Analysis of the application of cricoid pressure: implications for the clinician.

The application of cricoid pressure may reduce the incidence of pulmonary aspiration of gastric contents in at-risk patients. Cricoid pressure may be applied during intubation in a variety of settings including the operating room, postanesthesia care unit, intensive care unit, and emergency department. Significant deficits in cognitive knowledge and practical application skills have been demonstrated among medical personnel responsible for the application of cricoid pressure. It has been suggested that a formalized training program should improve cognitive knowledge and practical application skills of cricoid pressure. The purpose of this nonexperimental, correlational, descriptive study was to evaluate registered nurses' cognitive knowledge and ability to correctly identify and apply cricoid cartilage pressure. No statistically significant correlation was found between gender, hand dominance, frequency of application, or previous training and the ability to identify the correct anatomy, state the correct pressure, or apply the correct pressure. Participants who were unable to correctly identify the cricoid cartilage were less likely to demonstrate cognitive knowledge concerning the correct amount of cricoid pressure (P = .045). However, there was no significance between cognitive knowledge and practical application of the correct pressure (P = .187). The descriptive aspect of the study revealed significant deficiencies in knowledge and application skills. Despite 57.7% of the study participants acknowledging having formalized training within the previous 8 months, the results demonstrated that they were no more likely to identify, correctly state, or apply the proper cricoid pressure when compared with participants who did not attend formalized training. Future studies should focus on determining effective approaches to formalized training programs and the optimal timing of competency-based testing/review for retention of knowledge and skills related to the application of cricoid pressure.