Key result
Cricoid pressure application varies widely with ~47% of personnel failing to reach target force.
Why the study?
What is the force applied by anaesthetists and paramedical personnel during cricoid pressure, and what is the current status of the manoeuvre?
Cross-Sectional
What is the force applied by anaesthetists and paramedical personnel during cricoid pressure, and what is the current status of the manoeuvre?
There is an unacceptably wide variation in the force applied during cricoid pressure by trained personnel, with many failing to reach target forces and experiencing clinical problems.
May compromise aspiration protection during induction; leaves open whether force-targeted training improves outcomes.
A simple test rig was developed to assess the force applied during the application of cricoid pressure. Anaesthetists and paramedical personnel familiar with Sellick's manoeuvre were tested yielding results which indicate an unacceptably wide variation in performance in each group. The mean force was 46.4 N but 47% failed to reach a force of 44 N. In addition a survey was undertaken of trained anaesthetic staff to identify the current status of the manoeuvre. Of those sampled 78% routinely employed Sellick's manoeuvre and over 70% had experienced a problem with its application which exposed the patient to the risk of regurgitation.
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Howells et al. (1983) conducted a cross-sectional in Application of cricoid pressure. Cricoid pressure application was evaluated on Force applied during cricoid pressure. Application of cricoid pressure by anaesthetists and paramedical personnel showed wide variation, with a mean force of 46.4 N and 47% failing to reach a force of 44 N.
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