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Practice and knowledge of cricoid pressure in southern Sweden

Schmidt, A and Åkeson, Jonas LU (2001) In Acta Anaesthesiologica Scandinavica 45(10). p.1210-1214
Abstract
BACKGROUND: For 40 years cricoid pressure has been used to prevent regurgitation of gastric contents during induction of anaesthesia. Recent studies have emphasised use of more moderate force so as not to deteriorate ventilation or endotracheal intubation. This study was undertaken to assess the current practice and knowledge of cricoid pressure among anaesthesia personnel in southern Sweden. METHODS: Forty-eight subjects at two anaesthetic departments in southern Sweden were asked to apply and maintain cricoid pressure for 60 s with their dominant and non-dominant hands, respectively, in a laryngotracheal model during simulated intravenous induction of anaesthesia. Where and how pressure was applied as well as the force used by each... (More)
BACKGROUND: For 40 years cricoid pressure has been used to prevent regurgitation of gastric contents during induction of anaesthesia. Recent studies have emphasised use of more moderate force so as not to deteriorate ventilation or endotracheal intubation. This study was undertaken to assess the current practice and knowledge of cricoid pressure among anaesthesia personnel in southern Sweden. METHODS: Forty-eight subjects at two anaesthetic departments in southern Sweden were asked to apply and maintain cricoid pressure for 60 s with their dominant and non-dominant hands, respectively, in a laryngotracheal model during simulated intravenous induction of anaesthesia. Where and how pressure was applied as well as the force used by each subject was recorded together with information on individual experience and knowledge of the technique. RESULTS: There were no significant changes in force applied over time, and no significant differences in force between dominant (median 36 N; 25th percentile 26 N; 75th percentile 50 N) and non-dominant (37; 26; 50 N) hand, between female and male subjects or between physicians, nurses and assistant nurses. Force exceeding 60 N was recorded at least once in 21% of subjects. More than two-thirds (69%) had not heard of any recommended level of force to be applied. Forty percent of anaesthesiologists were unaware of any contraindications. CONCLUSION: More specific education and training seems mandatory to improve clinical use of cricoid pressure and possibly increase patient safety. Simulators allowing cricoid pressure to be carried out and evaluated in a standardised manner should therefore be incorporated into future training programmes and airway management courses. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anesthesia, cricoid pressure, educational model, rapid sequence induction, simulation, technique, training
in
Acta Anaesthesiologica Scandinavica
volume
45
issue
10
pages
1210 - 1214
publisher
Wiley-Blackwell
external identifiers
  • pmid:11736671
  • scopus:0035168968
ISSN
0001-5172
DOI
10.1111/j.1399-6576.2001.451006.x
language
English
LU publication?
yes
id
ed5e7543-a01b-4dd4-85c7-b879ea9e0ed6 (old id 1122161)
date added to LUP
2008-07-14 10:45:04
date last changed
2018-01-07 06:11:18
@article{ed5e7543-a01b-4dd4-85c7-b879ea9e0ed6,
  abstract     = {BACKGROUND: For 40 years cricoid pressure has been used to prevent regurgitation of gastric contents during induction of anaesthesia. Recent studies have emphasised use of more moderate force so as not to deteriorate ventilation or endotracheal intubation. This study was undertaken to assess the current practice and knowledge of cricoid pressure among anaesthesia personnel in southern Sweden. METHODS: Forty-eight subjects at two anaesthetic departments in southern Sweden were asked to apply and maintain cricoid pressure for 60 s with their dominant and non-dominant hands, respectively, in a laryngotracheal model during simulated intravenous induction of anaesthesia. Where and how pressure was applied as well as the force used by each subject was recorded together with information on individual experience and knowledge of the technique. RESULTS: There were no significant changes in force applied over time, and no significant differences in force between dominant (median 36 N; 25th percentile 26 N; 75th percentile 50 N) and non-dominant (37; 26; 50 N) hand, between female and male subjects or between physicians, nurses and assistant nurses. Force exceeding 60 N was recorded at least once in 21% of subjects. More than two-thirds (69%) had not heard of any recommended level of force to be applied. Forty percent of anaesthesiologists were unaware of any contraindications. CONCLUSION: More specific education and training seems mandatory to improve clinical use of cricoid pressure and possibly increase patient safety. Simulators allowing cricoid pressure to be carried out and evaluated in a standardised manner should therefore be incorporated into future training programmes and airway management courses.},
  author       = {Schmidt, A and Åkeson, Jonas},
  issn         = {0001-5172},
  keyword      = {Anesthesia,cricoid pressure,educational model,rapid sequence induction,simulation,technique,training},
  language     = {eng},
  number       = {10},
  pages        = {1210--1214},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Anaesthesiologica Scandinavica},
  title        = {Practice and knowledge of cricoid pressure in southern Sweden},
  url          = {http://dx.doi.org/10.1111/j.1399-6576.2001.451006.x},
  volume       = {45},
  year         = {2001},
}