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Manufacture of a Multi-Purpose Low-Cost Animal Bench-Model for Teaching Tracheostomy
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Variable application and misapplication of cricoid pressure.

Paul Brisson1, Michael Brisson

  • 1Department of Surgery, DeWitt Army Community Hospital, Fort Belvoir, Virginia, USA. paul.brisson@us.army.mil

The Journal of Trauma
|November 12, 2010
PubMed
Summary
This summary is machine-generated.

The Sellick maneuver, a technique to prevent gastric regurgitation during anesthesia, shows significant variability in application, with ten different methods observed. This highlights potential patient harm due to misapplication of cricoid pressure.

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Area of Science:

  • Anesthesiology
  • Airway Management
  • Patient Safety

Background:

  • The Sellick maneuver, a three-finger technique for cricoid pressure, has been standard practice since 1961 to prevent gastric regurgitation during anesthesia induction.
  • Observed variability in its application suggests potential misapplication by healthcare providers.
  • This study aimed to quantify technique variations and explore reasons for inconsistency.

Purpose of the Study:

  • To determine the number of different cricoid pressure techniques currently in use.
  • To identify factors contributing to the variability in cricoid pressure application.
  • To assess the consistency of cricoid pressure training in national airway management courses.

Main Methods:

  • An observational study involving 32 healthcare providers across five hospitals over 30 months.
  • Recorded the specific technique and professional degree of individuals performing cricoid pressure.
  • Reviewed five national airway management training courses for cricoid pressure instruction.

Main Results:

  • Ten distinct techniques of cricoid pressure were identified among 32 observations.
  • Instances of incorrect pressure application on the thyroid cartilage and sternocleidomastoid muscles were noted.
  • The original three-finger Sellick technique was used infrequently (3/32); national courses lacked specific training.

Conclusions:

  • Significant variability exists in cricoid pressure application, with 10 techniques observed.
  • Misapplication of cricoid pressure poses a risk of patient harm.
  • The authors advocate for the original three-finger Sellick technique due to its effectiveness, ease of teaching, and safety.