Quantification and time course of subjective psychotropic and somatic effects of tetrahydrocannabinol - a prospective, single-blind, placebo-controlled exploratory trial in healthy volunteers.

Background: Cannabis is increasingly used and debates about the legalisation of the recreational use of cannabis are ongoing. In this prospective, placebo-controlled study in healthy volunteers not regularly consuming cannabis, subjective psychotropic and somatic effects after a single dose of intravenous THC were assessed and quantified over 48 h.

Methods: Twenty-five healthy volunteers received a single IV bolus of THC and 6 received normal saline.

Critical airway-related incidents and near misses in anaesthesia: a qualitative study of a critical incident reporting system.

Background: Many serious adverse events in anaesthesia are retrospectively rated as preventable. Anonymous reporting of near misses to a critical incident reporting system (CIRS) can identify structural weaknesses and improve quality, but incidents are often underreported.

Methods: This prospective qualitative study aimed to identify conceptions of a CIRS and reasons for underreporting at a single Swiss centre.

Carbon dioxide and cardiac output as major contributors to cerebral oxygenation during apnoeic oxygenation.

Apnoeic oxygenation has experienced a resurgence in interest in critical care and perioperative medicine. However, its effect on cerebral oxygenation and factors influencing it, have not yet been investigated in detail. By using near-infrared spectroscopy, we intended to provide further evidence for the safety of apnoeic oxygenation and to increase our understanding of the association between cerebral perfusion, haemodynamic, respiratory and demographic factors.

Propofol sedation in routine endoscopy: A case series comparing target controlled infusion manually controlled bolus concept.

Background: Many studies have addressed safety and effectiveness of non-anaesthesiologist propofol sedation (NAPS) for gastrointestinal (GI) endoscopy Target controlled infusion (TCI) is claimed to provide an optimal sedation regimen by avoiding under- or oversedation.

Aim: To assess safety and performance of propofol TCI sedation in comparison with nurse-administered bolus-sedation.

Methods: Fouty-five patients undergoing endoscopy under TCI propofol sedation were prospectively included from November 2016 to May 2017 and compared to 87 patients retrospectively included that underwent endoscopy with NAPS.

Limitations of transcutaneous carbon dioxide monitoring in apneic oxygenation.

Background: High-flow nasal oxygenation is increasingly used during sedation procedures and general anesthesia in apneic patients. Transcutaneous CO2 (ptcCO2)-monitoring is used to monitor hypercapnia. This study investigated ptcCO2-monitoring during apneic oxygenation.

Stress of emergency physicians during helicopter operations: impact of patients' diagnoses, severity of diagnoses, and physicians' work experience.

Purpose: Emergency physicians are in danger of developing illnesses due to stress in their demanding work environment. Until today, scholars have not identified stressors or resilience factors that qualify to promote the preservation of emergency physicians' well-being. Therefore, potential influencing variables such as patients' diagnoses, the severity of diagnoses, as well as physicians' work experience have to be considered.

Team leadership assessment after advanced life support courses comparing real teams vs. simulated teams.

Aim: Effective team leadership is essential during cardiopulmonary resuscitation (CPR) and is taught during international advanced life support (ALS) courses. This study compared the judgement of team leadership during summative assessments after those courses using different validated assessment tools while comparing two different summative assessment methods.

Methods: After ALS courses, twenty videos of simulated team assessments and 20 videos of real team assessments were evaluated and compared.

Risk patterns of consecutive adverse events in airway management: a Bayesian network analysis.

Background: Minor adverse airway events play a pivotal role in the safety of airway management. Changes in airway management strategies can reduce such events, but the broader impact on airway management remains unclear.

Methods: Minor, frequently occurring adverse airway events were audited before and after implementation of changes to airway management strategies.

Direct versus video laryngoscopy with standard blades for neonatal and infant tracheal intubation with supplemental oxygen: a multicentre, non-inferiority, randomised controlled trial.

Background: Tracheal intubation in neonates and infants is a potentially life-saving procedure. Video laryngoscopy has been found to improve first-attempt tracheal intubation success and reduce complications compared with direct laryngoscopy in children younger than 12 months. Supplemental periprocedural oxygen might increase the likelihood of successful first-attempt intubation because of an increase in safe apnoea time.

Changes in lung volume estimated by electrical impedance tomography during apnea and high-flow nasal oxygenation: A single-center randomized controlled trial.

Background: Previous studies concerning humidified, heated high-flow nasal oxygen delivered in spontaneously breathing patients postulated an increase in functional residual capacity as one of its physiological effects. It is unclear wheter this is also true for patients under general anesthesia.

Methodology: The sincle-center noninferiority trial was registered at ClinicalTrials.

Assessment of Human Factors After Advanced Life Support Courses Comparing Simulated Team and Real Team Assessment: A Randomized Controlled Cohort Trial.

Aim: Human factors are essential for high-quality resuscitation team collaboration and are, therefore, taught in international advanced life support courses, but their assessment differs widely. In Europe, the summative life support course assessment tests mainly adhere to guidelines but few human factors. This randomized controlled simulation trial investigated instructors' and course participants' perceptions of human factors assessment after two different summative assessments.

Airway management in a Helicopter Emergency Medical Service (HEMS): a retrospective observational study of 365 out-of-hospital intubations.

Background: Airway management is a key skill in any helicopter emergency medical service (HEMS). Intubation is successful less often than in the hospital, and alternative forms of airway management are more often needed.

Methods: Retrospective observational cohort study in an anaesthesiologist-staffed HEMS in Switzerland.

Dexmedetomidine versus propofol for operator-directed nurse-administered procedural sedation during catheter ablation of atrial fibrillation: A randomized controlled study.

Background: Operator-directed nurse-administered (ODNA) sedation with propofol (PRO) is the preferred sedation technique for catheter ablation of atrial fibrillation (AF) in many centers.

Objective: The purpose of this study was to investigate whether dexmedetomidine (DEX), an α-adrenergic receptor agonist, is superior to propofol.

Methods: We randomized 160 consecutive patients undergoing first AF ablation to ODNA sedation by DEX (DEX group) vs PRO (PRO group), according to a standardized protocol.

Evaluation of atelectasis using electrical impedance tomography during procedural deep sedation for MRI in small children: A prospective observational trial.

Study Objective: To investigate the variation of poorly ventilated lung units (i.e., silent spaces) in children undergoing procedural sedation in a day-hospital setting, until discharge home from the Post-Anesthesia Care Unit (PACU).

Carbon Dioxide Changes during High-flow Nasal Oxygenation in Apneic Patients: A Single-center Randomized Controlled Noninferiority Trial.

Background: Anesthesia studies using high-flow, humidified, heated oxygen delivered via nasal cannulas at flow rates of more than 50 l · min-1 postulated a ventilatory effect because carbon dioxide increased at lower levels as reported earlier. This study investigated the increase of arterial partial pressure of carbon dioxide between different flow rates of 100% oxygen in elective anesthetized and paralyzed surgical adults before intubation.

Methods: After preoxygenation and standardized anesthesia induction with nondepolarizing neuromuscular blockade, all patients received 100% oxygen (via high-flow nasal oxygenation system or circuit of the anesthesia machine), and continuous jaw thrust/laryngoscopy was applied throughout the 15-min period.

Optimisation of airway management strategies: a prospective before-and-after study on events related to airway management.

Background: Poor medical outcomes often result from series of minor events. The present study assessed events related to airway management to determine whether targeted changes to departmental strategies for airway management can reduce the incidence.

Methods: This prospective before-and-after study was performed with ethics committee approval and written informed consent from patients.

Survival and long-term outcomes following in-hospital cardiac arrest in a Swiss university hospital: a prospective observational study.

Background: Incidence of in-hospital cardiac arrest is reported to be 0.8 to 4.6 per 1,000 patient admissions.

The effective group size for teaching cardiopulmonary resuscitation skills - A randomized controlled simulation trial.

Aim Of The Study: The ideal group size for effective teaching of cardiopulmonary resuscitation is currently under debate. The upper limit is reached when instructors are unable to correct participants' errors during skills practice. This simulation study aimed to define this limit during cardiopulmonary resuscitation teaching.

Simulation-based medical education for Ambulance Jet and Helicopter Emergency Medical Services: A program description and evaluation.

This article was migrated. The article was marked as recommended. In aviation, crew resource management trainings are established methods to enhance safety, a method that also gained popularity in medicine.

Analysis of tracheal intubation in out-of-hospital helicopter emergency medicine recorded by video laryngoscopy.

Background: Tracheal intubation remains the gold standard of airway management in emergency medicine and maximizing safety, intubation success, and especially first-pass intubation success (FPS) in these situations is imperative.

Methods: We conducted a prospective observational study on all 12 helicopter emergency medical service (HEMS) bases of the Swiss Air Rescue, between February 15, 2018, and February 14, 2019. All 428 patients on whom out-of-hospital advanced airway management was performed by the HEMS crew were included.

Nasal nalbuphine analgesia in prehospital trauma managed by first-responder personnel on ski slopes in Switzerland: an observational cohort study.

Background: Pain is one of the major symptoms complained about by patients in the prehospital setting, especially in the case of trauma. When there is mountainous topography, as in Switzerland, there may be a time delay between injury and arrival of professional rescuers, in particular on ski slopes. Administration of a safe opioid by first responders may improve overall treatment.

Prospective observational study evaluating the C-MAC Video Stylet for awake tracheal intubation: a single-center study.

Background: The gold standard for management of known or predicted difficult airways is awake tracheal intubation. The newly developed C-MAC Video Stylet promises to combine the advantages of rigid stylets and flexible optical scopes. We therefore evaluated the feasibility of awake orotracheal intubations with this device.

Hormonal and Subjectively Perceived Stress of the Emergency Physicians of the Airborne Rescue Service.

Due to their work activities, emergency physicians are regularly exposed to exceptional mental and physical situations. In order to prevent stress-related illnesses, the triggers of hormonal and subjectively perceived stress must be understood better. On a sample of emergency physicians from two air rescue services (N = 80), the cortisol awakening response (CAR) was determined on flight rescue days, clinic days, and days off.

Cricothyroidotomy competence and injuries using nonmedical equipment: A crossover noninferiority randomised controlled trial in a porcine cadaver model.

Background: International guidelines recommend cricothyroidotomy as a life-saving procedure for 'cannot intubate, cannot ventilate' situations. Although commercially available sets facilitate surgical cricothyroidotomy, regular training seems to be the key to success.

Objectives: The goal was to investigate if trained anaesthetists are able to transfer their skill in one surgical cricothyroidotomy technique to another.