* *88*A5- ?8 5?'1,(]'*5-

    0,) )(88(A'+52 (, 56*(1 @1?@*1

    0@@+(A05(?,N '-* ?8 0 5?'1,(]'*5

    5? A?,51?+ L+**)(,= ?8 56*

    *f51*/(5(*- (- (,)(A05*) ?,+2 (8

    )(1*A5 @1*--'1* (- ,?5 *88*A5(H*

    ?1 @?--(L+* SD+0-- 99LN FTJ EUO

    .PY[

    E*A0'-* 56* 105* ?8 A?/@+(A05(?,- (- +?M 0,)

    56* 105* ?8 6*/?-50-(- (- 6(=6N 8(1-5 0()

    @1?H()*1- /02 A?,-()*1 56* '-* ?8 0

    5?'1,(]'*5 M6*, -50,)01) 8(1-5 0()

    6*/?1160=* A?,51?+ )?*- ,?5 A?,51?+ -*H*1*

    *f5*1,0+ +(/L L+**)(,=O SD+0-- 99LN FTJ DQFKUO

    I 5?'1,(]'*5 /02 L* A?,-()*1*) 8?1 (,(5(0+

    A01* M6*, 0 8(1-5 0() @1?H()*1 (- ',0L+* 5?

    '-* -50,)01) 8(1-5 0() 6*/?1160=* A?,51?+N

    -'A6 0- )'1(,= 0 /0-- A0-'0+52 (,A()*,5N

    M(56 0 @*1-?, M6? 60- /'+5(-2-5*/ 510'/0N

    (, 0, ',-08* *,H(1?,/*,5N ?1 M(56 0 M?',)

    5605 A0,,?5 L* 0AA*--*) SD+0-- 99LN FTJ DQ

    JTUO .%[P

    I))(5(?,0+ *H()*,A* -(,A* "#$#

    (,)(A05*- 0 +?M 105* ?8 @?5*,5(0+

    A?/@+(A05(?,- 0,) 0 6(=6 105* ?8

    -'AA*-- M6*, '-(,= 0 5?'1,(]'*5 8?1

    -*H*1* L+**)(,= A?,51?+O k?1 /?-5

    -(5'05(?,-N 56* ='()*+(,* 1*/0(,- 56*

    -0/*d E*=(, M(56 )(1*A5 @1*--'1* ?, 0

    -*H*1*+2 L+**)(,= +(/L M?',) 0,) '-*

    0 5?'1,(]'*5 (8 )(1*A5 @1*--'1* A0,,?5

    L* 0@@+(*) ?1 A?,51?+ 56* L+**)(,=

    *88*A5(H*+2O 4?M*H*1N (, A*150(,

    A(1A'/-50,A*-N -'A6 0- 0 +01=* /0--Q

    A0-'0+52 *H*,5N 0 -(,=+* @*1-?, M(56

    /'+5(@+* (,a'1(*-N 0 )0,=*1?'-

    *,H(1?,/*,5N ?1 0 M?',) 5605 A0,,?5

    L* 0AA*--*)N 56* '-* ?8 0 5?'1,(]'*5

    0- 56* 8(1-5 L+**)(,= A?,51?+ /*0-'1*

    A0, L* A?,-()*1*)O

    >10'/0 J/*1=*,A(*-d

    D?,51?+ ?8 E+**)(,=

    ^*M 95 (- 1*0-?,0L+* 8?1 8(1-5 0() @1?H()*1- 5? L*

    510(,*) (, 56* @1?@*1 0@@+(A05(?, ?8

    5?'1,(]'*5-N L?56 /0,'80A5'1*) 0,)(/@1?H(-*) SD+0-- 990N FTJ DQJTUO .%[P

    D?//*1A(0++2 /0,'80A5'1*)

    5?'1,(]'*5- 60H* -6?M, 5? L* /?1*

    *88*A5(H* 560, (/@1?H(-*) ?,*-O 98 0/0,'80A5'1*) 5?'1,(]'*5 (- ,?5

    (//*)(05*+2 0H0(+0L+*N (5 (- @?--(L+* 5?

    A1*05* 0, (/@1?H(-*) 5?'1,(]'*5 '-(,=

    ,*01L2 /05*1(0+-O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    31/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    Y$; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    >10'/0 J/*1=*,A(*-d

    D?,51?+ ?8 E+**)(,=

    G@)05*) I/?,= 56* +01=* ,'/L*1 ?8

    A?//*1A(0++2 0H0(+0L+*

    6*/?-505(A 0=*,5-N -?/* 60H*

    L**, -6?M, 5? L* *88*A5(H*O

    4?M*H*1N 56*(1 1?'5(,* '-* (,

    8(1-5 0() A0,,?5 L*

    1*A?//*,)*) 05 56(- 5(/*

    L*A0'-* ?8 -(=,(8(A0,5 H01(05(?,

    (, *88*A5(H*,*-- L2 )(88*1*,5

    0=*,5- 0,) 56*(1 @?5*,5(0+ 8?1

    0)H*1-* *88*A5-N (,A+')(,=

    5(--'* )*-51'A5(?, M(56

    (,)'A5(?, ?8 0 @1? */L?+(A

    -505* 0,) @?5*,5(0+ 56*1/0+

    (,a'12 SD+0-- 99LN FTJ EUO .YP[

    4*/?-505(A )1*--(,=- /02 L* A?,-()*1*) L2

    8(1-5 0() @1?H()*1- M6*, -50,)01) L+**)(,=

    A?,51?+ S)(1*A5 @1*--'1* M(56 ?1 M(56?'5

    =0'i* ?1 A+?56 )1*--(,=U (- ,?5 *88*A5(H* 8?1

    -*H*1* ?1 +(8* 561*05*,(,= L+**)(,= SD+0-- 99LN

    FTJ DQFKUO 6* +05*-5 =*,*105(?, ?8

    56*-* )1*--(,=- 60- 0 /'A6 +?M*1 1(-R

    ?8 A?/@+(A05(?,- 0,) (- ,?M

    1*A?//*,)*) 8?1 '-* L2 8(1-5 0()

    @1?H()*1-O 4*/?-505(A )1*--(,=- 60H*

    -6?M, 5? L* L*,*8(A(0+ 8?1 L?)2

    +?A05(?,- S51',RN 0L)?/*,N =1?(,U

    M6*1* -50,)01) L+**)(,= A?,51?+

    1*A?//*,)05(?,- 01* ,?5 *88*A5(H*N

    ?1 M6*, 0 5?'1,(]'*5 (- ,?5 0H0(+0L+*

    ?1 A0,,?5 A?,51?+ L+**)(,= ?, (5- ?M,O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    32/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    Y"; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    >10'/0 J/*1=*,A(*-d

    T@*, D6*-5 `?',)-

    ^*M `* 1*A?//*,) 0=0(,-5 56* 0@@+(A05(?, ?8

    0, ?AA+'-(H* )1*--(,= ?1 )*H(A* L2 8(1-5 0()

    @1?H()*1- 8?1 (,)(H()'0+- M(56 0, ?@*, A6*-5

    M?',) SD+0-- 999d 401/N FTJ DQJTUO 9, 56*

    8(1-5 0() -(5'05(?,N (5 (- 1*0-?,0L+* 5? +*0H*

    0, ?@*, A6*-5 M?',) *f@?-*) 5? 0/L(*,5

    0(1 M(56?'5 0 )1*--(,= ?1 -*0+ SD+0-- 990N FTJ

    DQJTUO .%[P

    >6* =*,*10++2 0AA*@5*) 8(1-5 0()

    0@@1?0A6 5? /0,0=* 0, ?@*, M?',)

    ?, 56* A6*-5 M0++ 60- L**, 5? @1*H*,5

    56* q-'AR(,=q ?8 0(1 561?'=6 56*

    M?',) 0,) (,5? 56* A6*-5 A0H(52 L2

    '-(,= 0, ?AA+'-(H*N ?1 0(1 5(=65N

    )1*--(,=O >6(- M0- 0AA?/@0,(*) L2

    56* 1*A?//*,)05(?, ?8 +*0H(,= 0,

    ',-*0+*) A?1,*1 ?1 -()* ?8 56*

    )1*--(,= 5? 0++?M @1*--'1(i*) 0(1 5?

    *-A0@*O >6(- 0))1*--*) 56* @?--(L(+(52

    ?8 0 5*,-(?, @,*'/?56?10f M6(A6 A0,

    10@()+2 A0'-* -*1(?'- A?/@+(A05(?,-O

    K'* 5? 0 +0AR ?8 *H()*,A* ?8 56*

    *88*A5(H*,*-- ?8 0, ?AA+'-(H* )1*--(,=

    0,) 56* 6(=6 1(-R ?8 0, ',/0,0=*)

    5*,-(?, @,*'/?56?10fN 56* ,*M

    1*A?//*,)05(?, (- 5? ,?5 '-*

    ?AA+'-(H* )1*--(,=- 8?1 ?@*, (,a'1(*-

    ?8 56* A6*-5O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    33/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    YY; < 0 = *

    !"#$% 1( 2.34- ".)

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    >10'/0 J/*1=*,A(*-d

    .@(,0+ \?5(?,

    C*-51(A5(?,

    G@)05*) E*A0'-* ?8 56* )(1*

    A?,-*]'*,A*- (8 -*A?,)012

    (,a'12 )?*- ?AA'1N /0(,50(,

    -@(,0+ /?5(?, 1*-51(A5(?, L2

    /0,'0++2 -50L(+(i(,= 56* 6*0)

    -? 5605 56* /?5(?, ?8 6*0)N

    ,*ARN 0,) -@(,* (- /(,(/(i*)

    SD+0-- 99LN FTJ DUO .PY_

    98 0 8(1-5 0() @1?H()*1 -'-@*A5- 0 -@(,0+ (,a'12N

    6* ?1 -6* -6?'+) 60H* 56* @*1-?, 1*/0(, 0-

    -5(++ 0- @?--(L+* 0,) 0M0(5 56* 011(H0+ ?8 J\.

    @1?H()*1- SD+0-- 9N FTJ DQJTUO k?1 H(A5(/-

    M(56 -'-@*A5*) -@(,0+ (,a'12N 1*-A'*1-

    -6?'+) (,(5(0++2 '-* /0,'0+ -@(,0+ /?5(?,

    1*-51(A5(?, S*=N @+0A(,= $ 60,) ?, *(56*1 -()*

    ?8 56* @05(*,5h- 6*0) 5? 6?+) (5 -5(++U 1056*1

    560, (//?L(+(i05(?, )*H(A*-N L*A0'-* '-* ?8

    (//?L(+(i05(?, )*H(A*- L2 +02 1*-A'*1- /02

    L* 601/8'+ SD+0-- 999d 401/N FTJ DQFKUO .%_#N

    .V"$

    k'156*1 A+01(8(A05(?, M0- @1?H()*) (,

    1*=01) 5? 56* 5*A6,(]'* ?8 -@(,0+

    /?5(?, 1*-51(A5(?,N (,A+')(,= H*1L0+

    (,-51'A5(?,- 8?1 0 H(A5(/ 5? 1*/0(, -5(++

    0,) /0,'0++2 -50L(+(i(,= 56* 6*0) M(56

    0 60,) ?, *(56*1 -()* ?8 56* 6*0)O

    I))(5(?,0++2N 56* '-* ?8 0 6*0)

    (//?L(+(i05(?, )*H(A* L2 0 +02 1*-A'*1

    M0- ,?5 1*A?//*,)*) L*A0'-* ?8 56*

    @?5*,5(0+ )(88(A'+52 ?8 L*(,= 0L+* 5?

    /0(,50(, 0 A+*01 0,) ?@*, 0(1M02 M(56

    ?,* (, @+0A*O

    >10'/0 J/*1=*,A(*-d

    .@(,0+ \?5(?,

    C*-51(A5(?,

    ^*M `(56 0 =1?M(,= L?)2 ?8 *H()*,A* -6?M(,=

    /?1* 0A5'0+ 601/ 0,) ,? =??) *H()*,A*

    -6?M(,= A+*01 L*,*8(5N M* 1*A?//*,)

    0=0(,-5 1?'5(,* 0@@+(A05(?, ?8 A*1H(A0+ A?++01-

    L2 8(1-5 0() @1?H()*1- SD+0-- 999d 401/N FTJ DQ

    FKUO .%_#

    >6* "#$% *H0+'05(?, ?8 -@(,0+ /?5(?,

    1*-51(A5(?, M0- +(/(5*) 5? 56*

    0@@+(A05(?, ?8 A*1H(A0+ A?++01- L2 8(1-5

    0() @1?H()*1-O ^? *H()*,A* M0- -6?M,

    5605 56* '-* ?8 56* A*1H(A0+ A?++01-

    )*A1*0-*) 56* ?AA'11*,A* ?8

    ,*'1?+?=(A0+ (,a'12N L'5 56*1* M0-*H()*,A* ?8 0)H*1-* *88*A5-N -'A6 0-

    (,A1*0-(,= @1*--'1* M(56(, 56*

    A10,('/ 0,) 0(1M02 A?/@1?/(-*N (,

    56*(1 '-* L2 @1?H()*1- M(56 +(/(5*)

    510(,(,=O

    BI/*1(A0, 4*015 I--?A(05(?,O b"#$# I/*1(A0, 4*015 I--?A(05(?, !'()*+(,*- 8?1 D01)(?@'+/?,012 C*-'-A(505(?, 0,) J/*1=*,A2 D01)(?H0-A'+01 D01*Oc D(1A'+05(?

    $""N -'@@+ Y S"#$#Ud .:YPQ.PV:O

    BBI/*1(A0, 4*015 I--?A(05(?,O b"#$% I/*1(A0, 4*015 I--?A(05(?, !'()*+(,*- G@)05* 8?1 D01)(?@'+/?,012 C*-'-A(505(?, 0,) J/*1=*,A2 D01)(?H0-A'+01 D01*Oc

    D(1A'+05(?, $Y"N -'@@+ " S"#$%Ud .Y$YQ.%_PO

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    34/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    YV; < 0 = *

    !"#$% 5( 67,8-9+,37 :3/;.)73 ")*8- #$?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D01)(0A I11*-5

    I--?A(05*) `(56

    ? 1*+(*H* 0?15?A0H0+

    A?/@1*--(?, )'1(,= A6*-5

    A?/@1*--(?,- 0,) ?@5(/(i* 56*

    ]'0+(52 ?8 D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    35/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    Y%; < 0 = *

    !"#$% 5( 67,8-9+,37 :3/;.)73 ")*8- #$?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D01)(0A ?1

    C*-@(105?12 I11*-5

    I--?A(05*) `(56

    T@(?() TH*1)?-*

    ^*M k?1 @05(*,5- M(56 R,?M, ?1 -'-@*A5*) ?@(?()

    ?H*1)?-* M6? 60H* 0 )*8(,(5* @'+-* L'5 ,?

    ,?1/0+ L1*056(,= ?1 ?,+2 =0-@(,= S(*N 0

    1*-@(105?12 011*-5UN (, 0))(5(?, 5? @1?H()(,=

    -50,)01) EF. A01*N (5 (- 1*0-?,0L+* 8?1

    0@@1?@1(05*+2 510(,*) EF. 6*0+56A01*

    @1?H()*1- 5? 0)/(,(-5*1 9\ ?1 9^ ,0+?f?,*

    SD+0-- 990N FTJ DQFKUO 95 /02 L* 1*0-?,0L+* 5?

    0)/(,(-5*1 9\ ?1 9^ ,0+?f?,* L0-*) ?, 56*

    @?--(L(+(52 5605 56* @05(*,5 (- ,?5 (, A01)(0A

    011*-5 SD+0-- 99LN FTJ DQJTUO E0=Q/0-R

    H*,5(+05(?, -6?'+) L* /0(,50(,*) ',5(+

    -@?,50,*?'- L1*056(,= 1*5'1,-N 0,)

    -50,)01) IDF. /*0-'1*- -6?'+) A?,5(,'* (8

    1*5'1, ?8 -@?,50,*?'- L1*056(,= )?*- ,?5

    ?AA'1 SD+0-- 9N FTJ DQFKUO .V$_

    T@(?() ?H*1)?-* (- 0 -(=,(8(A0,5 6*0+56

    @1?L+*/O ^0+?f?,* (- 0 /*)(A05(?,

    5605 A0, ]'(AR+2 1*H*1-* 56*

    )*@1*--(?, ?8 56* 1*-@(105?12 )1(H*

    A0'-*) L2 0, ?H*1)?-* ?8 ?@(?()-O

    J+(/(,05(,= 56* *88*A5 ?8 56* ?@(?()-

    A0, 1*/?H* 56* ',)*1+2(,= A0'-* ?8

    1*-@(105?12 011*-5 0,) 0++?M 56*

    @*1-?, 5? 1*-'/* L1*056(,= ?, 6(- ?1

    6*1 ?M,O

    D01)(0A ?1

    C*-@(105?12 I11*-5

    I--?A(05*) `(56

    T@(?() TH*1)?-*

    ^*M

    0,)

    G@)05*)

    >6*1* 01* ,? )050 5? -'@@?15

    56* '-* ?8 -@*A(8(A 0,5()?5*- (,

    56* -*55(,= ?8 A01)(0A 011*-5

    )'* 5? ?@(?() ?H*1)?-*O

    C*-'-A(505(?, 81?/ A01)(0A011*-5 -6?'+) 8?++?M -50,)01)

    EF. 0,) IDF. 0+=?1(56/-O ._V#

    ^0+?f?,* 60- ,? 1?+* (, 56*

    /0,0=*/*,5 ?8 A01)(0A 011*-5O

    ._V$

    k?1 @05(*,5- (, A01)(0A 011*-5N /*)(A05(?,

    0)/(,(-5105(?, (- (,*88*A5(H* M(56?'5

    A?,A?/(50,5 A6*-5 A?/@1*--(?,- 8?1 )1'=

    )*+(H*12 5? 56* 5(--'*-N -? ,0+?f?,*

    0)/(,(-5105(?, /02 L* A?,-()*1*) 085*1(,(5(05(?, ?8 D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    36/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    Y:; < 0 = *

    !"#$% 5( 67,8-9+,37 :3/;.)73 ")*8- #$?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    .'-@*A5*) T@(?()Q

    C*+05*) F(8*Q

    >61*05*,(,=

    J/*1=*,A2

    ^*M 95 (- 1*0-?,0L+* 5? @1?H()* ?@(?() ?H*1)?-*

    1*-@?,-* *)'A05(?, M(56 ?1 M(56?'5

    ,0+?f?,* )(-51(L'5(?, 5? @*1-?,- 05 1(-R 8?1

    ?@(?() ?H*1)?-* (, 0,2 -*55(,= SD+0-- 990N FTJ

    DQFKUO .V$_

    J01+2 1*A?=,(5(?, 0,) 51*05/*,5 8?1 0,

    ?@(?() ?H*1)?-* A0, 60H* 0 -(=,(8(A0,5

    *88*A5 ?, -'1H(H0+O J)'A05(,= 56?-*

    /?-5 05 1(-RN 0+?,= M(56 ?56*1- M6?

    60H* A+?-* A?,50A5 M(56 56?-* 05 1(-RN

    A0, (/@1?H* 56* -@**) 05 M6(A6

    ,0+?f?,* A0, L* @1?H()*)O

    D6*-5 D?/@1*--(?,

    K*@56

    G@)05*) >6* 0)'+5 -5*1,'/ -6?'+) L*

    )*@1*--*) 05 +*0-5 " (,A6*- S%

    A/UO SD+0-- 990N FTJ EUO .:P#

    K'1(,= /0,'0+ D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    37/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    Y[; < 0 = *

    !"#$% 5( 67,8-9+,37 :3/;.)73 ")*8- #$?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D6*-5 D?/@1*--(?,

    C05*

    G@)05*) 95 (- 56*1*8?1* 1*0-?,0L+* 8?1

    +02 1*-A'*1- 0,) 6*0+56A01*

    @1?H()*1- 5? @*18?1/ A6*-5

    A?/@1*--(?,- 8?1 0)'+5- 05 0

    105* ?8 05 +*0-5 $##

    A?/@1*--(?,- @*1 /(,'5*

    SD+0-- 990N FTJ EUO .:P#

    9, 0)'+5 H(A5(/- ?8 A01)(0A 011*-5N (5 (-

    1*0-?,0L+* 8?1 1*-A'*1- 5? @*18?1/ A6*-5

    A?/@1*--(?,- 05 0 105* ?8 $##W/(, 5?

    $"#W/(, SD+0-- 990N FTJ DQFKUO .V$P

    K*8(,(,= 0, '@@*1 +(/(5 8?1

    A?/@1*--(?, 105*N ?1 -@**)N A0, 6*+@

    1*-A'*1- 8?A'- ?, 0A6(*H(,= 0,

    ?@5(/'/ 0@@1?0A6 )'1(,= D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    38/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    Y_; < 0 = *

    !"#$% 5( 67,8-9+,37 :3/;.)73 ")*8- #$?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D6*-5 D?/@1*--(?,

    k**)L0AR

    G@)05*) ^*H*156*+*--N 1*0+Q5(/* D6(- (- L0-*) ?, 56* ',)*1+2(,=A?,A*@5 5605 0 +(/(5*) 0/?',5 ?8

    ',A(1A'+05*) ?f2=*, 1*/0(,- (, 56*

    A(1A'+05?12 -2-5*/ 085*1 011*-5 0,) 56*

    L*,*8(5 ?8 ',(,5*11'@5*) A6*-5

    A?/@1*--(?,- A0, L* 8'++2 '5(+(i*) 5?

    (/@1?H* )*8(L1(++05(?, -'AA*--O 95 (-

    (/@?150,5 5? ,?5* 5605 56(- (- 0 -2-5*/

    0@@1?0A6 0,) ,?5 0, (,)(H()'0+

    1*A?//*,)05(?, 8?1 510(,*) 1*-A'*1-O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    39/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    YP; < 0 = *

    !"#$% 5( 67,8-9+,37 :3/;.)73 ")*8- #$?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    K*H(A*- 5? .'@@?15

    D(1A'+05(?,d F?0)Q

    K(-51(L'5(,= E0,)

    K*H(A*- SFKEU

    ^*M

    0,)

    G@)05*)

    >6* FKE /02 L* A?,-()*1*) 8?1

    '-* L2 @1?@*1+2 510(,*)

    @*1-?,,*+ (, -@*A(8(A -*55(,=-

    8?1 56* 51*05/*,5 ?8 A01)(0A

    011*-5 SD+0-- 99LN FTJ EUO

    4?M*H*1N 56*1* (- (,-'88(A(*,5

    *H()*,A* 5? -'@@?15 56*

    1?'5(,* '-* ?8 56* FKE (, 56*

    51*05/*,5 ?8 A01)(0A 011*-5O

    .["Y

    >6* *H()*,A* )?*- ,?5 )*/?,-5105* 0

    L*,*8(5 M(56 56* '-* ?8 FKEQD6* 1*A?//*,)05(?,

    )*8(,*- /0,'0+ A?/@1*--(?,- 0- 56*

    A?,5(,'(,= -50,)01) ?8 A01* 8?1

    )*+(H*1(,= A?/@1*--(?,- )'1(,= D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    40/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    V#; < 0 = *

    !"#$% 5( 67,8-9+,37 :3/;.)73 ")*8- #$?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    K*H(A*- 5? .'@@?15

    D(1A'+05(?,d

    \*A60,(A0+ D6*-5

    D?/@1*--(?, K*H(A*-d

    6*1* (- (,-'88(A(*,5 *H()*,A*

    5? -'@@?15 ?1 1*8'5* 56*

    1?'5(,* '-* ?8 /*A60,(A0+

    @(-5?, )*H(A*- (, 56* 51*05/*,5

    ?8 A01)(0A 011*-5O \*A60,(A0+

    @(-5?, )*H(A*- /02 L*

    A?,-()*1*) 8?1 '-* L2 @1?@*1+2

    510(,*) @*1-?,,*+ (, -@*A(8(A

    -*55(,=- 8?1 56* 51*05/*,5 ?8

    0)'+5 A01)(0A 011*-5 (,

    A(1A'/-50,A*- S*O=ON )'1(,=

    )(0=,?-5(A 0,) (,5*1H*,5(?,0+

    @1?A*)'1*-U 5605 /0R* /0,'0+

    1*-'-A(505(?, )(88(A'+5 SD+0-- 99LN

    FTJ DUO

    >6* *H()*,A* )?*- ,?5 )*/?,-5105* 0

    L*,*8(5 M(56 56* '-* ?8 /*A60,(A0+ @(-5?,

    )*H(A*- 8?1 A6*-5 A?/@1*--(?,- H*1-'-

    /0,'0+ A6*-5 A?/@1*--(?,- (, @05(*,5- M(56

    A01)(0A 011*-5O \0,'0+ A6*-5 A?/@1*--(?,-

    1*/0(, 56* -50,)01) ?8 A01* 8?1 56*

    51*05/*,5 ?8 A01)(0A 011*-5N L'5 /*A60,(A0+

    A6*-5 A?/@1*--(?,- '-(,= 0 @(-5?, )*H(A*

    /02 L* 0 1*0-?,0L+* 0+5*1,05(H* 8?1 '-* L2

    @1?@*1+2 510(,*) @*1-?,,*+ SD+0-- 99LN FTJ EQ

    CUO >6* '-* ?8 @(-5?, )*H(A*- 8?1 D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    41/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    V$; < 0 = *

    !"#$% 5( 67,8-9+,37 :3/;.)73 ")*8- #$?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    \(,(/(i(,=

    9,5*11'@5(?,- (, D6*-5

    D?/@1*--(?,-

    ^*M

    0,)

    G@)05*)

    4(=6Q]'0+(52 D6'-N (5 (- 1*0-?,0L+* 8?1

    6*0+56A01* @1?H()*1- 5?

    @10A5(A* *88(A(*,5 A??1)(,05(?,

    L*5M**, D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    42/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    V"; < 0 = *

    !"#$% 5( 67,8-9+,37 :3/;.)73 ")*8- #$?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    43/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    VY; < 0 = *

    !"#$% 5( 67,8-9+,37 :3/;.)73 ")*8- #$?@(A "#$#B "#$%BB C*0-?, 8?1 D60,=*

    X*,5(+05(?, `(56 0,

    I)H0,A*) I(1M02

    G@)05*) `6*, 56* H(A5(/ 60- 0,

    0)H0,A*) 0(1M02 (, @+0A*

    )'1(,= D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    44/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    VV; < 0 = *

    !"#$% ;)-, 6-/?:1,- @#$AB 6,1:)4-:;

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D?/@?,*,5- ?8 4(=6Q

    l'0+(52 D? /0f(/(i* -(/@+(A(52 (, D6*1* M0- H*12 +(55+* A60,=* (, 56*

    @*)(051(A A?/@1*--(?, )*@56

    1*A?//*,)05(?, 81?/ 56* @1*H(?'-

    1*A?//*,)05(?, (, "#$#O

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    45/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    V%; < 0 = *

    !"#$% ;)-, 6-/?:1,- @#$AB 6,1:)4-:;

    >?@(A >2@* "#$#B "#$%BB C*0-?, 8?1 D60,=*

    D?/@?,*,5- ?8 4(=6Q

    l'0+(52 D6* 0-@62f(0+ ,05'1* ?8 56* /0a?1(52 ?8

    @*)(051(A A01)(0A 011*-5- ,*A*--(505*-

    H*,5(+05(?, 0- @015 ?8 *88*A5(H* D6* (,A+'-(?, ?8 1*-A'* L1*056-

    A0, @?5*,5(0++2 1*H*1-* 56*

    @1?=1*--(?, 0,) 1*-5?1* L1*056(,= 0,)

    A(1A'+05(?,O `6(+* A?/@1*--(?,Q?,+2

    D

  • 7/25/2019 Cambios en Las Guas 2015 ASHI

    46/46

    !"#$% !'()*+(,*- .'//012 3"#$% 4*0+56 7 .08*52 9,-5(5'5*

    "#$ %&'()*+, -+*./

    4.9?- (,5*1@1*505(A,- A8 56* /A-5 -(>,(8(B0,5 1*B*,5 B60,>*- 5A */*1>*,B2 B01* -B(*,B* 0,) (,-51'B5(A, (,B+')*) 1*C(*D

    0,) (,@'5 A8 4.9?- E*)(B0+ F(1*B5A1G H6(*8 I*01,(,> J88(B*1G =1A>10/ K)C(-A12 !1A'@-G 0,) @1A8*--(A,0+ -5088L

    !"# %&'()*+ ,(-&)./-

    !1*>A12 ML H(A55A,*G EFG NKHO=

    !"# 01(&2 3&*-4(45 622()&-

    P*881*2 QL I(,)-*2G =6FG =EG HNJFG ONJ

    7"!# *4' %8,#0 9(-:. 7(' ;-/5-*< 7'=(:/-> ?-/@A

    R(/ F*,,(-A,G MSG E=4G T.SG HJ4SU.G HJ4H Q0,20 I*FA,,*G OEQ

    T10)8A1) KL F2V*,-G OEQU= P0-A, MA2B*

    4AD01) E0(,G SMOEQ=0 HHOEQ= P(++ W6(5*G NA',)*1G .5018(-6 KX'05(B- 9,-5(5'5* Y.K9Z

    PA6, NL E05*'-G OEQY(ZG E.SG MSG SMOEQU= =0/ 9-A/

    WL F0,(*+ MA-*,560+ MSG T. I0V* W6(5*

    Q0,0 .0D[0VG OEQUT H10(> K/0,G E9H=

    E01B2 Q6A\0\*,G I=SG OEQUT T*,]0/(, R01@G EKG =1*-()*,5^JD,*1 A8 !*A1>(0 H=MG IIH

    T10,)A, HA,)A,G TKG MSG OEQUT Y1*5Z P0/*- H+AC*1G EOFG KQHG =QKG HO.

    P*0,,(* 40,-A,G OEQUT W0)* 4(//*1+(BV

    S*0+ .60\0-6AC R(10 KL E(++*1G OEQG HSK Y1*5Z

    !"# ;-/2&::(/4*+ ".*22

    W(++(0/ H+*,)*,*,

    .5*C* T01,*55

    FA,,0 E*)(,0

    M0+@6 .6*,*8*+5W(++(0/ MAD*

    HA1*2 K\1060/

    P*88 E2*1-

    (Hazinski MF, Nolan JP, et al., 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatmen

    Recommendations. Circulation. 2015;132(suppl 1):S2S268.((Singletary EM, Zideman DA, et al., Part 9: first aid: 2015 International Consensus on First Aid Science With Treatment Recommendations. Circulation

    2015;132(suppl 1):S269S311.(((

    Neumar RW, Shuster M, et al., 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular CareCirculation. 2015;132(suppl 2):S315S573.(C

    Singletary EM, Charlton NP, et al., Part 15: first aid: 2015 American Heart Association and American Red Cross Guidelines Update for First Aid. Circulation

    2015;132(suppl 2):S574S589.