Cricoid Pressure: Closing the Knowledge-Practice Gap

Background and Review of Literature: Cricoid pressure is a technique of applying digital pressure along the outside of the upper airway to reduce the risk of aspiration of stomach contents during anesthesia induction. Improper placement can cause harm or make endotracheal intubation difficult. No accepted alternative practice exists, but it is performed incorrectly in most attempts. Incorrect placement and amount of force are typical causes of failure to occlude the esophagus and protect the airway There is no standardized training for cricoid pressure. Purpose: This project was developed to determine whether incorporating simulated training, an educational session, and practice applying pressure with force measurement would be able to improve knowledge of and ability to correctly place cricoid pressure. This could determine if such an intervention is a viable option for future standardization of education on the topic. Methods: A quality improvement design was used to test an education/simulation experience using the results of a 12 question pretest-posttest questionnaire and measurement of force placed on an airway manikin during three separate attempts with and without measured force feedback. Implementation Plan/Procedure: A convenience sample of 33 Marian University first-year nurse anesthesia students completed the educational/simulated training experience and practice attempts, and 26 of the students finished the posttest survey to compare against the pretest data. Implications/Conclusion: Average total questionnaire scores improved from 47.9% to 69.1% (p < 0.001) and cricoid pressure deviation from the target range decreased from 4.53 to 1.42 pounds (p < 0.001). There is still some room to improve, but the combined interventions created positive change in both data sets and could be a good starting point for standardizing education to reduce cricoid pressure variability in the clinical practice setting.

Creator

• Brown, Jacob M.

Contributors

• Monteiro, Derrianne
• Pepin, Christina

Language

• English

Keyword

• cricoid pressure
• Sellick(‘s) maneuver
• practice
• education
• training

Date created

• 2023

Resource type

• Research Paper

Rights statement

• http://rightsstatements.org/vocab/InC/1.0/