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Biomedical subjects

G J Kuhn

Publications and source records attributed to G J Kuhn.

11 recordsLinked to original sources
PubMed2003

Cardiac arrest in private locations: different strategies are needed to improve outcome.

BACKGROUND: A tremendous amount of public resources are focused on improving cardiac arrest (OHCA) survival in public places, yet most OHCAs occur in private residences. METHODS AND RESULTS: A prospective, observational study of patients transported to seven urban and suburban hospitals and the individuals who called 911 at the time of a cardiac arrest (bystander) was performed. Bystanders (N=543) were interviewed via telephone beginning 2 weeks after the incident to obtain data regarding patient and bystander demographics, including cardiopulmonary resuscitation (CPR) training. Of all arrests 80.2% were in homes. Patients who arrested in public places were significantly younger (63.2 vs. 67.2, P<0.02), more often had an initial rhythm of VF (63.0 vs. 37.7%, P<0.001), were seen or heard to have collapsed by a bystander (74.8 vs. 48.1%, P<0.001), received bystander CPR (60.2 vs. 28.6%, P<0.001), and survived to DC (17.5 vs. 5.5%, P<0.001). Patients who arrested at home were older and had an older bystander (55.4 vs. 41.3, P<0.001). The bystander was less likely to be CPR trained (65.0 vs. 47.4%, P<0.001), less likely to be trained within the last 5 years (49.2 vs. 17.9, P<0.001), and less likely to perform CPR if trained (64.2 vs. 30.0%, P<0.001). Collapse to shock intervals for public versus home VF patients were not different. CONCLUSIONS: Many important characteristics of cardiac arrest patients and the bystander differ in public versus private locations. Fundamentally different strategies are needed to improve survival from these events.

Cardiopulmonary Resuscitation↗
PubMed1998

Diagnosis and follow-up of Chlamydia trachomatis infections in the ED.

The purpose of this study was to determine the impact on patient care and the cost effectiveness of testing for chlamydial infection in the emergency department. All patients tested for chlamydial infection in three emergency departments between October 1, 1993 and January 31, 1994 were retrospectively reviewed for charges and adequacy of therapy. In one hospital, the effectiveness of a call-back system to enhance proper therapy of inadequately treated patients was evaluated. Of 2,416 test results, 249 were positive, and 197 of these charts were available for review. All 16 male patients were treated appropriately at the initial visit; 105 of 181 female patients were inadequately treated at the initial visit. The charge to identify each patient inadequately treated was $981.22 ($103,000 for 105). Of the 28 inadequately treated patients receiving a follow-up call, 20 sought treatment. The high cost of testing patients cannot be justified without an adequate surveillance system to enhance proper follow-up treatment.

Abdominal Pain↗
PubMed1997

Faculty development in emergency medicine.

Faculty development is an important, multifaceted topic in academic medicine. In this article, academic emergency physicians discuss aspects of faculty development, including: 1) a department chair's method for developing individual faculty members, 2) the traditional university approach to promotion and tenure, 3) faculty development in a new department, and 4) personal development.

Emergency Medicine↗
PubMed1981

Peripheral vs central circulation times during CPR: a pilot study.

The circulation time during closed chest cardiac compression was studied using Cardio-Green injected in either the right antecubital vein or right subclavian vein during CPR. Arterial blood was obtained from a right femoral arterial catheter at 30-second intervals for five minutes following injection. Six patients, in two groups, comprised the study population. The arterial sample for Cardio-Green after central venous injection revealed a high concentration of the dye at 30 seconds and an emerging second peak at five minutes. After peripheral injection, no peak concentration of the dye was achieved during the five-minute sampling method. Our preliminary study indicates reduced concentrations and significant delay in arrival of injected agents that are introduced at a peripheral intravenous site during closed chest compression.

Blood Circulation Time↗
PubMed1981

Inhibition of methacholine-induced bronchoconstriction with reproterol, a new beta agonist-xanthine derivative.

This study compared the efficacy of single oral doses of a new beta adrenergic agonist-xanthine derivative, reproterol, with placebo by measuring the degree of induced bronchodilation and inhibition of response to methacholine challenge in patients with bronchial asthma. In comparison with placebo, 30 mg reproterol was an effective bronchodilator. Attenuation of the response, but not complete blockage of the methacholine-induced bronchoconstriction, was observed with 30 mg reproterol. Methacholine-induced bronchoconstriction is of use in assessing effect and mechanism of the action of new pharmacologic agents.

Adult↗
PubMed1981

Inhibition of antigen-induced bronchoconstriction with reproterol, a new beta agonist-xanthine derivative.

The purpose of this study was to compare the efficacy of a new bronchodilator, reproterol with standard bronchodilators terbutaline and theophylline in patients with allergic asthma. Efficacy was determined by measuring the initial bronchodilating effect and the inhibition of antigen-induced bronchoconstriction. In a double-blind, randomized, controlled study with single doses of medication, patients were given reproterol (20 mg and 30 mg), anhydrous theophylline (200 mg), terbutaline (5 mg) and placebo prior to challenge with antigen. Prior to administration of antigen both reproterol and terbutaline had measurable bronchodilating effect when compared to placebo. The bronchodilating effect of theophylline was less than placebo. In comparison to placebo both doses of reproterol and terbutaline significantly attenuated the response to antigen challenge whereas the effect of theophylline was negligible.

Adult↗
PubMed1980

A comparison of diluent and methacholine challenge with spirometry and the body plethysmograph.

Bronchial reactivity to inhaled diluent and methacholine was determined for asthmatics using automated spirometry. These data were compared with challenge data from a matched group of asthmatics previously studied plethysmographically. High correlations were obtained between all indices both groups, suggesting that spirometry is adequate for the clinical characterization of the methacholine response.

Adult↗
PubMed1979

Mechanism for the diluent response in asthma.

To investigate the mechanism underlying the airway response to diluent challenge, three adult asthmatic patients who were known to be reactive to inhaled diluent were studied. Airway response as measured by conventional pulmonary function testing was measured under the conditions of time, inhalation of room air, diluent and placebo. Two of the patients responded to time or to room air, suggesting that the response was not due to the phenol-buffered diluent. The third subject reacted primarily to the diluent and not to time, room air or normal saline. Two of the three patients were placebo responders.

Adult↗
PubMedDate not supplied

Career planning and development for emergency medicine faculty.

In this article, we propose a methodology to be used by emergency medicine faculty members who are interested in career planning and faculty development on an individual basis. The basic competencies needed by faculty and methods of setting goals are described. Educational courses, workshops, seminars, and self-study strategies that can be used to provide the basic competencies and meet defined goals are described, including the advantages and disadvantages of each method, the time commitment, and needed resources. The advantage of this methodology is the ability to customize a program to meet individual needs and fit into the constraints of available time and monetary resources.

Career Mobility↗