Simulated cricoid pressure learning transfers to clinical practice

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Simulation training with force feedback significantly improved the performance of cricoid pressure in the clinical setting, according to researchers from Australia and Canada.  

Cricoid pressure is recommended during positive pressure ventilation CPR and during anaesthesia when there is a risk of regurgitation. Studies suggest that cricoid pressure is frequently applied incorrectly placing patients at risk of regurgitation.  

Simulation training has been shown to improve the performance of cricoid pressure on a simulator, but whether simulation training improves the clinical performance of cricoid pressure was unknown, according to the study (Resuscitation 2008;80[3]:346-349). 

Kurt J. Domuracki, MD, and colleagues from Flinders University in Australia and McMaster University in Ontario recruited 101 medical students and nursing staff. They were randomized to receive cricoid pressure simulator training with or without force feedback.  

Subjects then applied cricoid pressure to an anaesthetised patient while standing on a force plate. The main outcome measure was the number of subjects who applied a mean force of 20–30 N during their trial. 

Researchers found that significantly more subjects (20/53) in the feedback group applied force in the appropriate range (20–30 N) compared to the control group (9/48). In addition, the feedback group applied significantly higher forces than did the control group.

Researchers suggested that simulation training be used more frequently to train and maintain resuscitation skills.