PubMed Health⌕ Search

Biomedical subjects

G Prause

Publications and source records attributed to G Prause.

29 records · Page 2Linked to original sources
PubMed1996

[Preclinical blood gas analysis. Technical description--initial experiences--indications].

OBJECTIVE: A new portable device for blood gas analyses (BGA) has been examined for prehospital application. METHODS: After a 1 h introduction to the procedure, two physicians used the blood gas analyzer in the emergency medical system in Graz, Austria, for 7 months. The indications for prehospital BGA were prolonged cardiopulmonary resuscitation, mechanical ventilation, hyperventilation for reducing increased intracranial pressure, respiratory failure and metabolic disorders. All patients tested were also checked with pulse oximetry and capnography. TECHNICAL SPECIFICATION: The device measures pO2, pCO2 and pH using the fluorescence method. The innovation of a single-use cassette system makes it unnecessary to do any calibrations or transport any test substances. The storage battery measures eight samples without recharge. The time spent on one measurement is 3-6 min. RESULTS: We took 49 samples from 24 patients and found 16 indications for therapeutical intervention, such as buffering metabolic acidosis and adjusting mechanical ventilation by means of BGA. In all cases the analyzer worked reliably. CONCLUSIONS: One advantage of BGA over the non-invasive methods pulse oximetry and capnography is that it does not interfere with factors like peripheral vasoconstriction or inequality of the pulmonary ventilation/ perfusion ratio. Moreover, it is the only method for controlled buffering of acid-base disturbances. This means more security in diagnostics and therapeutical interventions for the patient in danger of dying. The device has proved to be a useful addition to the monitoring methods for prehospital application.

Acid-Base Equilibrium↗
PubMed1995

[Education of the medical student in first aid, emergency and disaster medicine--the Graz model].

In Austria emergency and disaster medicine is a young interdisciplinary subject. It is only a borderline discipline encompassing different medical subjects and was subdivided into emergency medicine for medical doctors only and first-aid for lay people and emergency technicians. In fact, since emergency medicine without first-aid can't be successful, the Department of Anaesthesiology at the University of Graz let all students of the medical faculty have a comprehensive education in the treatment of injured of acutely ill patients. According to the three steps of the study lectures and practices, all parts of first-aid, emergency and disaster medicine were offered. In spite of the short time since this has been running, we found a good acceptance and we hope to increase the interest evinced by medical students in our training programme.

Austria↗
PubMed1994

[15 years of preoperative ambulatory care in Graz].

In 1977 a new anaesthesiology preoperative evaluation clinic was started for evaluation of all elective surgical patients for their fitness to undergo anaesthesia. Physical examination, medical history and anaesthetic risk assessment are assessed in a standardized manner with the aid of computer menus. Comprehensive laboratory tests included electrocardiography, lung function assessment (vital capacity and forced exspiratory volume within 1 s), chest X-ray, and arterial blood gas analysis and blood chemistry analysis with an SMA-22 (System Multi Analyzer). At the conclusion of the preoperative evaluation, patients are classified according to ASA physical status, Goldman Cardiac Risk Index and an exercise classification such as NYHA. Only elective surgical patients are evaluated in this clinic. Within the last 15 years more than 75,000 patients have been seen in our preoperative clinic, 91.8% of whom were cleared for surgery and anaesthesia after the initial evaluation. There were 1132 patients who needed preoperative treatment first. Only 4.4% were discharged without operation because too many risk factors for perioperative complications were present. We found that comprehensive preoperative evaluation in this clinic was more efficient than bedside evaluation and reduced examination time for the patient. In 1983 and 1985 we published two prospective/retrospective studies on the improvement of perioperative morbidity and mortality of selected patients undergoing non-cardiac surgery. We found that perioperative complications and adverse outcome correlated with preoperative data and physical examination. The main source of perioperative morbidity and mortality was the cardiovascular system, followed by nephrologic diseases, correlating exactly with preoperative BUN and plasma creatinine. These studies also underlined the value of the ASA physical status to predict perioperative outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Care↗
PubMed1994

[Propofol in emergency care--areas of application and initial experiences].

So far propofol has only been used in clinical settings for sedation and induction of anaesthesia. This study describes several indications in preclinical and emergency events. All users were anaesthetists, so that experience of administration and dosage was extremely helpful. Since the drug met the expected criteria it is now regularly used for the sedation of ventilated patients during transport. The most important indications for preclinical induction of anesthesia with propofol are patients with isolated head injury and patients with respiratory insufficiency due to status asthmaticus resistant to therapy. After repeated unsuccessful attempts at therapeutic intervention with benzodiazepines and other antiepileptics we were able to interrupt status epilepticus in 11 patients by means of propofol, thereby preventing the patient from being intubated as a consequence of iatrogenic respiratory failure. However, emergency doctors must always be aware of the severe cardiocirculatory side effects of the drug, and must, hence, ensure that hypovolaemia or cardiac failure is excluded or corrected prior to propofol administration.

Adult↗
PubMed1991

The importance of early detection and therapy of reexpansion pulmonary edema.

Three cases are reported of unilateral pulmonary edema, two following rapid reexpansion after prolonged tension pneumothorax, with total collapse of the right lung and one after reexpanded atelectasis following left intrabronchial obstruction. In all cases decrease of blood pressure and tachycardia not responding to intravenous fluid substitution were already present within the first 15 min after chest drainage or after removal of the intrabronchial obstruction. The preexistent dyspnea failed to improve. A cloudy opacity of the reexpanded lung was found immediately after drainage in 2 cases. After immediate application of a continuous positive airway pressure mask no more extensive therapy was necessary in one patient. The two others in whom treatment was begun with more than 1 hour delay required artificial ventilation and adrenergics for 2 and 4 days, respectively.

Adult↗
PubMed1991

[Emergency systems in Styria].

Since 1980 the emergency systems of Graz consisting of two emergency ambulances, two large space emergency ambulances and an emergency helicopter with a range of more than 50 km has been sufficient. The two helicopters cover nearly 100% of the Federal State of Styria but regarding the ground emergency systems there are still insufficiently covered areas in many parts of our state. The ground emergency systems can only be supported but they cannot be replaced by the helicopter. We hope to have an emergency ambulance at every peripheral hospital in the future. Now an efficient emergency system exists in Graz since the first public lecture on first aid and reanimation has been held 175 years ago. The missing link of a well functioning rescue chain is a well trained lay assistant whose level of training regarding "Life Saving Emergency Measures" constantly has to be refreshed. Only with a sufficient number of trained lay assistants it is possible to save all those who have a real chance of successful reanimation.

Aircraft↗
PubMed1990

[The preoperative outpatient clinic--possible use of a personal computer].

Since 1977, the Department of Anesthesiology of the University of Graz has had a preoperative clinic. Since August 1988 we have processed current data using a personal computer (PC). We have adapted an IBM-compatible PC and a commercial data-processing program (dBase III plus) for the special requirements of the preoperative clinic. The procedure is directed by menus and is also easy to learn for non-professionals. Important functions have been executed automatically by the current program, such as loading the software or securing the data on a floppy disk. No additional work is necessary for data input. Every test result can be supplied immediately by a printer, whereby important parameters are denoted as such. After 13 months of testing, we could see that the use of a PC offers an inexpensive possibility for processing medical data with the help of electronics. The installation was not destined to remain a short trial, but will become a permanent system at our clinic.

Anesthesiology↗
PubMed1989

Incidence of sporadic infections due to enterotoxigenic Escherichia coli (ETEC) in the population of Hamburg, north Germany.

In two studies (1982 and 1985/86), the presence of enterotoxigenic E. coli (ETEC) and other enteropathogenic bacteria was investigated in 779 stool specimens from children and adults with and without diarrhoeal disease. ETEC was isolated from 2% of diseased children and 1.6% of adult patients, but also from 0.5% of asymptomatic persons. Mixed infections with two different ETEC strains or with other enteropathogenic bacteria were identified in 4 of 9 infected persons. The ETEC strains belonged to 10 different serovars, eight of which produced only heat-stable enterotoxin. One infection had been contracted in a tropical country. After Salmonella and Campylobacter, ETEC was more frequently isolated than Yersinia and Shigella; the difference of ETEC infections in diseased and asymptomatic persons was, however, not statistically significant (p greater than 0.05). Analysis of the isolated serovars suggests that most ETEC strains implicated in sporadic cases of diarrhoea in Hamburg are unrelated to those which are widely spread in the developing world.

Adolescent↗