Learning to apply effective cricoid pressure using a part task trainer

Summary An anatomically‐correct model of a larynx inside a head and neck model was constructed so that the location, direction and amount of force applied to the neck could be measured. Fifty trained staff from three general hospitals were then asked to apply cricoid pressure on the model. None was able to state the force that should be applied (30 N), and only five (10%) actually applied cricoid pressure effectively. After training using the model, 45 (90%) applied cricoid pressure correctly (p < 0.001). This study demonstrates that improved training in cricoid pressure is needed and supports earlier researchers who suggested that this can be achieved using simulators.

[1]  B. Sellick.  Cricoid pressure to control regurgitation of stomach contents during induction of anaesthesia. , 1961, Lancet.

[2]  M. Salem,et al.  The Historical Background of Cricoid Pressure in Anesthesia and Resuscitation , 1974, Anesthesia and analgesia.

[3]  Elam Jo,et al.  The historical background of cricoid pressure in anesthesia and resuscitation. , 1974 .

[4]  R. Bannister.  CHRONIC AUTONOMIC FAILURE WITH POSTURAL HYPOTENSION , 1979, The Lancet.

[5]  The application of cricoid pressure. An assessment and a survey of its practice. , 1983 .

[6]  T. Howells,et al.  The application of cricoid pressure. An assessment and a survey of its practice. , 1983, Anaesthesia.

[7]  R. Simons,et al.  The application of cricoid pressure , 1983 .

[8]  M. Morgan.  The confidential enquiry into maternal deaths , 1986, Anaesthesia.

[9]  L. Gemmel,et al.  The cricoid yoke--a device for providing consistent and reproducible cricoid pressure. , 1986, British journal of anaesthesia.

[10]  R. Vanner.  Tolerance of cricoid pressure by conscious volunteers. , 1992, International journal of obstetric anesthesia.

[11]  G. Shorten.  Airway obstruction from cricoid pressure. , 1993, Anesthesia and analgesia.

[12]  D. Benhamou.  French obstetric anaesthetists and acid aspiration prophylaxis. , 1993, European journal of anaesthesiology.

[13]  N Ashurst,et al.  Use of a mechanical simulator for training in applying cricoid pressure. , 1996, British journal of anaesthesia.

[14]  S. Fletcher,et al.  Fracture of the cricoid cartilage after Sellick's manoeuvre. , 1996, British journal of anaesthesia.

[15]  N. Herman,et al.  Cricoid Pressure: Teaching the Recommended Level , 1996, Anesthesia and analgesia.

[16]  T. Cook,et al.  Cricoid pressure: are two hands better than one? , 1996, Anaesthesia.

[17]  R. Vanner,et al.  The effect of cricoid pressure and neck support on the view at laryngoscopy , 1997, Anaesthesia.

[18]  T. Meek,et al.  Cricoid pressure: knowledge and performance amongst anaesthetic assistants , 1999, Anaesthesia.

[19]  T. Short,et al.  Aspiration during anaesthesia: a review of 133 cases from the Australian Anaesthetic Incident Monitoring Study (AIMS) , 1999, Anaesthesia.

[20]  R. Griffiths,et al.  Safe use of cricoid pressure , 1999, Anaesthesia.

[21]  E. Hart,et al.  The 50-millilitre syringe as an inexpensive training aid in the application of cricoid pressure. , 2000, European journal of anaesthesiology.

[22]  C A Koziol,et al.  Assessing the force generated with application of cricoid pressure. , 2000, AORN journal.

[23]  J. Palmer,et al.  Towards a pain‐free venepuncture , 2000, Anaesthesia.

[24]  T. Cook,et al.  Cricoid pressure: which hand? , 2000, Anaesthesia.

[25]  A. Schmidt,et al.  Practice and knowledge of cricoid pressure in southern Sweden , 2001, Acta anaesthesiologica Scandinavica.

[26]  T. Cook,et al.  Rapid sequence induction: a national survey of practice , 2001, Anaesthesia.

[27]  T. Clayton,et al.  A novel method of measuring cricoid force. , 2002, Anaesthesia.