外科学课件心肺复苏（八年制一班）.ppt

The first aider places the HEEL of his hand on this compression site. The other hand is placed atop the first one, with the heels of both hands parallel to one another. The fingers of both hands should be pointing away from the body. The fingers can be extended or interlaced, but the fingers must be kept off the patients chest. The first aiders elbows must be straightened and locked. Elbows should not be bent when delivering or releasing compression. Shoulders should be positioned directly over the hands so that they will deliver all compressions straight down, perpendicular to the chest and the ground, onto the compression site. There should be no swinging back and forth of the first aiders body. Enough force should be applied to the compression site so that the breast bone is depressed 1 1/2 to 2 inches or 3 to 5 centimeters. The sequence on the mannequin demonstrates correct compression amplitude. CPR should only be practiced on a mannequin. The rate of compressions for an adult victim, is approximately 80 per minute. A metronome can be useful when training. After compression, the first aider must fully release the pressure on the victims chest. This allows the heart to refill. The release of pressure should take the same amount of time as the time required for compression (50% compression/ 50% release). Lets see the correct compression rate with the metronome and the voice one and two and three and four and five Blow in and one and two and three and four and five Blow in and so on” pronouncing: one aaand two aaand three aaand Fooor aaand fiiive etc. with a drawl in the voice!! and not One! and two! and three! and four! abruptly After each compression of the chest, the pressure must be fully released. The first aiders hands should remain in contact with the chest. 血管加压素 Vasopressin 又称垂体后叶素或抗利尿激素（ADH） 下丘脑分泌储存于垂体后叶的肽类激素 血浆胶渗压变化或血压、血容量改变刺激压力感受器均能促使ADH释放 血容量减少5 ~ 10％ 血浆胶渗压改变1％ 作用于V1受体通过细胞内Ca2+－第二信使系统引起血管平滑肌收缩 释放 血管加压素 Vasopressin 动物实验（猪）显示ADH在室颤状况下能增加冠状动脉灌注