open access

Vol 49, No 4 (2017)
Original and clinical articles
Published online: 2017-09-26
Submitted: 2017-07-27
Accepted: 2017-09-16
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Measurement of cricoid pressure force during simulated Sellick’s manoeuvre

Paweł Andruszkiewicz, Mateusz Zawadka, Anna Kosińska, Paulina Walczak-Wieteska, Kalina Majerowicz
DOI: 10.5603/AIT.a2017.0049
·
Pubmed: 28953309
·
Anaesthesiol Intensive Ther 2017;49(4):283-287.

open access

Vol 49, No 4 (2017)
Original and clinical articles
Published online: 2017-09-26
Submitted: 2017-07-27
Accepted: 2017-09-16

Abstract

 BACKGROUND: Cricoid pressure is a standard anaesthetic procedure used to reduce the risk of aspiration of gastric contents during the induction of general anaesthesia. However, for several years its validity has been questioned. There still remains the question of whether we perform it correctly. The aim of the study was an evaluation of the theoretical knowledge of Sellick’s manoeuvre, as well an assessment of practical skill related with it when simulated on a model of the upper airway.

METHODS: The study was performed on a cohort of anaesthetists and anaesthetic nurses working in various hospitals in the Warsaw area. Measurements were taken on an upper airway model placed on an electronic kitchen scale. Participants were asked to perform Sellick’s manoeuvre in the way they do it in their clinical practice. The test was done twice. Both the position and pressures applied on the model were documented. Knowledge concerning current recommendations of cricoid force was noted.

RESULTS:

206 subjects participated in the study. Only 49% (n = 101) properly identified cricoid cartilage during their application of Sellick’s manoeuvre. Application of the correct pressure on the model of the airway was noted in 16.5% (n = 34) during the first attempt and in 20.4% (n = 42) during the second attempt. The median force applied during simulated Sellick’s manoeuvre was 36 N (IQR: 26–55) in the first attempt, and 38 (IQR 25–55) in the second attempt.

CONCLUSIONS: Sellick’s manoeuvre was performed incorrectly in many cases. Half of the participants of our study applied the pressure in the wrong place while the majority of them used an inappropriate amount of force. Thus, the application of cricoid pressure in patients should be preceded with simulation training.

Abstract

 BACKGROUND: Cricoid pressure is a standard anaesthetic procedure used to reduce the risk of aspiration of gastric contents during the induction of general anaesthesia. However, for several years its validity has been questioned. There still remains the question of whether we perform it correctly. The aim of the study was an evaluation of the theoretical knowledge of Sellick’s manoeuvre, as well an assessment of practical skill related with it when simulated on a model of the upper airway.

METHODS: The study was performed on a cohort of anaesthetists and anaesthetic nurses working in various hospitals in the Warsaw area. Measurements were taken on an upper airway model placed on an electronic kitchen scale. Participants were asked to perform Sellick’s manoeuvre in the way they do it in their clinical practice. The test was done twice. Both the position and pressures applied on the model were documented. Knowledge concerning current recommendations of cricoid force was noted.

RESULTS:

206 subjects participated in the study. Only 49% (n = 101) properly identified cricoid cartilage during their application of Sellick’s manoeuvre. Application of the correct pressure on the model of the airway was noted in 16.5% (n = 34) during the first attempt and in 20.4% (n = 42) during the second attempt. The median force applied during simulated Sellick’s manoeuvre was 36 N (IQR: 26–55) in the first attempt, and 38 (IQR 25–55) in the second attempt.

CONCLUSIONS: Sellick’s manoeuvre was performed incorrectly in many cases. Half of the participants of our study applied the pressure in the wrong place while the majority of them used an inappropriate amount of force. Thus, the application of cricoid pressure in patients should be preceded with simulation training.

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Keywords

anaesthesia, endotracheal intubation, Sellick’s manoeuvre, cricoid pressure, aspiration

About this article
Title

Measurement of cricoid pressure force during simulated Sellick’s manoeuvre

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 49, No 4 (2017)

Pages

283-287

Published online

2017-09-26

DOI

10.5603/AIT.a2017.0049

Pubmed

28953309

Bibliographic record

Anaesthesiol Intensive Ther 2017;49(4):283-287.

Keywords

anaesthesia
endotracheal intubation
Sellick’s manoeuvre
cricoid pressure
aspiration

Authors

Paweł Andruszkiewicz
Mateusz Zawadka
Anna Kosińska
Paulina Walczak-Wieteska
Kalina Majerowicz

References (20)
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