Efficacy of Surface Landmark Palpation for Identification of the Cricoid Cartilage in Obstetric Patients

Completed

• Conditions: Aspiration Pneumonia
• Interventions: Procedure: Cricoid pressure; Device: Ultrasound

• Registration Number: NCT02416219
• Lead Sponsor: Lawson Health Research Institute

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.

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.

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study First Submitted: 2015-04-07
• Study First Submitted QC: 2015-04-13
• Study First Posted: 2015-04-14
• Study Start: 2015-05
• Primary Completion: 2016-02
• Status Verified: 2016-03
• Study Completion: 2016-03
• Last Update Submitted: 2016-03-02
• Last Update Posted: 2016-03-03

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 90

Inclusion Criteria

• Patient 18 years and older
• ASA 1-2•Having singleton pregnancy.
• Gestational age >37.
• Elective cesarean section

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Exclusion Criteria

• Patient refusal.
• Renal failure.
• Severe preeclampsia.
• Non- scheduled caesarean delivery (urgent).
• Twin pregnancy.

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Cricoid Cartilage localization	Cricoid pressure	The caregiver will be asked to palpate the cricoid cartilage and draw aline where he will apply cricoid pressure during rapid sequence induction
Cricoid Cartilage localization	Ultrasound	The caregiver will be asked to palpate the cricoid cartilage and draw aline where he will apply cricoid pressure during rapid sequence induction

Primary Outcome Measures

Name	Time	Method
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

Trial Locations

Locations (1)

London Health Science Centre; 🇨🇦 London, Ontario, Canada