Nafiu Olubukola O, Bradin Stuart, Tremper Kevin K
Department of Anesthesiology, University of Michigan, Ann Arbor, MI 48109-0048, USA.
J Emerg Nurs. 2009 Jan;35(1):11-5. doi: 10.1016/j.jen.2008.01.009. Epub 2008 Jun 30.
Application of cricoid pressure (CP) is an important step during rapid sequence intubation. Previous surveys of anesthesia personnel showed a knowledge deficiency in the recommended level of cricoid force. There has been no previous attempt to assess the adequacy of knowledge of ED personnel in the application of CP. The objective of this study was to assess the theoretic knowledge of ED personnel about CP.
We carried out a convenience sample of all ED personnel present at the morbidity and mortality meeting of a major US teaching hospital. A questionnaire-based survey was distributed; respondents were unaware of the questions or the nature of the survey before participating.
In total, 83 completed questionnaires were returned by 38 residents, 25 attending physicians, and 20 nurses. Many of the respondents knew the anatomic structure to which CP is applied. However, 24 respondents (14 nurses and 10 residents) thought that CP is applied to both the cricoid and thyroid cartilage. Interestingly, 70% of the nurses in this survey gave an incorrect response to the question on the anatomic localization of CP. Many of the participants in this survey either were unsure of the recommended amount of cricoid force in the asleep patient or quoted values that were too low. The majority of respondents rated their training in CP application as either poor or nonexistent. Most were able to name 2 contraindications to the application of CP.
The theoretic knowledge about CP is poor in this survey from staff at a major US teaching hospital. Poor theoretic knowledge could lead to poor technique in the application of CP. More specific education and training are needed to improve the clinical use of CP and possibly increase patient safety.
环状软骨压迫（CP）的应用是快速顺序诱导插管过程中的重要步骤。先前对麻醉人员的调查显示，他们对推荐的环状软骨压迫力度缺乏了解。此前尚无研究尝试评估急诊科（ED）人员在CP应用方面的知识掌握程度。本研究的目的是评估ED人员关于CP的理论知识。
我们对一家美国大型教学医院 morbidity and mortality 会议上的所有ED人员进行了便利抽样。发放了一份基于问卷的调查；参与者在参与之前并不知晓问题或调查性质。
总共回收了83份完整问卷，来自38名住院医师、25名主治医师和20名护士。许多受访者知道CP所应用的解剖结构。然而，24名受访者（14名护士和10名住院医师）认为CP同时应用于环状软骨和甲状软骨。有趣的是，本次调查中70%的护士对CP解剖定位问题给出了错误回答。本次调查中的许多参与者要么不确定对入睡患者推荐的环状软骨压迫力度，要么给出的值过低。大多数受访者将他们在CP应用方面的培训评为较差或没有。大多数人能够说出CP应用的2个禁忌症。
在这家美国大型教学医院的工作人员进行的本次调查中，关于CP的理论知识较差。理论知识不足可能导致CP应用技术不佳。需要更具体的教育和培训来改善CP的临床应用，并可能提高患者安全性。
