James Vaughn Warren

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James Vaughn Warren
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Born(1915-07-01)July 1, 1915
Columbus, Ohio
DiedFebruary 14, 1990(1990-02-14) (aged 74)
NationalityAmerican
Alma materOhio State University
OccupationCardiologist
Spouse(s)Gloria Kicklighter Warren
Parent(s)
  • James Halford
  • Lucile Vaughn Warren

James Vaughn Warren (July 1, 1915 February 14, 1990) was an American cardiologist. He developed a national and international reputation as an investigator in cardiac catheterization and cardiac physiology. He was instrumental in developing the concept of mobile coronary care, and he was a consultant and advisor in America’s aerospace program. Warren served as chairman of the departments of medicine at multiple medical schools and the president of national medical societies. He authored or co-authored 251 scientific or history of medicine papers.[1]

Early life

Warren was born in Columbus, Ohio and the only child of James Halford and Lucile Vaughn Warren. His father was an assistant professor of anatomy, and he later practiced internal medicine in Columbus.[2][1]

Education

Warren graduated from the Ohio State University in 1935 with a degree in chemistry, and he earned his MD from Harvard in 1939. He completed his house staff training at the Brigham Hospital and followed that with a year of research with Dr. Eugene Stead. In 1942, his chief of service, Soma Weiss, died suddenly. Warren’s research mentor, Dr. Stead, was leaving to become chairman of the department of medicine at Emory University. Stead asked Warren to join him in Atlanta.[3][4]

Personal life

Gloria Kicklighter Warren met and married James Warren when she was chief of therapeutic dietetics at Duke Hospital in 1954. She received her B.S. degree in nutrition from the University of Georgia in 1946. She was a dietetic intern at the Medical College of Virginia Hospital and the staff dietitian at the University Hospital in Augusta, Georgia. While at Charity Hospital, New Orleans, she participated in innovative research in sodium metabolism.[5] At Duke, she was a therapeutic dietitian, instructor in diet therapy, and assistant director of the dietetic staff. Gloria and Evelyn Stead authored the book Low-Fat Cookery in 1956.[6]

Career

At Emory University and Grady Memorial Hospital (1942-1946), Warren was involved in war-time research for the Office of Scientific Research and Development. Because of the high volume of trauma at the Grady Memorial emergency room, Drs. Stead and Warren were recruited by Drs. Andre Cournand and Dickinson Richards from New York's Bellevue Hospital to study blood loss and shock. Warren reported the first diagnostic cardiac catheterization in 1945.[6] Warren and Stead were among the first to report Angiogram|angiograms using motion pictures.[7]

In 1946, Warren was recruited to Yale to develop a cardiac catheterization laboratory, but he left after a year to accept a position as chairman of the department of physiology at Emory. He transitioned to Professor of Medicine from 1947 to 1951 and was recruited by Stead in 1952 to be chairman of the department of medicine at the Duke VA hospital. It was during this time he carried out expeditions to Africa and studied the circulations of the giraffe, cow, and ox. His observations of the giraffe resulted in unique contributions to the field of comparative physiology. He also demonstrated the feasibility of well controlled clinical trials with several institutions at a multinational level.[8] In 1958, he was recruited to be chairman of the department of medicine at the University of Texas in Galveston. In 1961, Warren was asked to become chairman of the department of medicine at the Ohio State University. He returned there to direct the department until he retired in 1979, remaining as emeritus professor until 1986.[9] Among his many honors and responsibilities, he served as chairman of the committee established by the NIH for the first comprehensive assessment of the ethical, psychological, and economic implications of human heart transplantation.[10]

Heartmobile

Warren spearheaded the development of a mobile coronary care unit, the Heartmobile. He was able to locate funding for the program from a Federal Highway grant and Regional Medical Planning funds. He identified an industrial design firm to supervise the conversion of a Clark-Cortez camper-van into the mobile coronary care unit. He negotiated with the Fire Department to staff the van with three off-duty EMS personnel and to provide them with advanced training in a course that would become the model for paramedic curriculum.

The Columbus model of the Heartmobile was unique in that, while it provided electrocardiographic telemetry, its "paramedics" did not have to seek permission from base station personnel before initiating therapy or transportation. These "paramedics" were taught to evaluate medical history information and physical findings as well as to interpret electrocardiograms and a variety of common rhythm disturbances. They operated within well-defined "if this-then that" algorithms. To further assure their success and education, they were accompanied by a cardiology fellow or a senior internal medicine resident on all runs for the first two years of the program. After two years, the data indicated that the well-trained medics could, and would, usually perform just as well without on-site close physician supervision. Columbus therefore became the first mobile coronary care system with independent "Paramedics".

Central dispatch at the Columbus Fire Department would send the usual nearby EMS vehicle and personnel, plus the Heartmobile and its three paramedics, on all runs which involved the following medical issues or complaints: chest pain, heart attack, angina, palpitations, shortness of breath, syncope or passing out, drowning, cardiac arrest, man down, and similar paroxysmal medical catastrophes. Eventually the paramedic training and specialized equipment found their way into all Columbus Fire Department EMS vehicles, and the Heartmobile was retired after theoretical and practical feasibility were demonstrated.[11]

References

  1. 1.0 1.1 James V. and Gloria K. Warren Papers, Spec.199802.Warren, Medical Heritage Center, Health Sciences Library, The Ohio State University.
  2. Ohio State University Alumni Association (1912). The Ohio State University Monthly (v. 4 ed.). p. 37.
  3. Weissler, Arnold M. “James V. Warren: A Tribute.” In Profiles in Cardiology, edited by J. Willis Hurst, C. Richard Conti, and W. Bruce Fye. Mahwah, NJ: Foundation for the Advances in Medicine and Science, Inc., 2003.
  4. Wooley, Charles F. Academic Heritage: The Transmission of Excellence. Mount Kisco, NY: Futura Publishing Co, 1992.
  5. Weissler, Arnold M. “James V. Warren: A Tribute.” In Profiles in Cardiology, edited by J. Willis Hurst, C. Richard Conti, and W. Bruce Fye. Mahwah, NJ: Foundation for the Advances in Medicine and Science, Inc., 2003.
  6. 6.0 6.1 Hurst, JW. “History of Cardiac Catheterization.” In Coronary Arteriography and Angioplasty, edited by Spencer B. King and John S. Douglas Jr. New York: McGraw-Hill, 1985.
  7. Wooley, Charles F. Academic Heritage: The Transmission of Excellence. Mount Kisco, NY: Futura Publishing Co, 1992.
  8. Weissler, Arnold M. “James V. Warren: A Tribute.” In Profiles in Cardiology, edited by J. Willis Hurst, C. Richard Conti, and W. Bruce Fye. Mahwah, NJ: Foundation for the Advances in Medicine and Science, Inc., 2003.
  9. Weissler, Arnold M. “James V. Warren: A Tribute.” In Profiles in Cardiology, edited by J. Willis Hurst, C. Richard Conti, and W. Bruce Fye. Mahwah, NJ: Foundation for the Advances in Medicine and Science, Inc., 2003.
  10. Weissler, Arnold M. “James V. Warren: A Tribute.” In Profiles in Cardiology, edited by J. Willis Hurst, C. Richard Conti, and W. Bruce Fye. Mahwah, NJ: Foundation for the Advances in Medicine and Science, Inc., 2003.
  11. Lewis RP, Fulkerson PK, Stang JM, Sampson KL, Dutko HJ. “The Columbus Emergency Medical Service System.” Ohio State Medical Journal 75, no. 6 (June 1979): 391-394.

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