A Survey on Cricoid Pressure Application by Anesthetists.

For 40 years cricoid pressure has been used to prevent regurgitation of gastric contents during induction of anaesthesia. Available studies have highlighted poor techniques regarding cricoid pressure. Patient safety could be challenged by incorrect use of cricoid pressure The aim of this study was to assess the practice and knowledge of cricoid pressure among anesthesiologist attending in the ninth international congress of anesthesia and resuscitation in Iran. This cross sectional observational study included 59 anesthesiologists attending the 9th international Iranian congress of anesthesia and resuscitation in 2006. Each subject was asked to apply cricoid pressure on an undressed laryngeal model for one minute. The model was an anatomically correct representation of the human larynx. It was mounted onto the base plate of a kitchen scale. Participants were blinded to the results. Five measurements were obtained from each candidate(0,15,30,45 and 60th second).Participants was also asked to complete a questionnaire containing demographic data and some questions regarding attitude and knowledge of participants regarding Slick’s maneuver. Eighteen participants(30%) applied the target cricoid force (3-4 kg).When considering both correct anatomical position and right range of applied force only 11 participants(19%) were successful. Mean applied force significantly decreased at the end of one minute and mean applied force by women was significantly less than men. There was no statistically significant diffenece between academic staff and other anesthesiologists in application of target force. Only eight participants(13.6%) were aware of the target cricoid force. Application of cricoid pressure by the participant anesthesiologists is poor.Use of simple models for training during refresher courses for practicing anesthesiologist in addition to stressing on the theoretical base may improve the quality of performance of the Sellick`s maneuver.