Search PubMed⌕ Search

Biomedical subjects

J V Warren

Publications and source records attributed to J V Warren.

At least 37 records · Page 2Linked to original sources
PubMed1984

The role of paramedics in resuscitation of patients with prehospital cardiac arrest from coronary artery disease.

Columbus, Ohio added prehospital coronary care to its Emergency Medical Services System (EMS) in 1969. The EMS System, which is citizen activated and tax supported (+5 per citizen per year), currently sees 32,000 patients a year in a city with a population of 650,000. Ninety-six per cent of the population is aware of the system. Over two thirds of patients with ischemic sudden death or myocardial infarction are seen by advanced life support paramedic (EMT-P) units. The EMT-Ps operate by protocol without telemetry and carry all standard resuscitative drugs and devices. Serial evaluations have shown that within the limits of the protocol, the EMT-Ps perform as effectively as physicians in diagnosis and care of acute cardiovascular emergencies, including endotracheal intubation. One third of ischemic cardiac arrest patients in whom resuscitation is possible (60% of such patients seen) are discharged from the hospital alive (14.2/100,000 lives saved per year). Lives are also saved by treatment of other life-threatening prehospital complications. In Columbus, the estimated annual mortality from ischemic heart disease is only 19%. The EMS System contributes significantly to this low figure.

Allied Health Personnel↗
PubMed1982

John Gorrie.

Explore the source record for details and available documents.

Air Conditioning↗
PubMed1979

Effectiveness of advanced paramedics in a mobile coronary care system.

The mobilized coronary care system in Columbus, Ohio, began with operation of a single vehicle with a physician in attendance. Currently, advanced emergency medical technician-paramedics work without direct physician supervision. When both experiences are compared, the results indicate that advanced emergency medical technician-paramedics working independently perform as well as physician counterparts.

Allied Health Personnel↗
PubMed1977

Malnutrition in surgical patients. An unrecognised problem.

Indices of nutritional state were measured in 105 surgical patients. The indices were chosen to give information on protein-calorie malnutrition, anaemia, vitamin deficiency. Abnormal values for the various indices were common in the group as a whole and most frequent (50%) in patients who were still in hospital more than a week after major surgery. These patients had a high frequency of anaemia, vitamin deficiency, weight-loss, loss of arm-muscle bulk, and low plasma levels of transferrin and albumin. These abnormalities had gone almost entirely unrecognised, even in patients with sepsis after major surgery, who would benefit from improvement in nutritional state.

Adolescent↗
PubMed1977

Pleomorphic B cell neoplasm with monoclonal IgA secretion: a case report.

A case of non-myelomatous malignant disease with IgA paraproteinemia is described. A pleomorphic lymphoid/plasmacytoid infiltrate was found in the bone marrow. While the cells studied had some ultrastructural characteristics closer to myelomatosis than Waldenström's macroglobulinemia, immunofluorescence showed IgA in both the cytoplasm and at the cell surface, as seen with IgM in macroglobulinemia but not with IgA in typical IgA myelomatosis. This case illustrates that IgA paraproteinemia may be produced in association with pleomorphic B cell proliferative diseases as well as myelomatosis. There is probably a spectrum of disease states as with IgM paraproteinemia.

Adult↗
PubMed1977

T cells and protein nutrition in hospitalized surgical patients.

Percentage and number of T cells in peripheral blood and severe indices of protein nutrition were assessed in a random sample of 51 hospitalized surgical patients. Whole blood counts of the patients' lymphocytes and E rosette tests (after separation of lymphocytes from whole blood on Ficoll-Metrizoate) showed no difference from a control group of well-nourished people attending hospital for minor complaints. In general there was no consistent relationship between the level of protein nutrition and low T cell numbers, except for 5 malnourished patients tested less than 1 week after major surgery. Although a group of 11 patients who fulfilled the criteria for 'malnutrition' had normal T cell numbers, the percentage of T cells was significantly higher and the number of total lymphocytes was significantly lower than in the controls.

Adolescent↗
PubMed1976

Beneficial effects of atropine in the pre-hospital phase of coronary care.

The current widespread interest in early (pre-hospital) coronary care has raised questions regarding the safety and efficacy of the use of atropine in these circumstances. Although reports from early coronary care systems have been favorable, serious questions of safety have been raised on the basis of experimental animal studies and isolated case reports. A sample of the experience of a large scale emergency coronary care system in Columbus, Ohio has therefore been reviewed. A group of 70 patients who, during the early phases of myocardial infarction, exhibited bradyarrhythmia (less than 60 beats/min) was identified. When this group was further categorized on the basis of arterial pressure at the time of initial observation, patients with normal or elevated blood pressure had low mortality rates whether treated with atropine or not. In patients with hypotension the mortality rate was 75 percent without therapy, and 25 percent with therapy. Indeed, when normal hemodynamics were restored, the mortality rate was only 11 percent. Unexpected ventricular fibrillation occurred in 1 of 45 treated patients and 2 of 25 untreated patients. Although the study was not controlled, the data strongly suggest that atropine is both beneficial and safe for use in treating bradyarrhythmia and hypotension in the early phase of acute myocardial infarction.

Aged↗