Pressure applied by the healthcare staff on a cricoid cartilage simulator during Sellick's maneuver in rapid sequence intubation

Abstract

Background: Sellick's maneuver or cricoid pressure is a strategy used to prevent bronchoaspiration during the rapid intubation sequence. Several studies have described that the force required for an adequate maneuver is of 2.5-3.5 kg. The purpose of this paper was to determine the force applied (in kilograms) on a cricoid cartilage simulator by the healthcare professionals.

Methodology: Observational cross-section trial. The participants were the healthcare professionals at the San José University Hospital in Popayán and participants at the National Congress of Anesthesiology - S.C.A.R.E. 2011, who were conveniently selected. Every participant made three attempts to apply the maneuver on the simulator.

Results: Data from 156 participants were collected. The mean global pressures applied in the first, second and third attempts were 2.70, 2.71 and 2.73kg, respectively. Following a multivariate adjustment, males exhibited a higher force at the first attempt to do the maneuver. No association was found to other variables, such as labor experience or the training level.

Conclusions: The pressure applied by the participants in the trial during the first attempt was 2.7 kg. Most of the subjects in the trial did Sellick's maneuver applying an inadequate pressure in their first attempt. Only males exerted an overpressure in their first attempt to do the maneuver.