Efficacy of Surface Landmark Palpation for Identification of the Cricoid Cartilage in Obstetric Patients
Study Details
Study Description
Brief Summary
Rapid Sequence Induction (RSI), with cricoid pressure is advocated for all obstetric patients undergoing general anesthesia. Applying cricoid pressure correctly is crucial to prevent aspiration. Using Ultrasound guidance we will be assessing the ability of different disciplines of caregivers to correctly localize the cricoid cartilage in obstetric patients by anatomical landmark palpation.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
Detailed Description
Obstetric patients coming for elective cesarean delivery will be recruited for the study. Informed consent will be obtained from the patient. The participant (anesthesiologist, resident, nurse, or RT) will mark the center of the cricoid cartilage with the patient in the sniffing position, using fluorescent "invisible" ink. Another anesthesiologist who is expert in using ultrasound will find the proximal and distal margins of the cricoid cartilage an will draw a line at the middle of the 2 margins. Evaluation of the participant's assessment will be considered accurate if it falls within 5 mm from the ultrasound's measured line .The assessor will also be asked to score the ease of cricoid cartilage palpation between 1 to 10 using a visual analog scoring (VAS) scale. Total time taken for palpation will also be measured.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Cricoid Cartilage localization The caregiver will be asked to palpate the cricoid cartilage and draw aline where he will apply cricoid pressure during rapid sequence induction |
Procedure: Cricoid pressure
participants will ask to mark the place where they will apply cricoid pressure if the patients was undergoing rapid sequence induction. US will be used to confirm how accurate they are in their estimation.
Other Names:
Device: Ultrasound
|
Outcome Measures
Primary Outcome Measures
- Distance between measured Cricoid cartilage (by Assessors) and Ultrasound [10 minutes]
- The level of difficulty to locate Cricoid cartilage NRS score [10 minutes]
- Total time required for assessment [10 seconds]
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Patient 18 years and older
-
ASA 1-2•Having singleton pregnancy.
-
Gestational age >37.
-
Elective cesarean section
Exclusion Criteria:
-
Patient refusal.
-
Renal failure.
-
Severe preeclampsia.
-
Non- scheduled caesarean delivery (urgent).
-
Twin pregnancy.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
---|---|---|---|---|---|
1 | London Health Science Centre | London | Ontario | Canada |
Sponsors and Collaborators
- Lawson Health Research Institute
Investigators
- Principal Investigator: Indu Singh, MD, FRCPC, Western University, Schulish school of Medicine, Department of Anesthesia
Study Documents (Full-Text)
None provided.More Information
Publications
- Aslani A, Ng SC, Hurley M, McCarthy KF, McNicholas M, McCaul CL. Accuracy of identification of the cricothyroid membrane in female subjects using palpation: an observational study. Anesth Analg. 2012 May;114(5):987-92. doi: 10.1213/ANE.0b013e31824970ba. Epub 2012 Feb 24.
- Benhamou D, Bouaziz H, Chassard D, Ducloy JC, Fuzier V, Laffon M, Mercier F, Raucoules M, Samii K. Anaesthetic practices for scheduled caesarean delivery: a 2005 French national survey. Eur J Anaesthesiol. 2009 Aug;26(8):694-700. doi: 10.1097/EJA.0b013e328329b071.
- Fenton PM, Reynolds F. Life-saving or ineffective? An observational study of the use of cricoid pressure and maternal outcome in an African setting. Int J Obstet Anesth. 2009 Apr;18(2):106-10. doi: 10.1016/j.ijoa.2008.07.006. Epub 2009 Jan 13.
- Hung O, Scott J, Mullen T, Murphy M. Waiting to exhale! Anesth Analg. 2012 May;114(5):927-8. doi: 10.1213/ANE.0b013e31823a84ef.
- Singh M, Chin KJ, Chan VW, Wong DT, Prasad GA, Yu E. Use of sonography for airway assessment: an observational study. J Ultrasound Med. 2010 Jan;29(1):79-85.
- Zeidan AM, Salem MR, Mazoit JX, Abdullah MA, Ghattas T, Crystal GJ. The effectiveness of cricoid pressure for occluding the esophageal entrance in anesthetized and paralyzed patients: an experimental and observational glidescope study. Anesth Analg. 2014 Mar;118(3):580-6. doi: 10.1213/ANE.0000000000000068.
- 106074